Fluctuation of Disease Severity and Quality of Life Applying Intralymphatic Immunotherapy for Patients with Seasonal Allergic Rhinitis
-
Maryam Khoshkhui
,
Farahzad Jabbari
,
Fateme Shafiee Zargar
,
Nasrin Motavalli Haghi
,
Nazila Ariaee
Abstract
Allergen-specific immunotherapy is the only disease-modifying treatment for IgE-mediated allergic disorders. Intra lymphatic immunotherapy (ILIT) is an efficacious and time-saving alternative to subcutaneous immunotherapy (SCIT). This study aimed to evaluate the effects and safety of ILIT in patients with moderate to severe allergic rhinitis.
In this clinical trial, patients between 18 and 65 years old with moderate to severe allergic rhinitis were enrolled. They received monthly intra-lymphatic inguinal injections of an active allergen (1000 SQ-U Salsola kali pollen). Their clinical symptoms were assessed before and four weeks after treatments. The clinical signs were also evaluated during two consecutive pollination seasons and the following non-pollination season in April.
No moderate or severe reactions were recorded following ILIT treatment. Lymph node enlargement, angioedema/urticaria, and local itching were seen instantly after injection. Patients who received ILIT experienced a significant clinical improvement in self-recorded seasonal allergic symptoms after the treatments, compared to themselves before ILIT. Furthermore, their quality of life significantly improved.
This study suggests ILIT with Salsola-pollen extract may decrease symptoms of allergic rhinitis. It was safe and did not cause any crucial complications.
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28. Patterson AM, Bonny AE, Shiels WE, Erwin EA. Three-injection intralymphatic immunotherapy in adolescents and young adults with grass pollen rhinoconjunctivitis. Ann. Allergy Asthma Immunol. 2016;116(2):168-70.
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30. Senti G, Kündig TM. Novel delivery routes for allergy immunotherapy: intralymphatic, epicutaneous, and intradermal. Immunol Allergy Clin. 2016;36(1):25-37.
31. Weinfeld D, Westin U, Hellkvist L, Mellqvist U-H, Jacobsson I, Cardell L-O. A preseason booster prolongs the increase of allergen specific IgG4 levels, after basic allergen intralymphatic immunotherapy, against grass pollen seasonal allergy. Allergy Asthma Clin Immunol. 2020;16:1-8.
2. Brożek JL, Bousquet J, Baena-Cagnani CE, Bonini S, Canonica GW, Casale TB, et al. Allergic Rhinitis and its Impact on Asthma (ARIA) guidelines: 2010 revision. J Allergy Clin Immunol. 2010;126(3):466-76.
3. Alyasin S, Nabavizadeh SH, Houshmand H, Esmaeilzadeh H, Jelodar S, Amin R. Short time efficiency of rhinophototherapy in management of patients with allergic rhinitis resistant to medical therapy. Iran J Allergy Asthma Immunol. 2016;15(4):317-27.
4. Custovic A, Tovey E. Allergen control for prevention and management of allergic diseases. InMiddleton's Allergy 2014 Jan 1 (pp. 1406-1415). WB Saunders.
5. Meltzer EO, Bensch GW, Storms WW, editors. New intranasal formulations for the treatment of allergic rhinitis. Allergy Asthma Proc. 2014;35(2):8-9.
6. Durham SR, Shamji MH. Allergen immunotherapy: past, present and future. Nat Rev Immunol. 2023 May;23(5):317-28.
7. Calderon MA, Alves B, Jacobson M, Hurwitz B, Sheikh A, Durham S. Allergen injection immunotherapy for seasonal allergic rhinitis. Cochrane database of systematic reviews. 2007(1).
8. Jutel M, Akdis CA. Novel immunotherapy vaccine development. Curr Opin Allergy Clin Immunol. 2014;14(6):557-63.
9. Schmitt J, Schwarz K, Stadler E, Wüstenberg EG. Allergy immunotherapy for allergic rhinitis effectively prevents asthma: results from a large retrospective cohort study. J Allergy Clin Immunol. 2015;136(6):1511-6.
10. Pfaar O, Creticos PS, Kleine-Tebbe J, Canonica GW, Palomares O, Schülke S. One hundred ten years of allergen immunotherapy: a broad look into the future. J Allergy Clin Immunol Pract. 2021;9(5):1791-803.
11. Lam HY, Tergaonkar V, Ahn KS. Mechanisms of allergen-specific immunotherapy for allergic rhinitis and food allergies. Biosci Rep. 2020;40(4).
12. Kang S-Y, JUNG J-H, LEE S-M, LEE S-P. Intralymphatic allergen-specific immunotherapy. Allergy Asthma Respir Dis. 2020:53-65.
13. Lee SP, Shin YS, Kang S-Y, Kim T-B, Lee SM. Recent advances in allergen-specific immunotherapy in humans: a systematic review. Immune Netw. 2022;22(1).
14. Oskouei YM, Hosseini RF, Ahanchian H, Jarahi L, Ariaee N, Azad FJ. Report of common aeroallergens among allergic patients in northeastern Iran. Iran. J. Otorhinolaryngol. 2017;29(91):89.
