Clinico-immunologic Study on Immunotherapy with Mixed and Single Insect Allergens

Overview

Journal J Clin Immunol

Publisher Springer

Specialty Allergy & Immunology

Date 2009 Jun 18

PMID 19533313

Citations 1

Authors

Deepsikha Srivastava

Bhanu P Singh

Naveen Arora

Shailendra Nath Gaur

Affiliations

Soon will be listed here.

Abstract

Background: Immunotherapy (IT) is practiced mainly with mixed and single allergen vaccines. But studies are rare with mixed allergen preparations.

Objective: The objective of this study is to study mix and single insect allergen IT in patients of allergic rhinitis and asthma.

Methods: We performed a double-blind placebo-controlled trial of mix and single allergen IT for 1 year in 99 patients of asthma or rhinitis or both. There were two groups, (1) active allergen IT (n = 61) with three subgroups single insect extract (cockroach, housefly, or mosquito) and mix allergen IT (two or three insect extracts) and (2) placebo (n = 38). Clinical (skin reactivity, airway reactivity, and symptom score) and immunological (IgE/IgG4 and IgG1/IgG4 ratio) parameters were assessed at baseline and after 1 year of IT.

Results: Eighty-five patients completed 1 year of IT. The active allergen IT group patients showed a significant improvement compared to baseline values (p < 0.05) and placebo group patients (p < 0.05) with regard to symptom scores, FEV1 values, and immunological parameters (IgG4). No significant difference was found between mixed and single IT group patients for changes in clinical and immunological parameters. Positive correlation was observed between increase in IgG4 and clinical improvement. The changes in above parameters in placebo group were nonsignificant after 1 year of treatment.

Conclusion: IT with two to three mix extract from the same allergen group is effective for insect hypersensitivity.

Citing Articles

Guidelines for diagnosis and management of bronchial asthma: Joint ICS/NCCP (I) recommendations.

Agarwal R, Dhooria S, Aggarwal A, Maturu V, Sehgal I, Muthu V Lung India. 2015; 32(Suppl 1):S3-S42.

PMID: 25948889 PMC: 4405919. DOI: 10.4103/0970-2113.154517.

References

Gore J, Schal C . Cockroach allergen biology and mitigation in the indoor environment. Annu Rev Entomol. 2006; 52:439-63. DOI: 10.1146/annurev.ento.52.110405.091313. View

Lu F, Chou C, Chiang B, Hsieh K . Immunologic changes during immunotherapy in asthmatic children: increased IL-13 and allergen-specific IgG4 antibody levels. Ann Allergy Asthma Immunol. 1998; 80(5):419-23. DOI: 10.1016/s1081-1206(10)62995-x. View

Johnstone D, Crump L . Value of hyposensitization therapy for perennial bronchial asthma in children. Pediatrics. 1961; 27:39-44. View

Hoff M, Krail M, Kastner M, Haustein D, Vieths S . Fusarium culmorum causes strong degradation of pollen allergens in extract mixtures. J Allergy Clin Immunol. 2002; 109(1):96-101. DOI: 10.1067/mai.2002.120560. View

Adkinson Jr N, Eggleston P, Eney D, GOLDSTEIN E, Schuberth K, Bacon J . A controlled trial of immunotherapy for asthma in allergic children. N Engl J Med. 1997; 336(5):324-31. DOI: 10.1056/NEJM199701303360502. View

Sudha V, Srivastava D, Arora N, Gaur S, Singh B . Stability of protease-rich periplaneta Americana allergen extract during storage: formulating preservatives to enhance shelf life. J Clin Immunol. 2007; 27(3):294-301. DOI: 10.1007/s10875-007-9078-y. View

Kausar M, Vijayan V, Bansal S, Menon B, Vermani M, Agarwal M . Mosquitoes as sources of inhalant allergens: clinicoimmunologic and biochemical studies. J Allergy Clin Immunol. 2007; 120(5):1219-21. DOI: 10.1016/j.jaci.2007.07.017. View

Jackola D, Blumenthal M, Rosenberg A . Altered allergen binding capacities of Amb a 1-specific IgE and IgG4 from ragweed-sensitive patients receiving immunotherapy. Ann Allergy Asthma Immunol. 2000; 84(2):241-3. DOI: 10.1016/S1081-1206(10)62761-5. View

Crapo R, Casaburi R, Coates A, Enright P, Hankinson J, Irvin C . Guidelines for methacholine and exercise challenge testing-1999. This official statement of the American Thoracic Society was adopted by the ATS Board of Directors, July 1999. Am J Respir Crit Care Med. 2000; 161(1):309-29. DOI: 10.1164/ajrccm.161.1.ats11-99. View

10.

LOWELL F, Franklin W . A double-blind study of the effectiveness and specificity of injection therapy in ragweed hay fever. N Engl J Med. 1965; 273(13):675-9. DOI: 10.1056/NEJM196509232731302. View

11.

Jutel M, Akdis M, Blaser K, Akdis C . Mechanisms of allergen specific immunotherapy--T-cell tolerance and more. Allergy. 2006; 61(7):796-807. DOI: 10.1111/j.1398-9995.2006.01175.x. View

12.

Meier E, Whisman B, Rathkopf M . Effect of imported fire ant extract on the degradation of mountain cedar pollen allergen. Ann Allergy Asthma Immunol. 2006; 96(1):30-2. DOI: 10.1016/S1081-1206(10)61036-8. View

13.

Hogan M, Patterson R . Heterogeneity of histamine releasing factors and IgE. Allergy Proc. 1993; 14(5):351-5. DOI: 10.2500/108854193778773958. View

14.

Baldo B, Panzani R . Detection of IgE antibodies to a wide range of insect species in subjects with suspected inhalant allergies to insects. Int Arch Allergy Appl Immunol. 1988; 85(3):278-87. DOI: 10.1159/000234518. View

15.

Franklin W, LOWELL F . Comparison of two dosages of ragweed extract in the treatment of pollenosis. JAMA. 1967; 201(12):915-7. View

16.

Kordash T, Amend M, Williamson S, Jones J, Plunkett G . Effect of mixing allergenic extracts containing Helminthosporium, D. farinae, and cockroach with perennial ryegrass. Ann Allergy. 1993; 71(3):240-6. View

17.

Maestrelli P, Zanolla L, Pozzan M, Fabbri L . Effect of specific immunotherapy added to pharmacologic treatment and allergen avoidance in asthmatic patients allergic to house dust mite. J Allergy Clin Immunol. 2004; 113(4):643-9. DOI: 10.1016/j.jaci.2003.12.586. View

18.

Smith T, Hogan M, Welch J, Corder W, Wilson N . Modern prevalence of insect sensitization in rural asthma and allergic rhinitis patients. Allergy Asthma Proc. 2006; 26(5):356-60. View

19.

Bousquet J, Lockey R, Malling H . Allergen immunotherapy: therapeutic vaccines for allergic diseases. A WHO position paper. J Allergy Clin Immunol. 1998; 102(4 Pt 1):558-62. DOI: 10.1016/s0091-6749(98)70271-4. View

20.

Sudha V, Arora N, Sridhara S, Gaur S, Singh B . Biopotency and identification of allergenic proteins in Periplaneta americana extract for clinical applications. Biologicals. 2006; 35(2):131-7. DOI: 10.1016/j.biologicals.2006.07.004. View