Elazab Sahar Z, Hessam Waheed F, Gomaa Amal H
Department of Microbiology & Medical Immunology, Faculty of Medicine, Suez Canal University, Ismailia, Egypt.
Department of Dermatology & Venereology, Faculty of Medicine, Suez Canal University, Ismailia, Egypt.
Egypt J Immunol. 2018 Jun;25(2):97-106.
Atopic dermatitis (AD) is a chronic IgE-mediated skin disorder. Clinical usefulness of allergen-specific immunotherapy in the treatment of AD is still controversial. We assessed the effect of cluster allergen-specific subcutaneous immunotherapy (SCIT) in patients with AD sensitive to house dust mite. The study included 43 patients (32 with mild to moderate AD and 11 with severe AD). Disease severity was assessed by SCORAD index. Patients were treated by cluster SCIT for 8 weeks. SCORAD index, total IgE serum level and blood eosinophilic count (BEC) were assessed at the baseline visit and after the end of immunotherapy. Thirty-one patients (72.1%) responded to SCIT. Responders showed significant decrease in SCORAD index (P < 0.001) and BEC (P < 0.05) compared to non-responders. SCORAD index, total IgE and BEC were significantly decreased in responded patients after SCIT compared to the baseline. The reduction in SCORAD index was 49%. Patients with mild to moderate AD showed no difference in the serum IgE level after SCIT compared to the baseline, but a significant difference was reported in the SCORAD index and BEC. Patients with severe AD showed significant difference in SCORAD index, total IgE, and BEC between baseline and post-SCIT values. Patients with mild to moderate AD showed more reduction in SCORAD index than patients with severe AD (53.8% vs. 43.6%). No adverse reactions were reported during immunotherapy. We concluded that cluster allergen-specific immunotherapy is an effective and well-tolerated therapeutic modality for both mild to moderate and severe AD.
特应性皮炎（AD）是一种慢性IgE介导的皮肤疾病。变应原特异性免疫疗法在AD治疗中的临床实用性仍存在争议。我们评估了群组变应原特异性皮下免疫疗法（SCIT）对尘螨敏感的AD患者的疗效。该研究纳入了43例患者（32例轻度至中度AD患者和11例重度AD患者）。通过SCORAD指数评估疾病严重程度。患者接受群组SCIT治疗8周。在基线访视时以及免疫疗法结束后评估SCORAD指数、总IgE血清水平和血液嗜酸性粒细胞计数（BEC）。31例患者（72.1%）对SCIT有反应。与无反应者相比，有反应者的SCORAD指数（P < 0.001）和BEC（P < 0.05）显著降低。与基线相比，有反应的患者在SCIT后SCORAD指数、总IgE和BEC显著降低。SCORAD指数降低了49%。轻度至中度AD患者在SCIT后的血清IgE水平与基线相比无差异，但在SCORAD指数和BEC方面有显著差异。重度AD患者在基线和SCIT后的值之间，SCORAD指数、总IgE和BEC有显著差异。轻度至中度AD患者的SCORAD指数降低幅度大于重度AD患者（53.8%对43.6%）。免疫疗法期间未报告不良反应。我们得出结论，群组变应原特异性免疫疗法是一种对轻度至中度和重度AD均有效且耐受性良好的治疗方式。
