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Moises A Calderon - One of the best experts on this subject based on the ideXlab platform.
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basophil expression of diamine oxidase a novel biomarker of allergen immunotherapy response
The Journal of Allergy and Clinical Immunology, 2015Co-Authors: Moises A Calderon, Mohamed H Shamji, Janice A Layhadi, Guy W Scadding, Delica K M Cheung, Laurence A Turka, Deborah PhippardAbstract:Background Immunotherapy inhibits basophil histamine release, but the assay is cumbersome, and no one has studied the effects of immunotherapy withdrawal. Objective Intracellular fluorochrome-labeled diamine oxidase (DAO) was used as a novel functional readout of basophil histamine release after immunotherapy. Results were compared with conventional basophil surface expression of activation markers. Methods Subcutaneous immunotherapy (SCIT)–treated patients (n = 14), sublingual immunotherapy (Slit)–treated patients (n = 12), participants who completed 3 years of treatment with grass pollen sublingual immunotherapy (the Slit-TOL group; n = 6), patients with untreated seasonal allergic rhinitis (SAR; n = 24), and nonatopic control subjects (n = 12) were studied. Intracellularly labeled DAO + and surface expression of CD203c bright , CD63 + , and CD107a + on chemoattractant receptor-homologous molecule expressed on T H 2 lymphocytes (CRTh2)–positive basophils were measured by means of flow cytometry. Serum IgG 4 levels and serum inhibitory activity for IgE-allergen complex binding to B cells (IgE-FAB) and basophil histamine release were also determined. Results Proportions of allergen-stimulated DAO + CRTh2 + basophils were higher in participants in the SCIT, Slit, and Slit-TOL groups (all P + basophils expressing surface CD203c bright (all P P P P P Conclusion These results support long-term clinical and immunologic tolerance during and after grass pollen immunotherapy. Intracellularly labeled DAO expression by basophils merits further investigation as a surrogate biomarker for monitoring efficacy and tolerance after immunotherapy.
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basophil expression of diamine oxidase a novel biomarker of allergen immunotherapy response
The Journal of Allergy and Clinical Immunology, 2015Co-Authors: Moises A Calderon, Mohamed H Shamji, Janice A Layhadi, Guy W Scadding, Delica K M Cheung, Laurence A Turka, Deborah PhippardAbstract:BACKGROUND: Immunotherapy inhibits basophil histamine release, but the assay is cumbersome, and no one has studied the effects of immunotherapy withdrawal. OBJECTIVE: Intracellular fluorochrome-labeled diamine oxidase (DAO) was used as a novel functional readout of basophil histamine release after immunotherapy. Results were compared with conventional basophil surface expression of activation markers. METHODS: Subcutaneous immunotherapy (SCIT)-treated patients (n = 14), sublingual immunotherapy (Slit)-treated patients (n = 12), participants who completed 3 years of treatment with grass pollen sublingual immunotherapy (the Slit-TOL group; n = 6), patients with untreated seasonal allergic rhinitis (SAR; n = 24), and nonatopic control subjects (n = 12) were studied. Intracellularly labeled DAO(+) and surface expression of CD203c(bright), CD63(+), and CD107a(+) on chemoattractant receptor-homologous molecule expressed on TH2 lymphocytes (CRTh2)-positive basophils were measured by means of flow cytometry. Serum IgG4 levels and serum inhibitory activity for IgE-allergen complex binding to B cells (IgE-FAB) and basophil histamine release were also determined. RESULTS: Proportions of allergen-stimulated DAO(+)CRTh2(+) basophils were higher in participants in the SCIT, Slit, and Slit-TOL groups (all P < .0001) compared with those in patients in the SAR group. Similarly, there were lower proportions of CRTh2(+) basophils expressing surface CD203c(bright) (all P < .001), CD63 (all P < .001), and CD107a (all P < .01). Rhinitis symptoms were lower in the SCIT, Slit, and Slit-TOL groups (P < .001) compared with those in the SAR group. Serum inhibitory activity for IgE-FAB and basophil histamine release were also significantly greater in all immunotherapy groups (P < .05) compared with the SAR group. CONCLUSION: These results support long-term clinical and immunologic tolerance during and after grass pollen immunotherapy. Intracellularly labeled DAO expression by basophils merits further investigation as a surrogate biomarker for monitoring efficacy and tolerance after immunotherapy.
