Donovan J P, Buckeridge D L, Briscoe M P, Clark R H, Day J H
Division of Allergy and Immunology, Kingston General Hospital, Ontario, Canada.
Ann Allergy Asthma Immunol. 1996 Jul;77(1):74-80. doi: 10.1016/S1081-1206(10)63483-7.
Immunotherapy is a recognized component in the management of allergic rhinitis. Its efficacy has been evaluated in a number of clinical field trials. These methods of evaluation are limited by control of antigen exposure.
A study was designed to evaluate the efficacy of immunotherapy in ragweed-induced rhinoconjunctivitis using an environmental exposure unit.
Forty-three subjects were grouped into (1) immunotherapy group: ragweed-allergic subjects on maintenance ragweed immunotherapy for at least 2 years (N = 16), (2) positive control group: ragweed-allergic subjects who had never received immunotherapy (n = 16), and (3) negative control group: ragweed-nonallergic subjects (N = 11). Ragweed specific skin tests and ragweed IgE levels were obtained prior to exposure. The study was done in a room where levels of 2,500 to 3,000 grains m3 of ragweed were maintained over three hours. Symptoms were recorded every 15 minutes.
Nasal symptoms in the immunotherapy group were significantly less than in the positive control group after 45 minutes (P = .025). Significant differences were not observed for ocular symptoms. Combined nasal and ocular scores were 50% less in the immunotherapy group than in the positive control group by 75 minutes (P = .039). Ragweed-specific skin tests and IgE were significantly less in the immunotherapy group than in the positive control group. Rhinoconjunctivitis symptoms in the negative control group were absent throughout.
Controlled ragweed pollen exposure in this setting demonstrated that ragweed immunotherapy significantly reduced symptoms of ragweed-allergic rhinitis but had no significant effect on ocular symptoms. This system presents opportunities for additional studies on immunotherapy for allergic respiratory conditions.
免疫疗法是变应性鼻炎治疗中公认的组成部分。其疗效已在多项临床现场试验中得到评估。这些评估方法受到抗原暴露控制的限制。
设计一项研究，使用环境暴露装置评估免疫疗法对豚草引起的鼻结膜炎的疗效。
43名受试者分为三组：（1）免疫治疗组：接受豚草免疫维持治疗至少2年的豚草过敏受试者（N = 16）；（2）阳性对照组：从未接受过免疫治疗的豚草过敏受试者（n = 16）；（3）阴性对照组：非豚草过敏受试者（N = 11）。在暴露前进行豚草特异性皮肤试验和豚草IgE水平检测。研究在一个房间内进行，该房间在三小时内保持豚草水平为每立方米2500至3000粒。每15分钟记录一次症状。
45分钟后，免疫治疗组的鼻部症状明显少于阳性对照组（P = 0.025）。眼部症状未观察到显著差异。到75分钟时，免疫治疗组的鼻眼综合评分比阳性对照组低50%（P = 0.039）。免疫治疗组的豚草特异性皮肤试验和IgE明显低于阳性对照组。阴性对照组在整个过程中均无鼻结膜炎症状。
在这种环境下进行的豚草花粉暴露控制表明，豚草免疫疗法显著减轻了豚草变应性鼻炎的症状，但对眼部症状无显著影响。该系统为变应性呼吸道疾病免疫疗法的进一步研究提供了机会。
