Justicia José L, Padró Clara, Roger Albert, Moreno Francisco, Rial Manuel J, Parra Antonio, Valero Antonio, Malet Alfons, Teniente Aina, Boronat Anna, Torán-Barona Carla
Allergy Therapeutics Ibérica, Sant Joan Despí, Barcelona, Spain.
Allergy Department, Germans Trias i Pujol Hospital, Badalona, Spain.
World Allergy Organ J. 2021 Jun 6;14(6):100545. doi: 10.1016/j.waojou.2021.100545. eCollection 2021 Jun.
Despite the effectiveness of allergen immunotherapy (AIT), some patients are unresponsive for reasons still unknown; yet validated response biomarkers remain unavailable.
To analyze immunological parameters as biomarkers to monitor and predict clinical response to a MicroCrystalline Tyrosine-adjuvanted house dust mite (HDM) AIT in patients with allergic rhinitis (AR).
Observational, prospective, multicenter study including adult patients (aged 18-65 years) with AR, with and without asthma, sensitized to the HDM (DP) and prescribed Acarovac Plus® DP 100% in the routine practice. Serum concentrations of total IgE, specific IgE, specific IgG4, IL-4, IL-5, IL-10, IL-13, and IFN-γ were compared between baseline and 12 months after AIT. The relationship between patients' baseline immunological profiles and classification as low, high, and non-responders and between their sensitization profile to DP allergens and effectiveness were analyzed.
Of 141 patients recruited, 118 (mean [SD] age of 33.6 [9.5] years) were evaluable. One year after treatment, Der p 1-specific IgE, DP-specific IgG4, and IL-10 increased by a mean (SD) of 3.4 (13.6) kU/L ( = 0.016), 0.43 (0.55) mg/L ( < 0.0001), and 1.35 (7.56) pg/mL ( = 0.033), respectively. Non-responders showed increased baseline levels of IL-13 compared to high responders ( = 0.037). Changes in effectiveness variables between baseline and after AIT were similar regardless of the sensitization profile.
Non-responsive patients to AIT showed increased baseline IL-13 concentrations, suggesting its value as prognostic biomarker. DP-specific AIT increased Der p 1-specific IgE, DP-specific IgG4, and IL-10 concentrations in patients with AR. All patients benefited from treatment regardless of their sensitization profile to major DP allergens.
尽管变应原免疫疗法（AIT）有效，但一些患者仍无反应，原因尚不清楚；然而，尚未有经过验证的反应生物标志物。
分析免疫参数作为生物标志物，以监测和预测过敏性鼻炎（AR）患者对微晶酪氨酸佐剂屋尘螨（HDM）AIT的临床反应。
一项观察性、前瞻性、多中心研究，纳入年龄在18 - 65岁之间、患有或不患有哮喘、对HDM（DP）致敏且在常规治疗中使用Acarovac Plus® DP 100%的成年AR患者。比较AIT基线和12个月后血清中总IgE、特异性IgE、特异性IgG4、IL - 4、IL - 5、IL - 10、IL - 13和IFN - γ的浓度。分析患者基线免疫谱与低、高反应者及无反应者分类之间的关系，以及他们对DP变应原的致敏谱与疗效之间的关系。
在招募的141例患者中，118例（平均[标准差]年龄为33.6 [9.5]岁）可进行评估。治疗一年后，Der p 1特异性IgE、DP特异性IgG4和IL - 10平均（标准差）分别增加了3.4（13.6）kU/L（P = 0.01
