Agnieszka Bogacz-Piaseczyńska, Andrzej Bożek, Maciej Pastuszczak, Jolanta Zalejska-Fiolka
{"title":"过敏原抗体IgE的分子谱分析可能决定过敏原免疫治疗对特应性皮炎和屋尘螨过敏患者的疗效。","authors":"Agnieszka Bogacz-Piaseczyńska, Andrzej Bożek, Maciej Pastuszczak, Jolanta Zalejska-Fiolka","doi":"10.5114/ada.2023.129456","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>Allergen immunotherapy (AIT) has no clear recommendation for atopic dermatitis (AD).</p><p><strong>Aim: </strong>To evaluate the effect of AIT on house dust mites (HDM) in AD patients sensitised to HDM with different baseline molecular profiles of antigens.</p><p><strong>Material and methods: </strong>In this placebo-controlled study, 61 patients with moderate-to-severe AD allergy symptoms and HDM allergy were included. They received a 12 months' AIT with the use of HDM allergen extract or placebo. The authors adopted their AD improvement criterion after 1 year of AIT as a reduction of all examined indicators by at least 50% from the baseline for %BSA, TMS, and EASI scores. Additionally, the influence of individual HDM molecules on the final AIT effect was analysed.</p><p><strong>Results: </strong>Finally, from the 24 desensitised patients, 15 achieved a positive expected effect after 12 months of HDM AIT. None of the patients who received a placebo had an improvement in AD of at least 50% after 1 year of follow-up. Patients with polysensitisation less frequently achieved the expected HDM AIT effect than patients monosensitised to mites (<i>p</i> < 0.05). The presence of sensitisation to rDer p 1 (odds ratio = 4.35, 95% CI: 4.01-4.56) and/or rDer p 2 (OR = 2.16, 95% CI: 1.98-2.33) and/or rDer f 2 (OR = 1.41, 95% CI: 1.55-1.78) molecules significantly increased the efficacy of AIT. HDM AIT could be helpful for patients with moderate-to-severe AD and sensitised to HDM as an add-on therapy. Various HDM molecules may affect the effectiveness of the expected AIT effect. The presence of sensitisation to rDer p 1 (OR = 4.35, 95% CI: 4.01-4.56) and/or rDer p 2 (OR = 2.16, 95% CI: 1.98-2.33) and/or rDer f 2 (OR = 1.41, 95% CI: 1.55-1.78) molecules significantly increased the efficacy of AIT.</p><p><strong>Conclusions: </strong>HDM AIT could be helpful for patients with moderate-to-severe AD and sensitised to HDM as an add-on therapy. Various HDM molecules may affect the effectiveness of the expected AIT.</p>","PeriodicalId":54595,"journal":{"name":"Postepy Dermatologii I Alergologii","volume":null,"pages":null},"PeriodicalIF":1.4000,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/b6/8d/PDIA-40-51077.PMC10485758.pdf","citationCount":"0","resultStr":"{\"title\":\"Molecular profiling of allergen-antibody IgE might decide about the efficacy of allergen immunotherapy in a patient with atopic dermatitis and allergy to house dust mites.\",\"authors\":\"Agnieszka Bogacz-Piaseczyńska, Andrzej Bożek, Maciej Pastuszczak, Jolanta Zalejska-Fiolka\",\"doi\":\"10.5114/ada.2023.129456\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Introduction: </strong>Allergen immunotherapy (AIT) has no clear recommendation for atopic dermatitis (AD).</p><p><strong>Aim: </strong>To evaluate the effect of AIT on house dust mites (HDM) in AD patients sensitised to HDM with different baseline molecular profiles of antigens.</p><p><strong>Material and methods: </strong>In this placebo-controlled study, 61 patients with moderate-to-severe AD allergy symptoms and HDM allergy were included. They received a 12 months' AIT with the use of HDM allergen extract or placebo. The authors adopted their AD improvement criterion after 1 year of AIT as a reduction of all examined indicators by at least 50% from the baseline for %BSA, TMS, and EASI scores. Additionally, the influence of individual HDM molecules on the final AIT effect was analysed.