Serum-specific IgE and Allergen Immunotherapy in Allergic Children

Mariangela Tosca; Michela Sivestri; Andrea Accogli; Giovanni Arturo Rossi; Giorgio Ciprandi

Disclosures

Immunotherapy. 2014;6(1):29-33. 

In This Article

Results

All children with high sIgE levels (with the exception of one), perceived an improvement of allergic symptom severity and a reduction of drug use after AIT (Figure 1). The only child who did not perceive AIT benefit, reported severe recurrent respiratory infections (i.e., pneumonia and bronchitis); this condition could have affected the perception of a real AIT efficacy. On the other hand, only one child in the group with low sIgE levels perceived AIT efficacy, even though the VAS value was 6 and ACT score did not substantially change (from 22 to 23).

Figure 1.

Relationship between serum-specific IgE to house dust mites and perception of allergen immunotherapy efficacy assessed by visual analog scale in patients with serum-specific IgE ≥10 kU/l (white circles) and with serum-specific IgE <0 kU/l (black circles).
AIT: Allergen immunotherapy; sIgE: Specific IgE; VAS: Visual analog scale.

VAS of perceived AIT efficacy was significantly associated with sIgE levels (p < 0.001); a VAS value ≥6 was detectable in 94.7% of subjects with high sIgE and in 13% of children with low sIgE.

A strong and significant relationship (r = 0.615; p < 0.001) between sIgE levels and VAS score was demonstrated as reported in Figure 1.

VAS for assessing nasal symptoms significantly (p < 0.001) diminished in children with high sIgE levels (Figure 2). At baseline, median VAS was 7 (25–75th quartiles; between 6 and 9); at the end of SLIT treatment was 3 (25–75th quartiles; between 3 and 4). Also, ACT score significantly (p < 0.001) increased in children with high sIgE levels (Figure 2). The median ACT score was 15 (25–75th quartiles; between 13.5 and 16) at baseline, whereas it was 22 (25–75th quartiles; between 21 and 24) after SLIT treatment.

Figure 2.

Nasal symptom severity assessed by visual analog scale and asthma control measured by asthma control test before and after allergen immunotherapy in patients with serum-specific IgE ≥10 kU/l.
ACT: Asthma control test; AIT: Allergen immunotherapy; VAS: Visual analog scale.

On the contrary, VAS for assessing nasal symptoms did not significantly change (p = not significant) in children with low sIgE levels (Figure 3). At baseline, median VAS was 6 (25–75th quartiles; between 5.5 and 8); at the end of SLIT treatment was 5.5 (25–75th quartiles; between 4.5 and 7.5). Also, ACT score did not change (p = not significant) in children with low sIgE levels (Figure 3). The median ACT score was 18 (min: 16; max: 22) at baseline, whereas it was 19 (min: 17; max: 23) after SLIT treatment.

Figure 3.

Nasal symptom severity assessed by visual analog scale and asthma control measured by asthma control test before and after allergen immunotherapy in patients with serum-specific IgE <10 kU/l.
ACT: Asthma control test; AIT: Allergen immunotherapy; VAS: Visual analog scale.

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