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network meta analysis shows commercialized subcutaneous and sublingual grass products have comparable efficacy
The Journal of Allergy and Clinical Immunology: In Practice, 2015Co-Authors: Harold S. Nelson, Shannon Cartier, Felicia C Allenramey, Simon Lawton, Moises A CalderonAbstract:Background Subcutaneous immunotherapy (SCIT) and sublingual immunotherapy (Slit) have been shown to effectively treat grass pollen allergies, although direct comparisons are sparse. Objective To estimate the relative efficacy of Slit tablets compared with SCIT and Slit drops in commercially available products though network meta-analysis. Methods A literature search of MEDLINE, Embase, and Cochrane Library publications. Randomized, double-blind clinical trials of SCIT, Slit drops, and Slit tablets for grass pollen were included. Bayesian network meta-analyses estimated the standardized mean difference (SMD) across 3 immunotherapy modalities on allergic rhinoconjunctivitis symptom and medication score data from publications or received from authors. Both fixed and random effects models were investigated. Results Thirty-seven studies were included in meta-analyses for symptom scores and 31 studies for medication scores. In the random effects model, SCIT and Slit tablets were significantly different from placebo for symptom scores: SMDs (95% CI) of −0.32 (−0.45 to −0.18) and −0.32 (−0.41 to −0.23), respectively. No significant difference was identified for Slit drops compared with placebo (SMD, −0.17; −0.37 to 0.04). For medication scores, significant differences compared with placebo were observed for SCIT (SMD, −0.33; 95% CI, −0.52 to −0.13), Slit tablets (SMD, −0.23; 95% CI, −0.29 to −0.17), and Slit drops (SMD, −0.44; 95% CI, −0.83 to −0.06). Network meta-analysis revealed no significant differences in SMDs (95% credible interval) for symptom scores (0.0145 [−0.19 to 0.23]) or medication scores (0.133 [−0.31 to 0.57]) between Slit tablets and SCIT, or for symptom scores (−0.175 [−0.37 to 0.02]) and medication scores (0.188 [−0.18 to 0.56]) between Slit tablets and Slit drops. Conclusions The comparisons for grass pollen immunotherapy products commercialized in at least 1 country indicate comparable reductions in allergic rhinoconjunctivitis symptoms and supplemental medication use for Slit tablets and SCIT in the first pollen season.
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a comparative analysis of symptom and medication scoring methods used in clinical trials of sublingual immunotherapy for seasonal allergic rhinitis
Clinical & Experimental Allergy, 2014Co-Authors: Moises A Calderon, David I Bernstein, Michael S Blaiss, Jens Strodl Andersen, Hendrik NolteAbstract:Summary Symptom and medication use are the key outcomes for assessing the efficacy of subcutaneous (SCIT) and sublingual allergen immunotherapy (Slit). Our objective was to explore the similarities and differences between existing scoring mechanisms used in clinical trials of Slit for seasonal allergens and characterize the impact that such differences may have on efficacy reporting. Randomized, double-blind, placebo-controlled clinical trials investigating the efficacy of Slit for seasonal allergic rhinitis (2009–2013) were selected for review. Simulated and published data were used to demonstrate differences in scoring methods. Symptom and medication scoring methods across trials, although all designed to achieve the same objective, included important differences. The maximum daily symptom score (DSS) can vary widely depending on the number of symptoms assessed, and terminology of symptoms is not consistent. Similarly, daily medication scoring (DMS) methods differ greatly among studies and are dependent on medications allowed and weighting of scores assigned to each medication. When published DSS and DMS scores were used to calculate simulated daily combined scores (DCSs) based on various published methods, changes from placebo ranged from 19% to 29% when assuming all variables other than the DSS and DMS methods were equal. Variations in trial design, analysis, and seasonal characteristics also have effects on symptom and medication scoring outcomes. We identified multiple differences in trial scoring methods and design that make comparison among trials difficult. Symptom, medication, or combined scores cannot be indirectly compared among trials without taking the methods of scoring and other trial differences into account.