15. Adlany YK, Šošić L, Senti G, Lang CC, Wüthrich B, Kündig TM, et al. Quality of life in allergic rhinitis patients treated with intralymphatic immunotherapy (ILIT): A 19-year follow-up. J Allergy Clin Immunol. 2023;2(1):43-50.
16. Liu M, Liu J, Weitzel EK, Chen PG, editors. The predictive utility of the 22‐item sino‐nasal outcome test (SNOT‐22): A scoping review. Int Forum Allergy Rhinol; 2022: Wiley Online Library.
17. Aini NR, Mohd Noor N, Md Daud MK, Wise SK, Abdullah B. Efficacy and safety of intralymphatic immunotherapy in allergic rhinitis: A systematic review and meta‐analysis. Clin Transl Allergy. 2021;11(6):e12055.
18. Justicia JL, Cardona V, Guardia P, Ojeda P, Olaguíbel JM, Vega JM, et al. Validation of the first treatment-specific questionnaire for the assessment of patient satisfaction with allergen-specific immunotherapy in allergic patients: the ESPIA questionnaire. J Allergy Clin Immunol. 2013;131(6):1539-46.e2.
19. Roger A, Arcalá Campillo E, Torres M, Millan C, Jáuregui I, Mohedano E, et al. Reduced work/academic performance and quality of life in patients with allergic rhinitis and impact of allergen immunotherapy. Allergy Asthma Clin Immunol. 2016;12(1):1-9.
20. Hellkvist L, Hjalmarsson E, Kumlien SG, Winqvist O, Westin UP, Cardell LO. Intralymphatic Immunotherapy (ILIT) with both grass and birch allergen-a randomized controlled trial. Clin Transl Allergy. 2015;8(12):5.
21. Linton S, Burrows AG, Hossenbaccus L, Ellis AK. Future of allergic rhinitis management. Ann Allergy Asthma Immunol. 2021;127(2):183-90.
22. Ariaee N, Panahi M, Bakhshaee M, Ghorbani J, Ravanshad Y, Hosseini RF, et al. Shirazi thyme (Zataria multiflora) extract can alleviate allergic rhinitis: a randomized clinical trial. Postepy Dermatol Alergol. 2021;38(3):520-5.
23. Hoseini R, Jabbari F, Rezaee A, Rafatpanah H, Yousefzadeh H, Ariaee N, et al. House dust mite sublingual-swallow immunotherapy in perennial rhinitis: a double-blind, placebo-controlled Iranian study. J Biol Regul Homeost Agents. 2018;32(1):83-8.
24. Senti G, Crameri R, Kuster D, Johansen P, Martinez-Gomez JM, Graf N, et al. Intralymphatic immunotherapy for cat allergy induces tolerance after only 3 injections. J Allergy Clin Immunol. 2012;129(5):1290-6.
25. Hylander T, Latif L, Petersson-Westin U, Cardell LO. Intralymphatic allergen-specific immunotherapy: an effective and safe alternative treatment route for pollen-induced allergic rhinitis. J Allergy Clin Immunol. 2013;131(2):412-20.
26. Lee SP, Choi SJ, Joe E, Lee SM, Lee MW, Shim JW, et al. A pilot study of intralymphatic immunotherapy for house dust mite, cat, and dog allergies. Allergy Asthma Immunol Res. 2017;9(3):272-7.
27. Hylander T, Larsson O, Petersson-Westin U, Eriksson M, Georén SK, Winqvist O, et al. Intralymphatic immunotherapy of pollen-induced rhinoconjunctivitis: a double-blind placebo-controlled trial. Respir Res. 2016;17(1):10.
28. Patterson AM, Bonny AE, Shiels WE, Erwin EA. Three-injection intralymphatic immunotherapy in adolescents and young adults with grass pollen rhinoconjunctivitis. Ann. Allergy Asthma Immunol. 2016;116(2):168-70.
29. Witten M, Malling H-J, Blom L, Poulsen BC, Poulsen LK. Is intralymphatic immunotherapy ready for clinical use in patients with grass pollen allergy? J Allergy Clin Immunol. 2013;132(5):1248-52. e5.
30. Senti G, Kündig TM. Novel delivery routes for allergy immunotherapy: intralymphatic, epicutaneous, and intradermal. Immunol Allergy Clin. 2016;36(1):25-37.
31. Weinfeld D, Westin U, Hellkvist L, Mellqvist U-H, Jacobsson I, Cardell L-O. A preseason booster prolongs the increase of allergen specific IgG4 levels, after basic allergen intralymphatic immunotherapy, against grass pollen seasonal allergy. Allergy Asthma Clin Immunol. 2020;16:1-8.
| Files | ||
| Issue | Vol 23 No 2 (2024) | |
| Section | Original Article(s) | |
| DOI | https://doi.org/10.18502/ijaai.v23i2.15321 | |
| Keywords | ||
| Allergic rhinitis Allergen immunotherapy Intra-lymphatic injection | ||
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How to Cite
1.
Khoshkhui M, Jabbari F, Shafiee Zargar F, Motavalli Haghi N, Ariaee N. Fluctuation of Disease Severity and Quality of Life Applying Intralymphatic Immunotherapy for Patients with Seasonal Allergic Rhinitis. Iran J Allergy Asthma Immunol. 2024;23(2):149-157.
