Influence of Conventional Immunotherapy with D.f and D.p on Eosinophil, Specific IgE, Skin Test Reactivity, and Airway Hyperreactivity in House Dust Mite Sensitive Asthmatic Children

Kim, Bong Seong; Kim, Ja hyung; Lee, So Yeon; Hong, Soo Jong

Abstract

PURPOSE
Immunotherapy (IT) with house dust mite may be effective to treat house dust mite allergic disease, but the mechanism and prognostic index of IT are not completely understood. Generally allergen specific-IgE antibody significantly initially increases, then gradually declines, but there is no consistent data about the changes of allergen-specific IgE. Also there is some controversies for skin test reactivity and bronchial hyperreactivity after IT. To understand the mechanism and find the prognostic index after conventional IT, we compared the clinical and laboratory parameters before and after IT between patients with IT and patients without IT. METHODS: The IT group included 24 patients with D.f and D.p-sensitized asthmatic children who had received conventional IT. The control group included 22 D.f and D.p-sensitized asthmatic children who had not received IT. The symptom scores of asthma, methacholine challenge test (PC20), skin reactivity to D.f and D.p (allergen/histamine ratio), total eosinophil counts, the changes of D.f- and D.p-specific IgE, were compared before, 4 and 9 month after IT in two groups. RESULTS: The symptom scores and the skin reactivity to D.p were decreased significantly 9 month after IT. The eosinophil count in peripheral blood was decreased 9 month after IT. But D.p-specific IgE level was not changed 9 month after IT in either two groups. The bronchial hyperreactivity was not changed 9 month after IT. CONCLUSION: These findings suggest that the changes of effector cells such as skin mast cell may be induced after the result of IT regardless of the changes of serum IgE and bronchial hyperreactivity.