Two year follow-up of clinical and inflammation parameters in children monosensitized to mites undergoing subcutaneous and sublingual immunotherapy

PubMedID: 24053706Background: Both SCIT (subcutaneous immunotherapy) and SLIT (sublingual immunotherapy) have clinical and immunologic efficacy in children with rhinitis and asthma but comparative studies are scarce. Objective: To investigate the clinical and immunological efficacy of mite-specific SLIT and SCIT in children with rhinitis and asthma. Method: Thirty children monosensitized to house dust mite were randomized to receive either active SCIT or SLIT or placebo for 1 yr in a double-blind double-dummy placebo controlled design (Yukselen A et al., Int Arch Allergy Immunol 2012; 157:288-298). Thereafter, the placebo group was randomized to receive SCIT or SLIT, and for 1 yr all patients received active treatment with SCIT or SLIT. Symptom scores, drug usage, titrated skin prick tests, nasal and bronchial allergen provocation doses, serum house dust mite-specific immunglobulin E, sIgG4, IL-10 and IFN- ? levels were evaluated. Results: The reduction of clinical scores with SLIT was more evident after 2 years of treatment in comparison to both the baseline and DBPC phase of the study. The change in titrated skin prick tests and nasal provocative doses was more prominent with both SCIT and SLIT at the end of the open phase. Although the increase in bronchial provocative doses was not significant at the end of the first year of treatment with SLIT, it reached a statistically significant difference after two years of treatment. Conclusion: The clinical efficacy of SLIT is more prominent at the end of the second year, although this improvement is observed from the first year of treatment with SCIT in mite-sensitive children

Astım ve/veya rinitli çocuklarda B. tropicalis ve D. pteronyssinus ile nazal ve bronşiyal provokasyon

Giriş: Ev tozu akarları bölgemizde en sık rastlanan inhalan allerjenlerdir. Bu çalışmada, persistan allerjik semptomları olan çocuklarda, Blomia tropicalis’e duyarlılık ve Dermatophagoides pteronyssinus ile arasındaki çapraz reaksiyon oranını araştırmayı amaçladık. Gereç ve Yöntem: Her iki akara olan duyarlılık, deri testi ve spesifik IgE düzeyleri ile değerlendirildi. Ayrıca, hem B. tropicalis hem de D. pteronyssinus’a duyarlı bulunan 38 hastaya her iki akar ile nazal ve bronşiyal provokasyonlar uygulandı. Bulgular: Persistan semptomları olan, astım ve/veya rinitli 165 çocuğa, D. pteronyssinus ve B. tropicalis ile deri testleri yapıldı ve spesifik IgE düzeyleri ölçüldü. Daha sonra, her iki akar ile toplam 46 nazal ve 30 bronşiyal provokasyon yapıldı. B. tropicalis’e duyarlılık, deri testleri ile %37.4, CAP ile %42.4 oranında saptandı. Yirmi üç hastaya D. pteronyssinus ile nazal provokasyon uygulandı ve tümü pozitif bulundu. B. tropicalis ile nazal provokasin 23 patients and all had positive results with D. pteronyssinus. 20 out of 23 (86.9%) patients had positive nasal challenges with B. tropicalis. Bronchial challenges were conducted in 15 patients and all of them had positive challenge with D. pteronyssinus except one. Twelve (80%) out of 15 patients had positive bronchial challenges with B. tropicalis. Conclusion: We found that the sensitization rate to B. tropicalis is not as high as D. pteronyssinus in our patients with persistent allergic symptoms. (Asthma Allergy Immunol 2011;9:20-28)Objective: House dust mites were found to be the most prevalent inhalant allergens in our region. We aimed to investigate the sensitization rate to Blomia tropicalis and to evaluate the cross-reactivity between Dermatophagoides pteronyssinus and B. tropicalis in children with persistent allergic symptoms. Materials and Methods: In order to determine the sensitization rate to these two mites, skin prick tests and specific IgE levels were used. Additionally, we performed nasal and bronchial challenges in a group of 38 patients who sensitized to both D. pteronyssinus and B. tropicalis. Results: Skin prick tests and specific IgE levels with D. pteronyssinus and B. tropicalis were performed in 165 children with asthma and/or rhinitis having persistent allergic symptoms. Then, a total of 46 nasal and 30 bronchial challenges were conducted with both mite species. The sensitization rate to B. tropicalis was found 37.4% using prick tests and 42.4% using CAP results. Nasal challenges were performe

The change of fungal spore concentrations with meteorologic factors in atmospher of Adana and the usage of protein extracts obtained from these atmospheric fungi in skin prick tests

