Immunotherapy In Allergic Rhinitis Patients Research Articles

Efficacy of Sublingual Immunotherapy in Allergic Rhinitis Patients with Asthma: A Systematic Review and Meta-Analysis.

Sublingual immunotherapy (SLIT) has been widely applied to treat patients with allergic rhinitis (AR). However, meta-analyses on the efficacy of SLIT in AR patients with asthma are still limited. Literature without language limitation published before October 28, 2022, were retrieved from PubMed, EMBASE, and Cochrane Library. STATA 16.0 software was used for the meta-analysis of the extracted data. The results reported were symptom scores, drug scores, adverse effects rates, and cost of treatment. Ten studies involving 1722 patients met the inclusion criteria. The total rhinitis score (TRSS) (weighted mean difference [WMD] = -1.23, 95% CI: -1.39--1.06, P < .001) and total asthma symptom score (TASS) (WMD = -1.00, 95% CI: -1.12-0.89, P < .001) were significantly lower in the SLIT group than the placebo group. The SLIT group had higher rates of treatment-related adverse events (relative risk [RR] = 2.82, 95% CI: 1.77-4.48, P < .001) and total costs of treatment (standardized mean difference [SMD] = 0.71, 95% CI: 0.45-0.97, P < .001). There was no significant difference in inhaled corticosteroids (ICS) dose (P = .195), fractional exhaled nitric oxide (FeNO) (P = .158), forced expiratory volume in 1 s (FEV1) (P = .237), and direct costs of treatment (P = .630) between the SLIT and placebo groups. SLIT may be a therapeutic method for improving rhinitis symptoms and asthma symptoms in AR patients with asthma. However, as there was significant heterogeneity in results, more high-quality and well-designed studies are needed in the future to elucidate the efficacy of SLIT.

Evaluation of Intralymphatic Immunotherapy in Allergic Rhinitis Patients: A Systematic Review and Meta-analysis.

Intralymphatic immunotherapy (ILIT) is short-course administration of allergen-specific immunotherapy (AIT). This study is aimed at assessing the clinical efficacy and safety of ILIT in patients with allergic rhinitis (AR). MEDLINE, PUBMED, and Cochrane Library were used to conduct electronic searches for clinical trials comparing ILIT and placebo in patients with AR. The final search took place on August 24, 2022. Cochrane Handbook for Systematic Reviews of Interventions was used to assess the risk of bias in the included studies. The outcomes included combined symptom and medication scores (CSMS), visual analog scale (VAS), allergic rhinoconjunctivitis quality of life (RQLQ), Skin-prick test (SPT), and adverse events (AEs). Data were synthesized as mean difference (MD)/standard mean difference (SMD) or risk difference (RD) and 95% confidence interval (CI). Thirteen studies (454 participants) were included in this study. The ILIT group had better clinical improvement on the CSMS (random effects model, SMD-0.85, 95% CI [-1.58, -0.11], P = 0.02) and RQLQ (fixed-effects model, MD-0.42, 95% CI [0.69, 0.15], P = 0.003) than the placebo group. The booster injection was beneficial for CSMS (P < 0.0001), and the 4-week injection interval was superior to the 2-week injection period for improving VAS (P < 0.0001). Local swelling or erythema was the main AE following injection (random effects model, RD 0.16, 95% CI [0.05, 0.27], P = 0.005). Discussion. For individuals with AR, ILIT is safe and effective. ILIT alleviates clinical symptoms and reduces pharmaceutical consumption without causing severe AEs. However, the validity of this study is compromised by the substantial heterogeneity and risk of bias in the included researches. RegistrationCRD42022355329.

Comparative Review of Subcutaneous Immunotherapy and Nocturnal Vestibular Immunotherapy in Allergic Rhinitis Patients

For more than a century, no FDA-approved alternative to SCIT immunotherapy has been presented. We explored the use of a novel protocol with a ramp-up phase of sublingual administration followed by vestibular maintenance immunotherapy. Nocturnal administration offers physiological advantages due to the circadian cycle changes of the immune system. The dendritic-rich vestibular space is a desirable location for immunotherapy delivery.

Multiple-Cytokine Profiling: A Novel Method for Early Prediction of the Efficacy of Sublingual Immunotherapy in Allergic Rhinitis Patients.

