Jura-Szołtys Edyta, Gawlik Radosław, Branicka Olga, Stryjewska-Makuch Grażyna, Glück Joanna
Clinical Department of Internal Diseases, Allergology and Clinical Immunology, Medical University of Silesia, Katowice, Poland.
Department of Laryngology and Laryngological Oncology, Upper Silesian Medical Centre, Independent Public Research Hospital No. 7 of Silesian Medical University, Katowice, Poland.
Postepy Dermatol Alergol. 2022 Dec;39(6):1110-1115. doi: 10.5114/ada.2022.117978. Epub 2022 Jul 10.
Allergen immunotherapy (AIT) is the only disease-modifying treatment option available for patients with IgE-mediated allergic rhinitis. The identification of specific biomarkers, which may predict response to AIT, is currently an active field of research in the aspect of recommended personalization of medicine.
To assess the changes in rhinological parameters in intermittent allergic rhinitis (IAR) patients resulting from subcutaneous immunotherapy (SCIT).
Forty-two patients (female: 19; 45%) with IAR qualified for subcutaneous immunotherapy were enrolled in this study. Fourteen (33.3%) patients were desensitized with grass pollen allergen extracts, 12 (28.6%) with tree pollen allergen extracts, and 16 (38.1%) with grass and tree pollen allergen extracts. The patients were evaluated before AIT during the pollen season and in the next pollen season after introduction of subcutaneous immunotherapy. On both occasions, determination of total nasal symptom score (TNSS), rhinomanometry and nasal cytology were performed.
All examined parameters significantly improved after one course of allergen immunotherapy: the percentage of eosinophils in nasal mucosa, TNSS and nasal resistance decreased, whereas the nasal flow rate increased. The decrease in percentage of nasal eosinophils significantly correlated with improvement in TNSS ( = 0.39, < 0.05) and was the highest in the subgroup sensitive to grass pollen (44.5 (40-52)).
The rhinological assessment confirmed high effectiveness of SCIT in intermittent allergic rhinitis. A high percentage of eosinophils in nasal cytology before subcutaneous immunotherapy can predict its clinical efficacy for intermittent allergic rhinitis, especially in grass pollen allergy.
变应原免疫疗法（AIT）是唯一可用于IgE介导的变应性鼻炎患者的疾病改善治疗选择。识别可能预测AIT反应的特定生物标志物，目前是医学推荐个性化方面的一个活跃研究领域。
评估皮下免疫疗法（SCIT）对间歇性变应性鼻炎（IAR）患者鼻科参数的影响。
本研究纳入了42例符合皮下免疫疗法条件的IAR患者（女性19例，占45%）。14例（33.3%）患者用草花粉变应原提取物脱敏，12例（28.6%）用树花粉变应原提取物脱敏，16例（38.1%）用草和树花粉变应原提取物脱敏。在花粉季节AIT前以及引入皮下免疫疗法后的下一个花粉季节对患者进行评估。在这两个时间点，均进行总鼻症状评分（TNSS）、鼻阻力测量和鼻细胞学检查。
经过一个疗程的变应原免疫疗法后，所有检测参数均有显著改善：鼻黏膜嗜酸性粒细胞百分比、TNSS和鼻阻力降低，而鼻流速增加。鼻嗜酸性粒细胞百分比的降低与TNSS的改善显著相关（=0.39，<0.05），且在对草花粉敏感的亚组中降幅最大（44.5（40 - 52））。
鼻科评估证实了SCIT对间歇性变应性鼻炎的高效性。皮下免疫疗法前鼻细胞学检查中高百分比的嗜酸性粒细胞可预测其对间歇性变应性鼻炎的临床疗效，尤其是在草花粉过敏方面。
