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Hyposensitization with Dermatophagoides pteronyssinus in house dust allergy: a controlled study of clinical and immunological effects


Professor J. Pepys, Department of Clinical Immunology, Cardiothoracic Institute, Brompton, London, S.W.3.


A double-blind statistically controlled study was carried out on ninety-six patients with Type I allergy to D. pteronyssinus and a history of perennial asthma and/or rhinitis. Forty-eight received injections of an extract of Dermatophagoides pteronyssinus and forty-eight controls received injections of carbol saline. Both groups were closely comparable in all respects. Ninety-one were available for assessment, forty-six controls, and forty-five treated.

The D. pteronyssinus treated group showed a statistically significant decrease in nasal sensitivity to the mite extract after treatment and recorded less asthma, less use of drugs and an increased clinical tolerance of household dust.

A significant rise in specific IgE to D. pteronyssinus was found in twenty-three out of forty (58%) of the treated compared with eight out of forty-one (20%) of the controls and a rise in total IgE in twenty out of forty (50%) of the treated compared with nine out of thirty-nine (23%) of the control group.

Specific IgG antibodies to D. pteronyssinus were found prior to treatment in twelve out of thirty-nine (30%) of controls and twelve out of forty (31%) of the treated group. There was a significant increase in the number of patients with specific IgG antibody after injections of D. pteronyssinus extract as compared with the controls. This increase was associated with clinical improvement which occurred mainly in subjects who showed a decrease, little change or an increase of less than 30% in specific IgE antibody. In those with an increase of more than 30% in specific IgE antibody there was no evidence of clinical improvement even if specific IgG was produced.

Diminished release of histamine from leucocytes was found after treatment in six out of ten treated compared with three out of eleven controls. There were, however, no differences between treatment and control groups in lymphocyte transformation and the liberation of leucocyte inhibitory agents.

Clinical improvement was significantly better in those treated patients who gave strong nasal and skin reactions before treatment than in those with weak nasal and skin reactivity, who were no different from the controls.

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