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Original Article
 

Mite-Specific Immunotherapy Using Allergen and/or Bacterial Extracts in Atopic Patients in Brazil
 

M Guimarães Junqueira de Queirós,1,2 DA Oliveira Silva,1 R Alves,1 H Fukuhara Chiba,3 VB Soares de Amaral,2 KC de Almeida,1 LH Ynoue,1 R de Oliveira Resende,1 M Camargo Sopelete,1 G Rodrigues Silva Segundo,1 P Ferreira de Sousa Moreira,1 SJ Sung,4 EA Taketomi1

1 Laboratory of Allergy and Clinical Immunology, Biomedical Science Institute, Federal University of Uberlândia, Uberlândia, Minas Gerais, Brazil
2 Public Health System, Itumbiara, Goiás, Brazil
3 Laboratory of Clinical Analysis, Itumbiara, Goiás, Brazil
4 Division of Rheumatology and Immunology, Health Sciences Center, University of Virginia, Charlottesville, Virginia, USA

J Investig Allergol Clin Immunol 2008; Vol. 18(2): 84-92
 

 Abstract


Objective: This study aimed to evaluate the clinical effi cacy and antibody response changes after specific immunotherapy (SIT) using Dermatophagoides pteronyssinus (Dpt) allergens with or without bacterial extracts in Brazilian mite-atopic patients.

Methods: One-hundred patients with allergic rhinitis were selected for a randomized double-blind, placebo-controlled trial and distributed into 4 groups: Dpt (Dpt allergen extract), Dpt + MRB (Dpt allergen plus mixed respiratory bacterial extracts), MRB (MRB extract only) and placebo. Rhinitis symptom and medication scores; skin prick test (SPT) to Dpt extract; and serum immunoglobulin (Ig) E, IgG4, and IgG1 levels to Dpt, Der p 1, and Der p 2 allergens were evaluated before and after a year of treatment.

Results: After 1 year, the SPT response was reduced in the Dpt group (P = .03), whereas IgE levels to Der p 2 decreased only in the Dpt (P = .048) and Dpt + MRB (P = .005) groups. IgG4 and IgG1 levels to Dpt and Der p 1 increased in the Dpt group (P < .05), whereas in the Dpt + MRB group the IgG1 level only increased to Dpt (P = .001) and the IgG4 only increased to Der p 1 (P = .049). IgE levels to Dpt decreased only in the MRB (P= .005) and Dpt + MRB (P = .001) groups. Rhinitis symptom and medication scores fell in all groups, including the placebo group (P < .001).

Conclusions: SIT using Dpt extract alone was effective in reducing SPT response and IgE levels to Der p 2 allergen, while bacterial extracts induced decreases in IgE levels to whole Dpt extract. However, only groups receiving Dpt allergen had higher levels of IgG1 and IgG4 to Dpt and Der p 1 after a year of treatment.

Key words: Allergen-specific immunotherapy. Dermatophagoides pteronyssinus. Der p 1. Der p 2. Immunoglobulin (Ig) E antibody. IgG1 and IgG4 subclasses.