BackgroundAllergic rhinitis (AR) is a common inflammatory airway disease, and allergen-specific immunotherapy (AIT) is the only disease-modifying treatment for it. However, not all AR patients respond to AIT, and early prediction of patient response is extremely important. This study aimed to example serum levels of multiple cytokines in AR and explore their association with the efficacy of AIT.MethodsA total of 74 AR patients treated with sublingual immunotherapy (SLIT) were prospectively recruited. Serum samples were obtained before the onset of SLIT and cytokine levels detected by multiplex analysis. All patients were followed for >1 year, and associations between cytokine levels and the early efficacy of SLIT were evaluated. Significantly distinctive cytokines were further verified in another independent cohort.ResultsSixty patients completed the visit schedule set: 35 patients were put into a responder group and 25 a nonresponder group. Multiple-cytokine profiling showed that cytokine levels differed significantly between the two groups. The responder group had higher concentrations of BAFF and CCL11 and lower levels of CCL2, CCL7, IFNγ, IL8, IL10, IL16, and IL33 than the nonresponder group (P<0.05). Receiver-operating characteristic curves highlighted that serum BAFF, IFNγ, IL10, and IL33 levels were strongly predictive of the efficacy of SLIT (area under the curve <0.7, P<0.05). Serum IL10 and IL33 were overexpressed in nonresponders in the validation cohort. Patients in the responder group exhibited significantly higher IL10 levels and lower IL33 post-SLIT than pre-SLIT (P<0.05), but no statistical difference was found in nonresponders (P<0.05).ConclusionOur data indicated that serum multiple-cytokine profiling was associated with response to SLIT and that IL10 and IL33 might serve as novel biomarkers for early prediction of efficacy and be involved in the therapeutic mechanisms of SLIT in AR patients.

Predictive methods for efficacy of house dust mite subcutaneous immunotherapy in allergic rhinitis patients: a prospective study in a Chinese population.

Allergen-specific immunotherapy (AIT) is the only available treatment that can induce specific immune tolerance to allergens. However, the treatment course lasts >3 years, and there is no reliable method to predict treatment response. Therefore, in this study we aimed to establish a method that can predict treatment response to AIT in the second year. This prospective study enrolled 119 patients who had undergone 2-years of standard-quality house dust mite subcutaneous immunotherapy. Clinical characteristics, skin-prick test response, and treatment response were evaluated at months 4, 6, 12, and 18. Effective AIT was defined as a 25% reduction in average adjusted symptom score (AAdSS) from baseline at the end of the second year of immunotherapy. The overall efficacy rate at the end of year 2 of the AIT was 67.4%. Age, sex, asthma, body mass index, smoking history, and aeroallergen categories were not associated with efficacy of AIT. Meanwhile, efficacy data at month 4 (odds ratio [OR], 4.250; p = 0.004), month 6 (OR, 10.476; p < 0.000), month 12 (OR, 18.000; p < 0.000), and month 18 (OR, 9.716; p < 0.000) were associated with month 24 efficacy. The area under the curve for improvement at 4, 6, 12, and 18 months was 0.805, 0.834, 0.837, and 0.854, respectively. Efficacy of AIT at months 4, 6, 12, and 18 is strongly associated with efficacy at month 24. Efficacy as early as month 4 can predict efficacy at the second year, and this may help to determine the need for long-term treatment. Our findings may be useful for identifying novel treatment strategies for AIT.

Long-term efficacy of house dust mite subcutaneous immunotherapy in allergic rhinitis patients

Objective:This study was aimed to compare the long-term effects of house dust mite (HDM) subcutaneous immunotherapy (SCIT) in a cohort of Chinese pediatric and adult patients with allergic rhinitis (AR).Method:Total of 48 AR patients received standardized HDM-SCIT for 3 years, and they received 3 years of standardized dust mite-specific subcutaneous immunotherapy, followed by 2 years after treatment. Prior to treatment (baseline) and at the end of the 3-year and 5-year treatment periods, all patients were evaluated for total nasal symptom scores(TNSS),total combined score (TCS;symptoms(nasal+ocular)+daily medication score),and rhinoconjunctivitis quality of life questionnaire(RQLQ).Safety of HDM-SCIT was assessed according to adverse events reported.Result:Fifteen pediatric and 33 adult AR patients completed the study.HDM-SCIT significantly improved symptoms and RQLQ scores at the 3 rd year and 5th year in both children and adults. Superior efficacy was observed at the 3-year and 5-year timepoints in children compared to adults. The safety of HDM-SCIT was comparable in children and adults with AR.Conclusion:A 3-year course of HDM-SCIT is an effective, safe and sustainable long-term treatment in both pediatric patients and adults with AR, although children appear to achieve better long-term efficacy compared to the adults.