</p><p><strong>Results: </strong>Finally, from the 24 desensitised patients, 15 achieved a positive expected effect after 12 months of HDM AIT. None of the patients who received a placebo had an improvement in AD of at least 50% after 1 year of follow-up. Patients with polysensitisation less frequently achieved the expected HDM AIT effect than patients monosensitised to mites (<i>p</i> < 0.05). The presence of sensitisation to rDer p 1 (odds ratio = 4.35, 95% CI: 4.01-4.56) and/or rDer p 2 (OR = 2.16, 95% CI: 1.98-2.33) and/or rDer f 2 (OR = 1.41, 95% CI: 1.55-1.78) molecules significantly increased the efficacy of AIT. HDM AIT could be helpful for patients with moderate-to-severe AD and sensitised to HDM as an add-on therapy. Various HDM molecules may affect the effectiveness of the expected AIT effect. The presence of sensitisation to rDer p 1 (OR = 4.35, 95% CI: 4.01-4.56) and/or rDer p 2 (OR = 2.16, 95% CI: 1.98-2.33) and/or rDer f 2 (OR = 1.41, 95% CI: 1.55-1.78) molecules significantly increased the efficacy of AIT.</p><p><strong>Conclusions: </strong>HDM AIT could be helpful for patients with moderate-to-severe AD and sensitised to HDM as an add-on therapy. Various HDM molecules may affect the effectiveness of the expected AIT.</p>\",\"PeriodicalId\":54595,\"journal\":{\"name\":\"Postepy Dermatologii I Alergologii\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":1.4000,\"publicationDate\":\"2023-08-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/b6/8d/PDIA-40-51077.PMC10485758.pdf\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Postepy Dermatologii I Alergologii\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.5114/ada.2023.129456\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"ALLERGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Postepy Dermatologii I Alergologii","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.5114/ada.2023.129456","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"ALLERGY","Score":null,"Total":0}
Molecular profiling of allergen-antibody IgE might decide about the efficacy of allergen immunotherapy in a patient with atopic dermatitis and allergy to house dust mites.
Introduction: Allergen immunotherapy (AIT) has no clear recommendation for atopic dermatitis (AD).
Aim: To evaluate the effect of AIT on house dust mites (HDM) in AD patients sensitised to HDM with different baseline molecular profiles of antigens.
Material and methods: In this placebo-controlled study, 61 patients with moderate-to-severe AD allergy symptoms and HDM allergy were included. They received a 12 months' AIT with the use of HDM allergen extract or placebo. The authors adopted their AD improvement criterion after 1 year of AIT as a reduction of all examined indicators by at least 50% from the baseline for %BSA, TMS, and EASI scores. Additionally, the influence of individual HDM molecules on the final AIT effect was analysed.
Results: Finally, from the 24 desensitised patients, 15 achieved a positive expected effect after 12 months of HDM AIT. None of the patients who received a placebo had an improvement in AD of at least 50% after 1 year of follow-up. Patients with polysensitisation less frequently achieved the expected HDM AIT effect than patients monosensitised to mites (p < 0.05). The presence of sensitisation to rDer p 1 (odds ratio = 4.35, 95% CI: 4.01-4.56) and/or rDer p 2 (OR = 2.16, 95% CI: 1.98-2.33) and/or rDer f 2 (OR = 1.41, 95% CI: 1.55-1.78) molecules significantly increased the efficacy of AIT. HDM AIT could be helpful for patients with moderate-to-severe AD and sensitised to HDM as an add-on therapy. Various HDM molecules may affect the effectiveness of the expected AIT effect. The presence of sensitisation to rDer p 1 (OR = 4.35, 95% CI: 4.01-4.56) and/or rDer p 2 (OR = 2.16, 95% CI: 1.98-2.33) and/or rDer f 2 (OR = 1.41, 95% CI: 1.55-1.78) molecules significantly increased the efficacy of AIT.
Conclusions: HDM AIT could be helpful for patients with moderate-to-severe AD and sensitised to HDM as an add-on therapy. Various HDM molecules may affect the effectiveness of the expected AIT.