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an eaaci european survey on adverse systemic reactions in allergen immunotherapy eassi the methodology
Clinical and Translational Allergy, 2014Co-Authors: Moises A Calderon, Oliver Pfaar, C Vidal, J Just, Allan Linneberg, P DemolyAbstract:At present, there is no European report on clinically relevant systemic reactions due to the regular use of allergen immunotherapy (AIT), administered either subcutaneously or sublingually (SCIT and Slit, respectively) outside clinical trials. Using an electronic survey and a “harmonised terminology” according to MedDRA, we aimed to prospectively collect systemic adverse reactions due to AIT from real life clinical settings. Under the framework of the EAACI, a team of European specialists in AIT, pharmacovigilance, epidemiology and drugs regulation set up a web-based prospective pilot survey to be conducted in three European countries (France, Germany and Spain). A designated “national coordinator” was responsible for following ethics requirements relative to each country and to select at least 30 doctors per country. Patients were recruited the same day they received their first dose of either SCIT or Slit. Patient inclusion criteria were: adults and children, with IgE mediated pollen, house dust mite, Alternaria, and/or animal dander respiratory allergies who will initiate AIT. A list of 31 symptoms terms were extracted from the MedDRA (Medical Dictionary for Regulatory Activities) dictionary to harmonize the reporting of all adverse systemic reactions in this survey. The SurveyMonkey® online instrument was used by participant doctors to submit information directly to a blinded central database. Three questionnaires were generated: i) the Doctor Questionnaire, ii) the Patient Questionnaire and iii) the Adverse Reaction Questionnaire. A handbook and a mistake report form were given to each doctor. In this paper, we describe the methodology followed.
Hansjorgen Malling - One of the best experts on this subject based on the ideXlab platform.
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sublingual allergen immunotherapy mode of action and its relationship with the safety profile
Allergy, 2012Co-Authors: Moises A Calderon, Hansjorgen Malling, F E R Simons, Richard F Lockey, Philippe Moingeon, P DemolyAbstract:Allergen immunotherapy reorients inappropriate immune responses in allergic patients. Sublingual allergen immunotherapy (Slit) has been approved, notably in the European Union, as an effective alternative to subcutaneous allergen immunotherapy (SCIT) for allergic rhinitis patients. Compared with SCIT, Slit has a better safety profile. This is possibly because oral antigen-presenting cells (mostly Langerhans and myeloid dendritic cells) exhibit a tolerogenic phenotype, despite constant exposure to danger signals from food and microbes. This reduces the induction of pro-inflammatory immune responses leading to systemic allergic reactions. Oral tissues contain relatively few mast cells and eosinophils (mostly located in submucosal areas) and, in comparison with subcutaneous tissue, are less likely to give rise to anaphylactic reactions. Slit-associated immune responses include the induction of circulating, allergen-specific Th1 and regulatory CD4+ T cells, leading to clinical tolerance. Although 40-75% of patients receiving Slit experience mild, transient local reactions in the oral mucosa, these primary reactions rarely necessitate dose reduction or treatment interruption. We discuss 11 published case reports of anaphylaxis (all nonfatal) diagnosed according to the World Allergy Organization criteria and relate this figure to the approximately 1 billion Slit doses administered worldwide since 2000. Anaphylaxis risk factors associated with SCIT and/or Slit should be characterized further.
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food allergy to apple and specific immunotherapy with birch pollen
Molecular Nutrition & Food Research, 2004Co-Authors: Kirsten Hansen, Lars K Poulsen, Marianne Sondergaard Khinchi, Per Stahl Skov, Carsten Bindslevjensen, Hansjorgen MallingAbstract:Conflicting results concerning the effect of specific pollen immunotherapy (SIT) on allergy to plant foods have been reported. The aim of this study was to investigate the effect of SIT using a birch pollen extract on food allergy with focus on allergy to apple. Seventy-four birch pollen-allergic patients were included in a double-blind, double-dummy, and placebo-controlled comparison of sublingual-swallow (Slit) and subcutaneous (SCIT) administration of a birch pollen extract. Sixty-nine percent of these patients reported allergy to apple. The clinical reactivity to apple was evaluated by open oral challenges with fresh apple and a questionnaire. The immunoglobulin E (IgE)-reactivity was assessed by skin prick test (SPT), specific IgE, and leukocyte histamine release (HR). Forty patients were included in the final evaluation of the effect of SIT. The challenges were positive in 9 (SCIT), 6 (Slit), and 8 (placebo) patients after treatment compared to 10, 4, and 10 patients, respectively, before SIT. The symptom scores to apple during challenges decreased in all groups, but only significantly in the placebo group (p = 0.03). As evaluated by the questionnaire, the severity of food allergy in general did not change and there were no differences between the groups. In spite of a significant effect on seasonal hay fever symptoms and use of medication and decrease in IgE-reactivity, SIT was not accompanied by a significant decrease in the severity of allergy to apple compared to placebo. Therefore, oral allergy syndrome (OAS) to apple should not be considered as a main criterion for selecting patients for birch pollen immunotherapy at present.
