Allergy Asthma Immunol Res.  2017 May;9(3):272-277. 10.4168/aair.2017.9.3.272.

A Pilot Study of Intralymphatic Immunotherapy for House Dust Mite, Cat, and Dog Allergies

• Lee SP
• Choi SJ
• Joe E
• Lee SM
• Lee MW
• Shim JW
• Kim YJ
• Kyung SY
• Park JW
• Jeong SH
• Jung JH

• KMID: 2371728
• DOI: http://doi.org/10.4168/aair.2017.9.3.272

Abstract

Several recent clinical trials reported that intralymphatic immunotherapy (ILIT) for some allergens, such as cat dander and pollen, induce tolerance more rapidly than conventional subcutaneous or sublingual immunotherapy, have a comparable duration of effect after only 3 injections, and do not provoke serious local or systemic reactions. However, the efficacy and safety of ILIT are using Dermatophagoides farinae (Df), Dermatophagoides pteronyssinus (Dp), and dog, which are indoor allergens that are commonly found globally, need to be evaluated. Furthermore, use of multiple allergens in ILIT should be investigated. We assessed the clinical efficacy and adverse effects of ILIT using aqueous Df, Dp, dog, and cat allergens or mixtures thereof in patients with allergic rhinitis. A total of 11 subjects with AR sensitized to Df, Dp, cat, and/or dog allergens received 3 intralymphatic inguinal injections of sensitized allergen extract (HollisterStier, New Orleans, LA, USA). Clinical parameters were assessed before ILIT, and 4 months and 1 year after the first injection. Rhinitis symptoms were alleviated and quality of life was improved 4 months after ILIT (P=0.012 and P=0.007, respectively), and these improvements lasted for 1 year after ILIT (P=0.047 and P=0.009, respectively). However, we observed 2 cases of anaphylaxis, one case of a moderate-to-severe systemic hypersensitivity reaction and the other case of a severe local reaction at the injection site after ILIT. In conclusion, ILIT can rapidly improve allergy symptoms and quality of life, and this effect lasts for 1 year. In hypersensitized patients, however, ILIT can provoke severe systemic and/or local hypersensitivity reactions when performed using aqueous allergen extracts.

Keyword

Allergen-specific immunotherapy; allergic rhinitis; intralymphatic immunotherapy

MeSH Terms

Allergens
Anaphylaxis
Animals
Cats
Dander
Dermatophagoides farinae
Dermatophagoides pteronyssinus
Dogs*
Dust*
Humans
Hypersensitivity*
Immunotherapy*
Pilot Projects*
Pollen
Pyroglyphidae*
Quality of Life
Rhinitis
Rhinitis, Allergic
Sublingual Immunotherapy
Treatment Outcome
Allergens
Dust

Figure

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  Figure Subject-reported rhinitis symptoms and quality of life. (A) Sinonasal Outcome Test-20 (SNOT-20) scores. (B) Rhinoconjunctivitis Quality of Life Questionnaire (RQLQ) scores.

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