Sublingual house dust mite immunotherapy has no impact on decrease of circulating erythrocytes upon airway allergen challenge in allergic rhinitis

Galateja Jordakieva,Jasminka Godnic-Cvar,Erika Jensen-Jarolim,Michael Kundi,René Zieglmayer,Petra Zieglmayer,Patrick Lemell

doi:10.1038/s41598-017-02321-y

Abstract

House dust mite (HDM) allergy is a predominant cause for perennial allergic rhinitis (AR) in Europe. We recently reported that circulating erythrocyte numbers decrease after airway allergen challenge in a murine asthma model and in grass-pollen sensitized AR subjects. Consequently, we aimed to evaluate these findings in HDM sensitized AR subjects and the influence of preceding allergen immunotherapy. Seventy-seven (age 26.8 ± 7.3 years; 54.5% female) HDM-allergic rhinitis subjects previously enrolled in a randomized, monocentric sublingual immunotherapy (SLIT) trial at the Vienna Challenge Chamber (VCC) were included. Subjects had either received placebo (n = 22), low-dose HDM (n = 29) or high-dose HDM specific sublingual immunotherapy (n = 26) daily for 24 weeks. Blood sampling was performed before and after 6 hours of HDM allergen exposure. Overall, specific airway allergen challenge resulted in a significant decrease in circulating erythrocytes and hematocrit (p < 0.001), and elevation of leukocytes (p < 0.001), particularly segmented neutrophils (p < 0.001). Gender had no significant effect on the observed changes in circulating blood cells. Erythrocytes decreased and neutrophil counts increased significantly after airway allergen challenge regardless of preceding immunotherapy. These findings imply a rapid systemic mobilization of neutrophils occurring within immediate type hypersensitivity response upon a specific allergen challenge, which is possibly inversely linked with the erythrocyte numbers.

Highlights

Allergic rhinitis (AR) is the most common cause for chronic rhinitis worldwide, affecting up to 30% of the human population[1, 2]
The aim of the present study was to i) confirm the previously observed changes in blood cell counts with a different allergen, House dust mite (HDM), in an environmental exposure chamber, and ii) to compare laboratory parameters for red blood cells (RBC) and granulocytes before and after HDM challenge in allergic rhinitis (AR) subjects being treated with sublingual immunotherapy (SLIT) versus placebo[15]
According to the preceding drug therapy, subjects were divided in three groups[15]: group 1 had received placebo (n = 22), group 2 low dose (6 developmental units [DU] of MK-8237) (n = 29), and group 3 high dose (12 DU of MK-8237) (n = 26) HDM specific sublingual immunotherapy

Summary

Introduction

Allergic rhinitis (AR) is the most common cause for chronic rhinitis worldwide, affecting up to 30% of the human population[1, 2]. After 6-hour exposure the total nasal symptom score was a primary endpoint, the total ocular symptom scores and total symptom scores secondary end points in this study. Samples of this clinical trial were examined in the present study. The aim of the present study was to i) confirm the previously observed changes in blood cell counts with a different allergen, HDM, in an environmental exposure chamber, and ii) to compare laboratory parameters for RBC and granulocytes before and after HDM challenge in AR subjects being treated with SLIT versus placebo[15]

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Discussion

Conclusion