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clinical efficacy of sublingual and subcutaneous birch pollen allergen specific immunotherapy a randomized placebo controlled double blind double dummy study
Allergy, 2004Co-Authors: M S Khinchi, Lars K Poulsen, F Carat, Claude Andre, A B Hansen, Hansjorgen MallingAbstract:Background: Both sublingual allergen-specific immunotherapy (Slit) and subcutaneous immunotherapy (SCIT) have a documented clinical efficacy, but only few comparative studies have been performed. Objective: To investigate the clinical efficacy of Slit vs SCIT and secondary to compare Slit and SCIT with placebo and to evaluate the relative clinical efficacy in relation to systemic side-effects. Methods: A 3-year randomized, placebo-controlled, double-blind, double-dummy study including 71 adult birch pollen hay fever patients treated for two consecutive years after a baseline year. Allocation to treatment groups was based on disease severity in the baseline season, gender and age. Results: Clinical efficacy was estimated in 58 patients completing the first treatment year by subtracting baseline data and by calculating the ratio first treatment season vs baseline. Slit diminished the median disease severity to one-half and SCIT to one-third of placebo treatment. No statistical significant difference between the two groups was observed. Both for symptoms and medication scores actively treated patients showed statistically significant and clinical relevant efficacy compared with placebo. Slit treatment only resulted in local mild side-effects, while SCIT resulted in few serious systemic side-effects. Conclusion: Based on the limited number of patients the clinical efficacy of Slit was not statistically different from SCIT, and both treatments are clinically effective compared with placebo in the treatment of birch pollen rhinoconjunctivitis. The lack of significant difference between the two treatments does not indicate equivalent efficacy, but to detect minor differences necessitates investigation of larger groups. Due to the advantageous safety profile Slit may be favored.
Isil B Barlan - One of the best experts on this subject based on the ideXlab platform.
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long term effect of sublingual and subcutaneous immunotherapy in dust mite allergic children with asthma rhinitis a 3 year prospective randomized controlled trial
Journal of Investigational Allergology and Clinical Immunology, 2015Co-Authors: Elif Karakocaydiner, Tunc Akkoc, Nerin N Bahceciler, Aarif O Eifan, Safa Baris, E Gunay, E Akturk, Isil B BarlanAbstract:BACKGROUND AND OBJECTIVE Specific allergen immunotherapy is the only treatment modality that might change the natural course of allergic diseases in childhood. We sought to prospectively compare the long-term clinical and immunological effects of sublingual (Slit) and subcutaneous (SCIT) immunotherapy compared with pharmacotherapy alone. METHODS In this single-center, prospective randomized controlled trial, 48 children with mild persistent asthma with/without rhinitis, monosensitized to house dust mites (HDMs) were followed for 3 years. At baseline and years 1 and 3 of follow-up, patients were evaluated and compared for total rhinitis (TRSS) and asthma (TASS) symptom scores, total symptom scores (TSS), total medication scores (TMS), safety profiles, skin-nasal-bronchial reactivity, and immunological parameters. RESULTS A significant reduction was observed in TASS for both HDM-SCIT and HDM-Slit at year 3 of treatment compared with baseline and controls (P<.05 for both), with significant improvement in rhinitis symptoms for both groups compared with controls (P=.01 for both). TSS decreased significantly in both HDM-SCIT and HDM-Slit at year 3 compared with baseline (P=.007 and P=.04, respectively) and controls (P<.01 for both). A significant reduction in TMS was observed in HDM-SCIT and HDM-Slit compared with baseline and controls (P=.01 in all cases), with a reduction in skin reactivity to HDM (P<.05). Finally, a significant increase in allergen specific IgG4 was observed in the SCIT group at year 3 compared with baseline, the Slit group, and controls (P<.001 in all cases). CONCLUSIONS HDM-sensitized asthmatic children treated for at least 3 years with either SCIT or Slit showed sustained clinical improvement.
