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- Title
Augmented type 2 inflammatory response in allergic rhinitis patients experiencing systemic reactions to house dust mite subcutaneous immunotherapy.
- Authors
Ji, Ping; Yang, Lin; Zhu, Li; Hu, Lintao; Wang, Yin; Shi, Cancan; Jiang, Qing; Huang, Nan; Yang, Yaqi; Chen, Hao; Zhu, Rongfei
- Abstract
Background: Subcutaneous immunotherapy (SCIT) can induce systemic reactions (SRs) in certain patients, but the underlying mechanisms remain to be fully elucidated. Methods: AR patients who were undergoing standardized HDM SCIT (Alutard, ALK) between 2018 and 2022 were screened. Those who experienced two consecutive SRs were included in the study group. A control group was established, matched 1:1 by gender, age, and disease duration with the study group, who did not experience SRs during SCIT. Clinical and immunological parameters were recorded and analyzed both before SCIT and after 1 year of treatment. Results: A total of 161 patients were included, with 79 (49.07%) in the study group. The study group had a higher proportion of AR combined asthma (26.8% vs. 51.8%, p < 0.001) and higher levels of sIgE to HDM and HDM components (all p <.001). Serum IL‐4 and IL‐13 levels in the study group were higher than those in the control group (p <.05). The study group received a lower maintenance dosage of HDM extracts injections than control group due to SRs (50000SQ vs. 100000SQ, p <.05). After 1 year of SCIT, the VAS score, the lung function parameters of asthmatic patients over 14 years old significantly improved in both groups (all p <.05). After a 7‐day exposure to 20 μg/mL HDM extracts, the percentages of Th1, Th17, Tfh10, and Th17.1 in PBMCs decreased, while the Tfh13 cells significantly increased in the study group (p <.05). Conclusion: The type 2 inflammatory response is augmented in HDM‐induced AR patients who experienced SRs during SCIT. Despite this, SCIT remains effective in these patients when administered with low‐dosage allergen extracts.
- Subjects
HOUSE dust mites; ALLERGENIC extracts; ALLERGIC rhinitis; PATIENTS' attitudes; DISEASE duration
- Publication
Pediatric Allergy & Immunology, 2024, Vol 35, Issue 8, p1
- ISSN
0905-6157
- Publication type
Article
- DOI
10.1111/pai.14207