Nasal Carriage of Staphylococcus Aureus Does Not Affect the Clinical Response to Immunotherapy in Allergic Rhinitis Patients

Nasal Carriage of Staphylococcus Aureus Does Not Affect the Clinical Response to Immunotherapy in Allergic Rhinitis Patients

Nasal Carriage of Staphylococcus aureus does not affect the Clinical Response to Immunotherapy in Allergic Rhinitis Patients

Nasal Carriage of Staphylococcus aureus does not affect the Clinical Response to Immunotherapy in Allergic Rhinitis Patients

Clinical observation of flupentixol and melitracen combined with specific immunotherapy for treatment of allergic rhinitis patients with anxiety and depression

Objective:To explore the clinical effects of Flupentixol/Melitracencombined with specific immunotherapy in allergic rhinitis patients with anxiety and depression. Method:Totally ninetynine moderate to severe persistent allergic rhinitis patients with anxiety and depression from October 2014 to Sepetember 2015 were randomly divided into two groups: 45 patients in experimental group (Flupentixol/Melitracen 10.5 mg，QD,treatment last 4 months)and 44 patients in control group.All patients were treated with specific immunotherapy for 1 years. The nasal symptoms score, mini Rhinoconjunctivitis Quality of life questionnaire(MiniRQLQ), Medication score, SAS and SDS score and the clinical curative effect were observed before treatment, after 4 months or one year treatment. The drug reactions were also recorded. Result:The VAS scores, MiniRQLQ scores, medication scores, SAS and SDS scores of patients in two groups who were treated after 4 months and 1 year were significantly reduced than that of patients before treatment.The differences were statistically significant(P<0.05).Compared with the control group, nasal symptom scores, MiniRQLQ scores, medication scores, SAS and SDS scores in experimental group were decreased after 4 month or 1 year treatment(P<0.05).After 4 months of treatment, the total effective rate of the experimental group was 84.4%, while the control group was 56.8%.After 1 years of treatment, the experimental group excellence rate was 57.8%, while the control group was 22.7%.The differences were statistically significant(P<0.05). During the course of treatment, there were thirteen cases of mild adverse reactionsin experimental group (17.7%) and control group(11.4%). There was no significant differences(P>0.05). Conclusion:Flupentixol and melitracen combined with specific immunotherapy could sifnificantlly relieve clinical symptom, quality of life and mental depression.is a safe and reliable therapeutic regimen for further improving clinical symptoms,quality of life,mental statusand the clinical efficacy in moderate to severe persistent with anxiety anddepression.

Early Intervention Improves Clinical Responses to House Dust Mite Immunotherapy in Allergic Rhinitis Patients

Background: Allergen immunotherapy (AIT) is the unique causal treatment for respiratory allergy. As AIT is expensive and of long duration, the availability of a marker predicting AIT responders is of crucial relevance. Objective: To investigate clinical parameters correlated with effective AIT in allergic rhinitis (AR) patients. Methods: This is a prospective, nonrandomized open study in which a total of 284 AR patients who had received house dust mite (HDM) subcutaneous AIT were enrolled from January 2011 to December 2015, and then followed up for 3 consecutive years. Demographic data, clinical history, laboratory tests (specific and total IgE levels), symptoms score, concomitant medication, and adverse reactions during AIT were collected. An AIT responder patient was defined when a visual analog score (assessing global symptoms) had decreased by >30% compared to baseline and concomitant medication was equal to or less than before AIT. Results: Thirty-three patients dropped out, so 251 patients were analyzed; 175 (69.7%) patients were responders. This group had a higher baseline symptom score than the AIT nonresponder group (7.5 vs. 6.9). A significant negative correlation was found between AR symptom duration and the clinical response to AIT. Local reactions (LRs) during AIT had a positive correlation. Other variables such as a family history of atopy, combined asthma history, and the levels of specific and total IgE had no correlations with effective AIT. Conclusion: Early intervention with AIT helps to improve the efficacy of AR treatment. LRs might predict successful AIT. Highly symptomatic AR patients may develop increased clinical responses to AIT.

