Asia Pac Allergy.  2017 Apr;7(2):82-91. 10.5415/apallergy.2017.7.2.82.

Changes in skin reactivity and associated factors in patients sensitized to house dust mites after 1 year of allergen-specific immunotherapy

• Son JY
• Jung MH
• Koh KW
• Park EK
• Heo JH
• Choi GS
• Kim HK

• KMID: 2396929
• DOI: http://doi.org/10.5415/apallergy.2017.7.2.82

Abstract

BACKGROUND
Allergen-specific immunotherapy (SIT) can significantly improve symptoms and reduce the need for symptomatic medication.
OBJECTIVE
The aim of this study was to investigate changes in skin reactivity to house dust mites (HDMs) as an immunologic response and associated factors after 1 year of immunotherapy.
METHODS
A total of 80 patients with allergic airway diseases who received subcutaneous SIT with HDMs from 2009 to 2014 were evaluated. The investigated parameters were basic demographic characteristics, skin reactivity and specific IgE for HDM, serum total IgE level, blood eosinophil counts, and medication score.
RESULTS
The mean levels of skin reactivity to HDMs, blood eosinophil counts, and medication scores after 1 year were significantly reduced from baseline. In univariate comparison of the changes in skin reactivity to HDMs, age ≤30 years, HDMs only as target of immunotherapy, and high initial skin reactivity (≥2) to HDMs were significantly associated with the reduction in skin test reactivity. In multivariate analysis, high initial skin reactivity and HDMs only as target allergens were significantly associated with changes in skin reactivity to HDMs. In the receiver operating characteristic curve of the initial mean skin reactivity to HDMs for more than 50% reduction, the optimal cutoff value was 2.14.
CONCLUSION
This study showed significant reductions in allergen skin reactivity to HDMs after 1 year of immunotherapy in patients sensitized to HDMs. The extent of initial allergen skin reactivity and only HDMs as target allergen were important predictive factors for changes in skin reactivity.

Keyword

Allergen immunotherapy; Skin reactivity; House dust mites

MeSH Terms

Allergens
Desensitization, Immunologic
Dust*
Eosinophils
Humans
Immunoglobulin E
Immunotherapy*
Multivariate Analysis
Pyroglyphidae*
ROC Curve
Skin Tests
Skin*
Allergens
Dust
Immunoglobulin E

Figure

• 

  Fig. 1 Changes of skin reactivity (A), serum specific IgE level (B), serum total IgE (C), serum specific IgE/total IgE (×100) (D), blood eosinophils (E), and medication score (mean number/day) (F) between baseline and after 1 year of therapy. HDM, house dust mites; Dp, Dermatophagoides pteronyssinus; Df, Dermatophagoides farinae.

• 

  Fig. 2 Receiver operating characteristic curves of initial mean skin reactivity to house dust mites for more than 50% reduction of skin reactivity. The area under the curve was 0.87 (95% confidence interval, 0.776–0.965, p < 0.001). With a cutoff value of 2.14, the sensitivity and specificity were 0.90 and 0.80, respectively.

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