The Ewha Medical Journal
Ewha Womans University School of Medicine
Original Article

Therapeutic Effect of Antigen-Specific Immunotherapy in Patients with Asthma Sensitized to House Dust Mite

Kyung Won Park, Kyung Eun Lee*, Young Joo Cho

Copyright ⓒ 2004. Ewha Womans University School of Medicine. This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Published Online: Sep 30, 2004

Abstract

Immunotherapy has been considered as secondary strategy of IgE mediated allergic disease. It decreases delayed airway inflammation and blocks irreversible airway change but many controversies still exist despite of its remarkable effect.

The purpose of this study was to estimate clinical effectiveness of immunotherapy in patients with asthma sensitized to house dust mite and to evaluate related factors.

Thirty asthmatic patients visiting allergy clinic of Mock-Dong hospital of Ewha woman university enrolled from March, 1996 to February. All patients were received the D. farinae and D. pteronyssinus standardized extract by a immunotherapy(IT) schedule and we measured clinical parameters.

1) Symptom-medication score was significantly improved after treatment (8.9±0.29 ; before IT vs. 3.4±0.20 ; after IT, p<0.05).

2) Methacholine challenge test demonstrated significant improvement (PC20 0.78± 0.09 before IT vs. 1.l8±0.17 after I year of IT, p<0.05). After we divided patients into two groups, group I that showed more than twice increasing in PC20 after I year IT and group II that did not. There was no significant difference between the groups in pre-treatment PC20s (8.75±2.75mg/ml in group I vs. 7.08±1.84mg/ml in group II, p<0.05).

3) Skin prick test demonstrated no significant change (wheel flare ratio in D. farinae 2.44±0.24 before IT vs. 2.11±0.26 after IT, in D. pteronyssinus 2.33±0.29 before IT vs. 2.22±0.22 after IT, p>0.05).

4) There were no significant correlations for any combination among these three parameters (symptomatic improvement, change of PC20 and disease duration of asthma).

5) In view of side effects, no fatal systemic reaction occurred during treatment period. Only one patient experienced injection-related dyspnea and urticaria that were easily controlled by medication.

This study demonstrated that patients with asthma sensitized to house dust mite benefit from specific immunotherapy through symptomatic improvement and reduced nonspecific bronchial hyperreactivity. As for side reactions immunotherapy might be relatively safe if allergen is carefully administered a controlled and supervised environment.

Keywords: House dust mite; Immunotherapy; Allergic inflammation