Is There Any Parameter Helpful for Predicting a Suitable Candidate for Mite Immunotherapy?
Abstract
Few biomarkers that can predict the clinical response to allergen immunotherapy (AIT) have been identified. The aim of the present study was to investigate parameters that could be used “in predicting the clinical response to AIT” in children with asthma caused by house dust mites. We evaluated 107 children with mild persistent asthma who were sensitised only to mite aeroallergens. The study group included 47 patients who underwent a 4-to-5-year course of subcutaneous immunotherapy with standardised mite allergenic extract. Sixty patients who had not undergone AIT but were allergic to house mites were included in the control group. The clinical features and laboratory parameters of patients who did and did not sustain remission were compared. Remission was achieved in 74.5% of the 47 patients in the study group and in 20% of those in the control group. In the study group, one parameter predictive of a clinical response to AIT was identified by multivariate logistic analysis. This parameter was the serum total IgE level (tIgE) at the time of diagnosis (OR 131.64 and CI 0.858–20193; p = 0.032). Serum tIgE levels ≤ 339 kU/L at diagnosis were associated with an effective clinical response to AIT, with a sensitivity of 64.5% and specificity of 88.9%. We conclude that measurement of the serum tIgE level can be used as a predictive test prior to AIT in patients sensitized to mite aeroallergens.
1. Burks AW, Calderon MA, Casale T, Cox L, Demoly P, Jutel M, et al. Update on allergy immunotherapy: American Academy of Allergy, Asthma & Immunology/European Academy of Allergy and Clinical Immunology/PRACTALL consensus report. J Allergy Clin Immunol 2013; 131(5):1288-96.
2. Soyka MB, van de Veen W, Holzmann D, Akdis M, Akdis CA. Scientific foundations of allergen-specific immunotherapy for allergic disease. Chest 2014;146(5):1347-57.
3. Özdemir Ö. The local and systemic reactions due to sublingual immunotherapy: Is anaphylaxis associated with therapy. Iran J Allergy Asthma Immunol 2015;14(2):228-30.
4. Ciprandi G, Silvestri M. Serum specific IgE: A biomarker of response to allergen immunotherapy. J Investig Allergol Clin Immunol 2014; 24(1):35-9.
5. Ciprandi G, Toska MA, Silvestri M. The practical role of serum allergen-specific IgE as potential biomarker for predicting responder to allergen immunotherapy. Expert Rev Clin Immunol 2014; 10(3):321-4.
6. Global Initiative for Asthma (GINA). Global strategy for asthma management and prevention. 2014 [updated 2014; accesed 2015 Jun 10]. Available from URL: http://www.ginasthma.org/guidelines-gina-report-global- strategy-for-asthma.html.
7. Boulet LP. Influence of comorbid conditions on asthma.Eur Respir J 2009; 33(4):897-906.
8. Brand PL, Baraldi E, Bisgaard H, Boner AL, Castro- Rodriguez JA, Custovic A, et al. Definition, assessment and treatment of wheezing disorders in preschool children: an evidence-based approach. Eur Respir J 2008;32(4):1096-110.
9. Cazzoletti L, Corsico AG, Albicini F, Di Vincenzo EMG, Gini E, Grosso A, et al. The course of asthma in young adults: a population-based nine-year follow-up on asthma remission and control. PLOS ONE 2014; 9(1):e86956.
10. Durham SR, Emminger W, Kapp A, de Monchy JG, Rak S, Scadding GK, et al. SQ-standardized sublingual grass immunotherapy: confirmation of disease modification 2 years after 3 years of treatment in a randomized trial. J Allergy Clin Immunol 2012; 129(3):717–25.
11. Marogna M, Spadolini I, Massolo A, Canonica GW, Passalacqua G. Long-lasting effects of sublingual immunotherapy according to its duration: a 15-year prospective study. J Allergy Clin Immunol 2010;126(5):969–75.
12. Jacobsen L, Niggemann B, Dreborg S, Ferdousi HA, Halken S, Høst A, et al. PAT Investigator Group: Specific immunotherapy has long-term preventive effect of seasonal and perennial asthma: 10-year follow- up on the PAT study. Allergy 2007; 62(8):943–8.
13. Akdis CA, Akdis M. Mechanisms of allergen-specific immunotherapy. J Allergy Clin Immunol 2011; 127(1):18-27.
14. Akdis CA. Therapies for allergic inflammation: refining strategies to induce tolerance. Nat Med 2012; 18(5):736-79.
15. Calderón MA, Casale T, Cox L, Akdis CA, Burks AW,Nelson HS, et al. Allergen immunotherapy: a new semantic framework from the European Academy of Allergy and Clinical Immunology/American Academy of Allergy, Asthma and Immunology/PRACTALL consensus report. Allergy 2013; 68(7):825–8.
16. Abramson MJ, Puy RM, Weiner JM. Injection allergen immunotherapy for asthma. Cochrane Database Syst Rev 2010; (8):CD001186.
17. Yukselen A, Kendirli SG. Role of immunotherapy in the treatment of allergic asthma. World J Clin cases 2014;2(12):859-65.
18. Zhang X, Li MR, Wang C, Wang XN, Zhang HL, Lin J, et al.Clinical efficacy of a standardized specific immunotherapy against house dust mite in 85 asthmatic children. Zhonghua Er Ke Za Zhi 2010; 48(7):526-30.
19. Tabar AI, Arroabarren E, Echechipía S, García BE, Martin S, Alvarez-Puebla MJ. Three years of specific immunotherapy may be sufficient in house dust mite respiratory allergy. J Allergy Clin Immunol 2011; 127(1):57-63.
20. Di Lorenzo G, Mansueto P, Pacor ML, Rizzo M, Castello F, Martinelli N, et al. Evaluation of serum s-IgE/total IgE ratio in predicting clinical response to allergen-specific immunotherapy. J Allergy Clin Immunol 2009;123(5):1103–10.
21. Li Q, Li M, Yue W, Zhou J, Li R, Lin J et al. Predictive factors for clinical response to allergy immunotherapy in children with asthma and rhinitis. Int Arch Allergy Immunol 2014; 164(3):210-7.
22. Tosca M, Silvestri M, Accogli A, Rossi GA, Ciprandi G.Serum-specific IgE and allergen immunotherapy in allergic children. Immunotherapy 2014; 6(1):29-33.
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Issue | Vol 15, No 2 (2016) | |
Section | Original Article(s) | |
Keywords | ||
Allergen immunotherapy Asthma Children Immunoglobulin E Mite |
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