Eff icacy evaluation of specif ic immunotherapy with standardization allergen vaccine of dermatophagoides pteronyssinus

OBJECTIVE To explore the effectiv- eness and mechanisms of allergen specifi c immunoth- erapy (SIT) with standardization allergen vaccine of Dermatophagoides pteronyssinus (house dust mite) in the patients of allergic rhinitis combining with asthma. METHODS A total of 37 patients of allergic rhinitis combining with mild-moderate asthma were recruited into the study.The course of SIT was treated by standardization allergen vaccine for 3 years. Subcutaneous immunotherapy were performed depending on concentration and dosage (from initial 100 SQ-U 0.2ml/time/week to maintenance dosage 100 000 SQ-U1.0ml/time/6weeks).The levels of serum total IgE(tIgE), specific IgE(sIgE), IgG and Eosinophil cationic protein(ECP) were determined with Uni CAP system , and Eosinophil numbers were counted. The serum IL-4, IL-5, IFN-γ were detected by ELISA. The above-mentioned indices, lung function test, symptomatic score and skin test results were compared before and after treatment. RESULTS The elevatedlevels of serum tIgE, ECP and eosinophil counts in peripheral blood of the patients were significantly reduced compared to before SIT and the healthy control respectively(P0.01, and P0.01). The levels of IL-4 and IL-5 were decreased to normal, but IgG and IFN-γ were increased. Although the level of serum sIgE was decreased, no statistic differences were found after 3 years' treatment. 64.86 %of the patients were clinically cured, 35.14 %of them were effective; the lung function test and symptomatic score were achieved normal or improved signifi cantly. 62.12 % of patients were not treated by any medicine, skin test index were decreased in 78.4 % of them signifi cantly. There is no new sensitized symptoms developed after 3 years SIT. CONCLUSION SIT was able to improve the clinical symptoms and lung function,inhibit the recruitment of Eosinophil and increase the ability of immune tolerance. The balance between Th1 and Th2 was well regulated and was kept a long-stable clinical eff icacy in patients with allergic rhinitis and asthma.