Giriş: Hava kaynaklı mantar sporlarının konsantrasyonlarının belirlenmesi mevsimsel allerjik hastalıkların klinik tanısında ve izleminde yararlı olmaktadır. Bu çalışmada birinci amaç, 12 ay süresince, meteorolojik faktörlerin Adana atmosferindeki fungal spor konsantrasyonlarının değişimi üzerine etkilerini araştırmak; ikinci amaç ise, atmosferden elde edilen fungal hücre protein ekstrelerinin deri prik (delme) testlerinde kullanılabilirliğini test etmektir. Gereç ve Yöntem: 01 Ocak 2006-01 Ocak 2007 tarihleri arasında Adana atmosferinde bulunan fungal sporlar şehir merkezine yerleştirilen Burkard spor tutma aleti ile toplanmıştır. Cladosporium ve Alternaria spor konsantrasyonları günlük olarak sayılmıştır. Sıcaklık, yağış, rüzgar, göreli nem gibi meteorolojik faktörlerin spor konsantrasyonlarının değişimi üzerine etkileri incelenmiştir. Ayrıca, atmosferden izole edilmiş ve tür düzeyinde tanımlanmış Cladosporium herbarum, Cladosporium oxysporum, Alternaria alternata, Alternaria pluriseptata ve Alternaria tenuissima mantar türlerinden total hücre proteini ekstreleri hazırlanmış; bu ekstreler, 35 mantar allerjili birey ve 20 kişilik kontrol grubuna deri prik testinde uygulanarak sonuçlar, klinikte kullanılan standart fungal allerjenler ile kıyaslanmıştır. Bulgular: Çalışma dönemini içeren 12 aylık süreçte, Adana atmosferinde toplam 1.537.307 mantar sporu mikroskopta sayılmış, bunlardan 1.117.763 (%73)’ü Cladosporium, 419.544 (%27)’ü Alternaria olarak tanımlanmıştır. Cladosporium ve Alternaria spor sayısı mayıs ayında 314.477 Cladosporium ve 159.291 Alternaria ile maksimuma ulaşmıştır. Özellikle 15-25°C sıcaklık ve %60-70 civarı nem oranı olduğu zaman fungal spor sayısının arttığı görülmüştür. Bu çalışmada hazırlanan mantar ekstrelerinin deri testlerinde, kontrol grubunda hiçbir reaksiyona yol açmadığı, mantar-allerjik bireylerde ise, klinikte kullanılan standart mantar allerjenlerinkine çok benzer hiperemi ve endurasyon yanıtı oluşturdukları saptanmıştır. Sonuç: Adana atmosferinde fungal spor konsantrasyonları, allerjik eşik değerinin çok üzerinde olup, başta sıcaklık ve nem olmak üzere, birçok meteorolojik parametreden etkilenebilmektedir. Bunun yanı sıra, atmosferdeki mantarlardan elde edilen protein ekstrelerinin deri testlerinde kullanımı, standart fungal allerjenler ile kıyaslandığında başarılı bulunmuştur.Objective: The determination of airborne fungal spore concentrations can be useful in the diagnosis and follow-up of allergic diseases. The first aim was to investigate the effects of meteorologic factors on the changes of fungal spore concentrations atmosphere. The second aim was to test the usage of cell protein extracts which obtained from these atmospheric fungi in skin prick tests. Materials and Methods: The fungal spores were collected by means of a Burkard seven-day recording volumetric trap. Daily concentrations of Cladosporium and Alternaria spores have been recorded. The effects of the meteorological factors like temperature and relative humidity on the variation of spore concentrations have been investigated. Additionally, total cell protein extracts were prepared from fungi; these extracts were used in skin prick tests of 35 children with fungal allergy and 20 children as control group: the results were compared with standart fungal allergens. Results: During the study period, total 1.537.307 fungal spores were counted; 1.117.763 (73%) of them were defined as Cladosporium and 419.544 (%27) were Alternaria. The number of Cladosporium and Alternaria spores reached to maximum level at may with 314.477 of Cladosporium and 159.291 of Alternaria. The increase in number of fungal spores was detected especially in the presence of temperature between 15-25°C and in humidity of 60- 70%. The fungal extracts prepared in this study did not caused any reaction when applied in skin prick tests of the control group; in the fungal allergic children, the response of hyperemia and enduration was very similar to the those of the standart fungal allergens. Conclusion: The fungal spore concentrations in Adana were above the allergic threshold levels; and could be affected by various meteorologic factors. Additionally, when compared with the standart fungal allergens, the usage of protein extracts obtained from the atmospheric fungi in skin prick tests was found success full