Effect of immunotherapy on asthma progression, BHR and sputum eosinophils in allergic rhinitis
Article first published online: 2 SEP 2004
Volume 59, Issue 11, pages 1224–1228, November 2004
How to Cite
Polosa, R., Li Gotti, F., Mangano, G., Paolino, G., Mastruzzo, C., Vancheri, C., Lisitano, N. and Crimi, N. (2004), Effect of immunotherapy on asthma progression, BHR and sputum eosinophils in allergic rhinitis. Allergy, 59: 1224–1228. doi: 10.1111/j.1398-9995.2004.00537.x
- Issue published online: 2 SEP 2004
- Article first published online: 2 SEP 2004
- Accepted for publication 28 January 2004
- bronchial hyperresponsiveness;
- induced sputum;
- Parietaria allergy;
- seasonal allergic rhinitis;
- specific immunotherapy
Background: Bronchial hyperresponsiveness (BHR) and airway inflammation are frequently associated with allergic rhinitis, and may be important risk factors for the development of asthma. Specific immunotherapy (SIT) reduces symptom in subjects with allergic rhinitis, but the mechanisms are not clear.
Aims of the study: To assess the effect of Parietaria-SIT on asthma progression, rhinitic symptoms, BHR, and eosinophilic inflammation.
Methods: Nonasthmatic subjects with seasonal rhinitis were randomly assigned to receive Parietaria pollen vaccine (n = 15) or matched placebo (n = 15). Data on symptoms and medication score, BHR to methacholine, eosinophilia in sputum were collected throughout the 3-year study.
Results: By the end of the study, in the placebo group, symptoms and medication scores significantly increased by a median (interquartile range) of 121% (15–280) and 263% (0–4400) respectively (P < 0.01), whereas no significant difference was observed in the SIT group. We found no significant changes in sputum eosinophils and BHR to methacholine in both groups throughout the study. Nine of 29 participants developed asthma symptoms during the study; of these, only two subjects (14%) in the SIT-treated group (P = 0.056).
Conclusions: Parietaria-SIT reduces symptom and rescue medication scores, but no changes in BHR to methacholine or sputum eosinophilia were observed. Moreover, Parietaria-SIT appears to prevent the natural progression of allergic rhinitis to asthma, suggesting that SIT should be considered earlier in the management of subjects with allergic rhinitis.