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a novel approach in allergen specific immunotherapy combination of sublingual and subcutaneous routes
The Journal of Allergy and Clinical Immunology, 2011Co-Authors: Sevgi Keles, Elif Karakocaydiner, Ahmet Ozen, Ayse Gul Izgi, Ayzer Tevetoglu, Tunc Akkoc, Nerin N Bahceciler, Isil B BarlanAbstract:Background Subcutaneous allergen-specific immunotherapy (SIT) has an early onset of action, whereas repeated injections and safety concerns have limited its use in the pediatric age group. Meanwhile, the improved safety profile of the sublingual route has been accepted as an alternative despite its relatively late onset of action. Objective We sought to improve the efficacy and safety of SIT with a combination of the subcutaneous route in the build-up phase and sublingual maintenance in comparison with the sublingual or subcutaneous routes alone. Methods Fifty-one house dust mite–sensitized children with mild-to-moderate asthma were randomized into one of 4 groups to receive either (1) subcutaneous immunotherapy (SCIT), (2) sublingual immunotherapy (Slit), (3) SCIT plus Slit, or (4) pharmacotherapy. Clinical parameters were evaluated at baseline and months 1, 4, 12, and 18. Allergen-specific immunoglobulin levels and allergen-induced IL-5, IL-10, IL-13, IL-17, TGF-β, and IFN-γ levels were evaluated as well. Results In the SCIT and SCIT plus Slit groups, the number of asthma attacks and inhaled corticosteroid dosage decreased compared with baseline values at the months 4, 12, and 18 but only at month 12 in the Slit group. The improvement in visual analog scores for rhinitis was significant only in the SCIT plus Slit group. Increases in the levels of regulatory and T H 1 cytokines were observed both in the SCIT and Slit groups, with some differences in dynamics. Antigen-specific IgG 4 levels increased in the SCIT and SCIT plus Slit groups but not in the Slit group. Clinical symptom scores were correlated positively with IL-5 levels and negatively with antigen-specific IgG 4 , IFN-γ, and TGF-β levels. Conclusion Our novel regimen of immunotherapy, SCIT plus Slit, appeared promising in that it successfully combined the advantages of the 2 alternatives: rapid onset and potency in SCIT and safety and avoidance of injections in Slit.
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clinical efficacy and immunological mechanisms of sublingual and subcutaneous immunotherapy in asthmatic rhinitis children sensitized to house dust mite an open randomized controlled trial
Clinical & Experimental Allergy, 2010Co-Authors: Sevgi Keles, Tunc Akkoc, Nerin N Bahceciler, Aarif O Eifan, A Yildiz, Cevdet Ozdemir, Isil B BarlanAbstract:BACKGROUND: In children, the clinical efficacy and immunological mechanisms of sublingual immunotherapy (Slit) compared with subcutaneous immunotherapy (SCIT) is still to be elucidated. OBJECTIVES: To compare Slit, SCIT and pharmacotherapy in relation to clinical efficacy and immunological mechanisms that govern its effect in asthmatic/rhinitis children who were sensitized to house dust mite (HDM). METHODS: In this single centre, prospective, randomized, controlled, open labelled, three parallel group trial, 48 patients mono-sensitized to HDM were randomized to receive either Slit (n=16), SCIT (n=16) or pharmacotherapy alone (n=16). Symptom, medication and visual analogue score (VAS) were collected and bronchial-nasal hyper-reactivity, skin prick tests, total-specific IgE were performed at baseline and 12 months after treatment. In addition, peripheral blood mononuclear cells were cultured with recombinant Der p 1 and Bet v 1 extracts and allergen-specific IL-4, IL-5, IL-13, IFN-gamma, IL-10, and TGF-beta secretions were measured. RESULTS: Slit and SCIT demonstrated a significant reduction of total rhinitis and asthma symptom score, total medication score, VAS and skin reactivity to HDM (P<0.05) when compared with pharmacotherapy. A significant reduction of serum-specific HDM-IgE in SCIT and Slit were observed. Moreover, titrated nasal provocative dose significantly increased in both immunotherapy groups when compared with the pharmacotherapy group. No adverse effects were reported in Slit, while two patients demonstrated serious adverse events in SCIT. After 1 year of treatment, Der p 1-driven IL-10 significantly increased in Slit compared with pharmacotherapy, whereas Bet v 1-driven TGF-beta (negative control) increased significantly in Slit only. No changes were observed for Th1-Th2 cytokines. CONCLUSION: Both Slit and SCIT demonstrated clinical improvement compared with pharmacotherapy in asthma/rhinitis children sensitized to HDM.