Current specific immunotherapy for allergic rhinitis: perspectives from otorhinolaryngologists.

Current specific immunotherapy for allergic rhinitis: perspectives from otorhinolaryngologists.

Immunological markers in allergic rhinitis patients treated with date palm immunotherapy

Allergic rhinitis (AR) is regulated by the local production and release of several cytokines. Allergen specific immunotherapy (IT) has been widely used for many years as a specific treatment of allergic diseases. This study aimed to investigate the changes in clinical and immunological markers before and after Phoenix dactylifera IT in AR patients. Total symptom score and levels of total immunoglobulin E (IgE), albumin, interferon (IFN)-γ, tumor necrosis factor (TNF)-α, interleukin (IL)-10, IL-4, and IL-13 were measured in the serum and nasal samples of thirty non-atopic healthy controls and thirty patients with allergic rhinitis before and after 15 months of IT. We found significantly higher concentrations of serum TNF-α and nasal TNF-α and IL-13, and significantly lower concentration of nasal IL-10, in allergic patients than in non-allergic. Moreover, serum and nasal IL-10 increased significantly after IT. However, there was neither a significant reduction in total IgE nor a significant increase in IFN-γ at the end of IT. Our data show a clinical improvement associated with a decline in some inflammation parameters after IT. Moreover, date palm IT induced a significant increase in serum and nasal IL-10 levels.

The Changes of Clinical Characteristics of Pre‐ and Post immunotherapy in Allergic Rhinitis Patients Sensitized to Dermatophagoides farinae (Df)

Objective: By analyzing the difference of clinical manifestations, such as MAST results, total IgE, and Eosinophil count, before and after IT in AR patients who have been sensitized to the Df allergen, this research tried to find out about the character of the treatment response. Method: The study included 192 patients, excluding one patient who stopped therapy during the process. After dividing the group by the duration of therapy and the degree of sensitization to the Df, the MAST, total IgE, and eosinophil count of each group were compared before and at least 6 months after therapy. Results: After dividing the subjects into different groups according to the duration of IT into the 6 to 12-months group (n = 136) and the more than 12-months group (n = 56), the latter group showed a significant reduction in the Df specific antibody IgE, Dermatophagoides pteronyssinus (Dp) specific antibody IgE, and eosinophil count. Conclusion: In conclusion, immunotherapy has greater treatment response in patients with a more severe degree of sensitization to the Df allergen and the duration of treatment for more than 1 year.

Potential Adjuvant Effects of Nigella sativa Seeds to Improve Specific Immunotherapy in Allergic Rhinitis Patients

Objective: To investigate the effects of Nigella sativa seed supplementation on symptom levels, polymorphonuclear leukocyte (PMN) functions, lymphocyte subsets and hematological parameters of allergic rhinitis. Subjects and Methods: Twenty-four patients randomly selected from an experimental group of 31 (mean age 34 years) sensitive to house dust mites with allergic rhinitis and a control group of 8 healthy volunteers (mean age 23 years) were treated with allergen-specific immunotherapy in conventional doses for 30 days. After a month of immunotherapy, 12 of the 24 patients and the 8 healthy volunteers were given N. sativa seed supplementation (2 g/day orally) for 30 days. The remaining 12 patients continued only on immunotherapy during the same period. The other 7 patients were given 0.1 ml saline solution subcutaneously once a week as a placebo. The symptom scores, PMN functions, lymphocyte subsets and other hematological parameters were evaluated before and after all treatment periods. Results: There was a statistically significant increase in the phagocytic and intracellular killing activities of PMNs of patients receiving specific immunotherapy, especially after the addition of N. sativa seed. The CD8 counts of patients receiving specific immunotherapy plus N. sativa seed supplementation significantly increased compared to patients receiving only specific immunotherapy. PMN functions of healthy volunteers significantly increased after N. sativa seed supplementation compared to baseline. Conclusion:N. sativa seed supplementation during specific immunotherapy of allergic rhinitis may be considered a potential adjuvant therapy.