Clinical Evaluation for Sublingual Immunotherapy With Dermatophagoides farinae in Polysensitized Allergic Asthma Patients

Ai-Zhi Zhang; Mei-E Liang; Xiao-Xue Chen; Yan-Fen Wang; Ke Ma; Zhi Lin; Kuan-Kuan Xue; Li-Ru Cao; Rong Yang; Huan-Ping Zhang

doi:10.3389/fmed.2021.645356

Clinical Evaluation for Sublingual Immunotherapy With Dermatophagoides farinae in Polysensitized Allergic Asthma Patients

Front Med (Lausanne). 2021 Aug 5:8:645356. doi: 10.3389/fmed.2021.645356. eCollection 2021.

Authors

Ai-Zhi Zhang¹, Mei-E Liang², Xiao-Xue Chen², Yan-Fen Wang², Ke Ma², Zhi Lin³, Kuan-Kuan Xue⁴, Li-Ru Cao⁴, Rong Yang⁴, Huan-Ping Zhang²

Affiliations

¹ Department of Pulmonary and Critical Care Medicine, Second Hospital Affiliated to Shanxi Medical University, Taiyuan, China.
² Department of Allergy Medicine, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Third Hospital of Shanxi Medical University, Taiyuan, China.
³ Department of Pulmonary and Critical Care Medicine, First Hospital Affiliated to Shanxi Medical University, Taiyuan, China.
⁴ Department of Internal Medicine, Shanxi Medical University, Taiyuan, China.

Abstract

Background: Many studies have demonstrated the efficacy of single-allergen sublingual immunotherapy (SLIT) in polysensitized patients with allergic rhinitis (AR), but less is reported in polysensitized patients with allergic asthma (AS). Method: Data of 133 adult patients with house dust mite (HDM)-induced AS who had been treated for 3 years were collected. These patients were divided into the control group (treated with low to moderate dose of inhaled glucocorticoids and long-acting β2 agonists, n = 37) and the SLIT group (further treated with Dermatophagoides farinae drops, n = 96). The SLIT group contained three subgroups: the single-allergen group (only sensitized to HDM, n = 35), the 1- to 2-allergen group (HDM combined with one to two other allergens, n = 32), and the 3-or-more-allergen group (HDM combined with three or more other allergens, n = 29). The total asthma symptom score (TASS), total asthma medicine score (TAMS), and asthma control test (ACT) were assessed before treatment and at yearly visits. Forced expiratory volume in 1 s/forced vital capacity (FEV1/FVC) was assessed before treatment and at the end of SLIT. Results: TASS and ACT scores in the control group were significantly higher than that in the single-allergen group and the 1- to 2-allergen group after 1, 2, and 3 years of SLIT and significantly higher than that in the 3-or-more-allergen group after 3-year SLIT (all p < 0.05). TAMS of the control group was significantly higher than that of the other three groups after 0.5, 1, 2, and 3 years of SLIT (all p < 0.05). FEV1/FVC in the control group was significantly higher than baseline after 3 years of immunotherapy (p < 0.05). Conclusion: Patients sensitized to HDM with/without other allergens showed similar efficacy after 3 years of SLIT. However, the initial response of patients with three or more allergens was slower during immunotherapy process.

Keywords: allergic asthma; efficacy; monosensitization; polysensitization; sublingual immunotherapy.