Gulbin Bingol Karakoc - One of the best experts on this subject based on the ideXlab platform.
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two year follow up of clinical and inflammation parameters in children monosensitized to mites undergoing subcutaneous and sublingual immunotherapy
Asian Pacific Journal of Allergy and Immunology, 2013Co-Authors: Ayfer Yukselen, Seval Guneser Kendirli, Mustafa Yilmaz, Derya Ufuk Altintas, Gulbin Bingol KarakocAbstract:Background: Both SCIT (subcutaneous immunotherapy) and Slit (sublingual immunotherapy) have clinical and immunologic efficacy in children with rhinitis and asthma but comparative studies are scarce. Objective: To investigate the clinical and immunological efficacy of mite-specific Slit and SCIT in children with rhinitis and asthma. Method: Thirty children monosensitized to house dust mite were randomized to receive either active SCIT or Slit or placebo for 1 yr in a double-blind double-dummy placebo controlled design (Yukselen A et al., Int Arch Allergy Immunol 2012; 157:288-298). Thereafter, the placebo group was randomized to receive SCIT or Slit, and for 1 yr all patients received active treatment with SCIT or Slit. Symptom scores, drug usage, titrated skin prick tests, nasal and bronchial allergen provocation doses, serum house dust mite-specific immunglobulin E, sIgG4, IL-10 and IFN- g levels were evaluated. Conclusion: The clinical efficacy of Slit is more prominent at the end of the second year, although this improvement is observed from the first year of treatment with SCIT in mite-sensitive children. Results: The reduction of clinical scores with Slit was more evident after 2 years of treatment in comparison to both the baseline and DBPC phase of the study. The change in titrated skin prick tests and nasal provocative doses was more prominent with both SCIT and Slit at the end of the open phase. Although the increase in bronchial provocative doses was not significant at the end of the first year of treatment with Slit, it reached a statistically significan t difference after two years of treatment.
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effect of one year subcutaneous and sublingual immunotherapy on clinical and laboratory parameters in children with rhinitis and asthma a randomized placebo controlled double blind double dummy study
International Archives of Allergy and Immunology, 2012Co-Authors: Ayfer Yukselen, Seval Guneser Kendirli, Mustafa Yilmaz, Derya Ufuk Altintas, Gulbin Bingol KarakocAbstract:Background: It has been reported that both sublingual (Slit) and subcutaneous (SCIT) allergen-specific immunotherapy have clinical efficacy, yet there are rather few comparative placebo studies of children. We aimed to investigate the clinical and immunological efficacy of mite-specific Slit and SCIT versus a placebo in rhinitis and asthma in children. Methods: The outcomes of this 1-year, randomized, placebo-controlled, double-blind, double-dummy study were symptom and medication scores, visual analog scores (VAS), titrated skin prick tests, nasal and bronchial allergen provocation doses, serum house dust mite-specific immunglobulin E (HDM-sIgE), sIgG4, IL-10 and IFN-γ levels. Results: Clinical and laboratory parameters were evaluated in 30 patients. SCIT significantly diminished symptom and medication scores for rhinitis and asthma (p = 0.03 and p = 0.05 for rhinitis; p = 0.01 and p = 0.05 for asthma) and VAS. Slit also reduced VAS, symptoms associated with rhinitis and asthma as well as medication usage for rhinitis, but this reduction was not significant when compared with the placebo. Skin reactivitiy to HDM and HDM-sIgE levels was reduced significantly in both immunotherapy groups. Serum IL-10 levels and nasal provocative doses increased significantly with both SCIT and Slit. Nasal eosinophil increments after nasal challenge decreased with two treatment modes, but bronchial provocative doses and sputum eosinophil increments after bronchial challenge were reduced only with SCIT. In both treatment arms, there was no change in IFN-γ levels. Serum sIgG4 levels increased significantly only in the SCIT group. Conclusion: Based on the limited number of patients at the end of the 1-year immunotherapy, the clinical efficacy of SCIT on rhinitis and asthma symptoms was more evident when compared with the placebo.
