Bulbul Lida, Toprak Ali, Nursoy Mustafa A
Department of Pediatric Allergy and Immunology, University of Health Science, Bagcilar Education and Research Hospital, Istanbul, Turkey.
Department of Biostatistics, Bezmialem Vakif University, Faculty of Medicine, Istanbul, Turkey.
Asia Pac Allergy. 2025 Sep;15(3):176-185. doi: 10.5415/apallergy.0000000000000202. Epub 2025 Mar 31.
We aimed to investigate clinical and laboratory parameters that can predict clinical response in patients who completed subcutaneous immunotherapy (SCIT) against house dust mites (HDM) and to determine parameters associated with systemic adverse effects (SAE).
In total, 108 patients who had complete medical data were evaluated.
Around 54.6% of patients were male; mean age was 11.7 ± 3.1 years. All patients had allergic rhinitis, 86% had asthma, and 22% had atopic dermatitis. After SCIT, mean symptom score (SS) for allergic rhinitis had decreased in 86% of patients, asthma severity had decreased in 35.5% of asthma patients. After SCIT, median eosinophil count and HDM skin prick test (SPT) diameters decreased, there was not statistically significant change in total IgE ( = 0.001, 0.001, and 0.824, respectively). No statistically significant difference was detected between the SS change groups (decreased, same, or increased) in terms of age, gender, disease duration, presence and severity of asthma, presence of atopic dermatitis, duration of SCIT, time after SCIT, initial sensitization status, total IgE, eosinophil and basophil counts, and SPT diameter for HDM. However, in the group with decreasing SS, total IgE change (in direction of decrease) was found to be statistically significantly higher ( = 0.008). SAEs were observed in 15.7% of patients, 0.41% of injections. SAEs were more common in girls ( = 0.023). Initial eosinophil count, basophil count, and dermatophagoides farina SPT diameter were statistically significantly higher in group with SAE ( = 0.007, 0.008, and 0.036, respectively).
HDM-specific SCIT is a treatment that provides reduction in allergic rhinitis symptoms and asthma severity in children. However, we could not identify any clinical or laboratory findings that could predict clinical success before treatment. Girls and patients with high eosinophil and basophil counts should be monitored more carefully for the development of SAE.
我们旨在研究能够预测完成针对屋尘螨（HDM）的皮下免疫疗法（SCIT）的患者临床反应的临床和实验室参数，并确定与全身不良反应（SAE）相关的参数。
总共评估了108例拥有完整医疗数据的患者。
约54.6%的患者为男性；平均年龄为11.7±3.1岁。所有患者均患有过敏性鼻炎，86%患有哮喘，22%患有特应性皮炎。SCIT后，86%的患者过敏性鼻炎的平均症状评分（SS）下降，35.5%的哮喘患者哮喘严重程度下降。SCIT后，嗜酸性粒细胞计数中位数和HDM皮肤点刺试验（SPT）直径减小，总IgE无统计学显著变化（分别为=0.001、0.001和0.824）。在SS变化组（下降、不变或增加）之间，在年龄、性别、病程、哮喘的存在和严重程度、特应性皮炎的存在、SCIT持续时间、SCIT后时间、初始致敏状态、总IgE、嗜酸性粒细胞和嗜碱性粒细胞计数以及HDM的SPT直径方面未检测到统计学显著差异。然而，在SS下降的组中，发现总IgE变化（呈下降趋势）在统计学上显著更高（=0.008）。15.7%的患者、0.41%的注射出现了SAEs。SAEs在女孩中更常见（=0.023）。SAE组的初始嗜酸性粒细胞计数、嗜碱性粒细胞计数和粉尘螨SPT直径在统计学上显著更高（分别为=0.007、0.008和0.036）。
HDM特异性SCIT是一种可减轻儿童过敏性鼻炎症状和哮喘严重程度的治疗方法。然而，我们在治疗前未能识别出任何能够预测临床成功的临床或实验室发现。对于SAE的发生，女孩以及嗜酸性粒细胞和嗜碱性粒细胞计数高的患者应更仔细地监测。
