Clinical improvement and immunological changes in atopic dermatitis patients undergoing subcutaneous immunotherapy with a house dust mite allergoid: a pilot study
Clinical improvement and immunological changes in atopic dermatitis patients undergoing subcutaneous immunotherapy with a house dust mite allergoid: a pilot study
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DOI：
10.1111/j.1365-2222.2007.02783.x
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发表时间：
2007-09-01
影响因子：
6.1
通讯作者：
Novak, N.
中科院分区：
文献类型：
--
作者：
Bussmann, C.;Maintz, L.;Novak, N.
屋尘螨是特应性皮炎患者的重要室内变应原来源。皮下变应原特异性免疫疗法（SCIT）已被证明是成功的过敏性鼻炎和轻度哮喘患者，并可能代表一个有吸引力的治疗选择，长期治疗HDM致敏的AD患者。然而，关于HDM SCIT在AD中的有效性的研究很少，导致了有争议的临床结果。AD patients. Objectives的SCIT诱导的免疫学变化的数据是罕见的，我们进行了一项开放的试点研究，以评估临床变化和客观的实验室参数和评估HDM SCIT的好处在25例AD患者IgE介导的致敏对HDM. Methods AD的严重程度进行了评估的严重程度评分的特应性皮炎系统（SCORAD）。SCIT期间检测HDM特异性IgE和IgG 4，以及血清TARC/CCL 17、MDC/CCL 22、IL-16、IL-4、IFN-γ、IL-10和TGF-β 1水平。在SCIT期间，患者血清中致耐受性细胞因子IL-10的水平升高，而CCL 17和IL-16降低。结论在这项开放性的先导性研究中，SCIT与HDM提取物在AD患者中导致AD的显着改善，反映了SCORAD的减少以及血清学和免疫学的变化，这可能是有价值的参数，以评估SCIT的治疗效果。
Background House dust mites (HDMs) represent significant indoor allergen sources for patients with atopic dermatitis (AD). Subcutaneous allergen-specific immunotherapy (SCIT) has been shown to be successful in patients with allergic rhinitis and mild asthma and might represent an attractive therapeutic option for the long-term treatment of HDM sensitizations in AD patients. However, only a few studies have been conducted on the effectiveness of HDM SCIT in AD, resulting in controversial clinical results. Data on immunological changes induced by SCIT in AD patients are rare.Objectives We performed an open pilot study to assess clinical changes and objective laboratory parameters and evaluate the benefit of HDM SCIT in 25 AD patients with IgE-mediated sensitization against HDM.Methods The severity of AD was evaluated by the severity scoring of atopic dermatitis system (SCORAD). Specific IgE and IgG4 against HDM and serum levels of TARC/CCL17, MDC/CCL22, IL-16, IL-4, IFN-gamma, IL-10 and TGF-beta 1 were measured during SCIT.Results Subjective and objective SCORAD improved significantly within only 4 weeks of treatment. The level of the tolerogenic cytokine IL-10 increased, whereas CCL17 and IL-16 decreased in the sera of the patients during SCIT. Allergen specific IgE decreased, while IgG4 increased during SCIT.Conclusion In this open-label pilot study, SCIT with an HDM extract in patients with AD led to a significant improvement of AD mirrored by a reduction of SCORAD as well as serological and immunological changes, which might serve as valuable parameters to estimate the therapeutic effect of SCIT.