Tu Y Y, Yuan G M, Shi F P, Zhou X M, Liu S Y, Yu J Z, Wan Y Z, Shi L
Department of Rhinology, Department of Allergy, Shandong Provincial ENT Hospital, Shandong University, Jinan 250021, China.
Department of Otorhinolaryngology, the Second Hospital, Cheeloo College of Medicine, Shandong University, Jinan 250033, China.
Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2023 Oct 7;58(10):992-997. doi: 10.3760/cma.j.cn115330-20230329-00139.
To evaluate the efficacy of 1-year subcutaneous immunotherapy (SCIT) with dust mites in polysensitized allergic rhinitis (AR) patients and to analyze the serological markers associated with clinical response. A retrospective analysis of data from 69 polysensitized AR patients who completed 1-year SCIT with dust mites from Oct 2020 to Mar 2022 in Shandong Provincial ENT Hospital was conducted. The median patient age was 21 years, including 41 males and 28 females. The changes in symptoms and serum IgE, IgG4 assessed before and after treatment were evaluated. The differences in serological markers between effective and ineffective groups were analyzed. Multivariate regression analysis was used to investigate the predictors of clinical response. SPSS 22.0 software was used for data processing. After immunotherapy, there was a significant reduction in symptom scores and a substantial improvement in the quality of life of polysensitized AR patients (all <0.001). Dust mite specific IgG4 (sIgG4) significantly increased and dust mite specific IgE (sIgE)/sIgG4 significantly decreased (all <0.05). sIgE, total IgE (tIgE), sIgE/tIgE and sIgE/sIgG4 were significantly lower in ineffective group than those in effective group (all <0.05). The clinical response of SCIT related only to dust mite sIgE (=0.29, =0.036), and sIgE≥53.86 kU/L had the best sensitivity (77.78%) and specificity (57.89%) to predict effective SCIT in polysensitized AR patients. One-year dust mite SCIT is effective for polysensitized AR patients. Pre-treatment serum dust mite sIgE≥53.86 kU/L may play a role in predicting clinical response of dust mite SCIT in polysensitized AR patients.
评估尘螨皮下免疫疗法(SCIT)对多致敏性过敏性鼻炎(AR)患者的疗效,并分析与临床反应相关的血清学标志物。对2020年10月至2022年3月在山东省耳鼻喉医院完成1年尘螨SCIT治疗的69例多致敏性AR患者的数据进行回顾性分析。患者中位年龄为21岁,其中男性41例,女性28例。评估治疗前后症状及血清IgE、IgG4的变化。分析有效组和无效组血清学标志物的差异。采用多因素回归分析研究临床反应的预测因素。使用SPSS 22.0软件进行数据处理。免疫治疗后,多致敏性AR患者的症状评分显著降低,生活质量显著改善(均P<0.001)。尘螨特异性IgG4(sIgG4)显著升高,尘螨特异性IgE(sIgE)/sIgG4显著降低(均P<0.05)。无效组的sIgE、总IgE(tIgE)、sIgE/tIgE和sIgE/sIgG4均显著低于有效组(均P<0.05)。SCIT的临床反应仅与尘螨sIgE相关(r=0.29,P=0.036),sIgE≥53.86 kU/L对预测多致敏性AR患者尘螨SCIT疗效具有最佳的敏感性(7
7.78%)和特异性(57.8
9%)。1年尘螨SCIT对多致敏性AR患者有效。治疗前血清尘螨sIgE≥53.86 kU/L可能对预测多致敏性AR患者尘螨SCIT的临床反应有一定作用。