Comparison between the use of adsorbed and aqueous immunotherapy material in dermatophagoides pteronyssinus sensitive asthmatic children

PubMedID: 10611556Background: dermatophagoides pteronyssinus (Der Pl) is the major allergen which causes allergic asthma and perennial rhinitis. The extracts of Der Pl may be used in treatment of patients who are unresponsive to pharmacological treatment and avoidance of allergens. The success of immunotherapy (IT) depends on the selection of appropriate patients and allergens as well as a regular follow up. Objective: three different groups of IT materials and a placebo were tested on 34 patients with Der Pl sensitive asthma. Clinical evaluations of allergen challenge and in vitro immunologic tests were made on the 6th month and at the end of the second year of IT. The results were compared to the placebo treated group. Results: there were no significant differences among the groups in regard to age, sex and duration of illness. The time required for reaching the maintenance dose for group I (Alutard®), II (APSI retard Ca®) and III (Greer®) was 15.40 ± 0.69, 18.2 ± 4.0 and 108 ± 33 weeks, respectively. Even though there was some significant difference between those receiving aqueous IT and the placebo (p 0.05), but significant differences was found between group III and the other two groups (p 0.05). No significant correlation was found between (1) spIgE and the symptom medication score (SMS) (2) spIgE and spIgG4 (3), DSPT and BPT. A significant positive correlation was found between the maximum tolerated dose with DSPT and increase in spIgG4 (r = 0.33, p = 0.046). A negative correlation was found between SMS and spIG4 (p = 0.012, r = -0.42) after IT. Conclusion: SIT with Der Pl is an effective and reliable treatment in allergic asthmatic children. Adsorbed extracts may be preferable to in childhood because of effectively, safety, tolerability and, fewer numbers of injection. The best IgG4 response and velocity of maintenance doses achieved was found in group I. Easy, cheap and safe parameters such a SMS and DSPT can be useful for a follow-up of SIT. Further investigation is required to determine which one of the products is the best