Chaeseo Rhee - One of the best experts on this subject based on the ideXlab platform.
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sublingual immunotherapy Slit for house dust mites does not prevent new allergen sensitization and bronchial hyper responsiveness in allergic rhinitis children
PLOS ONE, 2017Co-Authors: Jae Hyun Lim, Doo Hee Han, Chul Hee Lee, Chaeseo Rhee, Jin Youp Kim, Seung No Hong, Jee Hye Wee, Sue K ParkAbstract:Introduction The aim of this study is to identify the effects of sublingual immunotherapy (Slit) on immunologic parameters and bronchial-hyper-responsiveness in children with allergic rhinitis to house-dust mite (HDM), through long-term follow-up cohort. Methods Among the Allergic Rhinitis Cohort Study for Kids, pediatric patients who visited the hospital for rhinitis symptoms and proven allergy to HDM through skin prick test were studied. In this cohort, 37 patients received Slit more than 3-years (Slit group), and 184 patients received only pharmacologic therapy (non-Slit group) were included in this study. The results of skin prick test, eosinophil percent and count, total immunoglobulin E (IgE), and bronchial provocation test at initial and 3-year followed-up were compared in the two groups. Results After 3 year follow-up, only the serum eosinophil percent decreased more significantly in Slit group than that in the non-Slit group. New-sensitization rate other than HDM between Slit and non-Slit group did not show any significant differences. The distribution of sensitized allergen other than HDM showed increasing tendency after 3 years in both groups. Older age and a small number of sensitized allergen affected the improvement of bronchial hyper-responsiveness regardless of Slit. Conclusion HDM Slit in allergic rhinitis children for 3 years in Korea does not affect prevention of new sensitization and poly-sensitization rate increment, and improvement of bronchial hyper-responsiveness.
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early compliance and efficacy of sublingual immunotherapy in patients with allergic rhinitis for house dust mites
Clinical and Experimental Otorhinolaryngology, 2009Co-Authors: Hyun Chang, Doo Hee Han, Chul Hee Lee, Yang Gi Min, Jeong Whun Kim, Dongyoung Kim, Chaeseo RheeAbstract:Objectives. Sublingual immunotherapy (Slit) has recently received much attention around the world as a treatment for allergic rhinitis. This study aimed to investigate the efficacy and adverse effects of Slit in Korean patients with allergic rhinitis caused by house dust mites. The treatment compliance and the patient satisfaction with Slit were also assessed. Methods. The patients who were sensitized to Dermatophagoides pteronyssinus and Dermatophagoides farinae and who started Slit between November 2007 and July 2008 were included in this study. The symptom questionnaires, which included items on rhinorrhea, sneezing, nasal obstruction, itchy nose, olfactory disturbance, eye discomfort and sleep disturbance, were obtained before and 6 months after Slit. The patient satisfaction and the adverse effects were also investigated. Results. One hundred forty-two patients started Slit and 98 of them continued Slit for 6 months or more. Ninety-two of the 98 patients completed the questionnaires. The duration of receiving Slit was 9.8 months on average (range, 6 to 13 months). All the symptoms of allergic rhinitis were improved with Slit. Forty-five percent of the patients were satisfied for Slit, while 12% were unsatisfied. The incidence of adverse effects was 12% during maintenance therapy, although it was 48% during the up-dosing phase. The drop-out rate of Slit was 31.0%. Conclusion. The subjective symptoms were improved with Slit in Korean patients with allergic rhinitis for house dust mites. Yet the drop out rate was high despite of the symptomatic improvement.
