Pre-seasonal immunotherapy is effective in both monosensitized and polysensitized patients with allergic rhinitis
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Authors Information
1Division of Immunology and Allergic Diseases, Department of Chest Diseases, Ankara University, School of Medicine, Ankara, Turkey
2Department of Biology, Hacettepe University, School of Medicine, Ankara, Turkey
3Department of Biostatistics, Ankara University, School of Medicine, Ankara, Turkey
4Faculty of Medicine, Istinye University, Ankara Liv Hospital, Immunology and Allergic Diseases, Turkey
History
Published: 22 April 2022
Accepted: 14 April 2022
Received: 11 March 2022
SUMMARY
Background. The effectiveness of pre-seasonal allergoid immunotherapy in polysensitized patients are not well-known. The aim of the present study was to compare the clinical efficacy and immunological changes of pre-seasonal allergoid immunotherapy in mono and polysensitized patients with grass pollen allergy. Methods. Fourty six patients with seasonal allergic rhinitis undergoing pre-seasonal grass pollen immunotherapy and 28 cases followed by conventional drug treatment were included. These groups were divided into monosensitized and polysensitized ones. All patients were followed between March-September with symptom-medication scores, and visual analogue scale (VAS). The quality of life was assessed using the Mini-RQLQ questionnaire. Phleum pratense (Phl p) specific IgE and IgG4 (UNI-CAP 100, Phadia) measurements were performed before and after 7 weeks of immunotherapy. Results. In the immunotherapy group, 15th weekly symptom-medication scores and VAS scores between May and August were found to be significantly lower than those in the control group (p < 0.05). Phl p specific IgE and IgG4 levels were significantly higher after immunotherapy compared to those before immunotherapy (p = 0.001). Furthermore, Phl p specific IgG4 levels after immunotherapy were also significantly higher than in the control group (p = 0.001). Improvements in activities-practical problems and non-nose/eye symptoms quality of life scores were significantly different between two groups (p < 0.05). There was no difference in terms of clinical and immunological parameters in mono- and polysensitized patients (p > 0.05). Conclusions. This study indicates that clinical improvement with pre-seasonal grass pollen immunotherapy is accompanied by important increase in specific IgG4 blocking antibodies. Furthermore, a single-allergen immunotherapy can lead to similar clinical efficacy and immunological changes in polysensitized as well as monosensitized patients with grass pollen allergy.
