Modulation of mucosal/systemic antibody response after sublingual immunotherapy in mite-allergic children

Authors

  • Meimei G. J. Queirós,

    1. Laboratory of Allergy and Clinical Immunology, Institute of Biomedical Sciences, Federal University of Uberlandia, Uberlandia, Brazil
    2. Public Health System, Itumbiara, Brazil
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  • Deise A. O. Silva,

    1. Laboratory of Allergy and Clinical Immunology, Institute of Biomedical Sciences, Federal University of Uberlandia, Uberlandia, Brazil
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  • Isabella L. Siman,

    1. Laboratory of Allergy and Clinical Immunology, Institute of Biomedical Sciences, Federal University of Uberlandia, Uberlandia, Brazil
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  • Leandro H. Ynoue,

    1. Laboratory of Allergy and Clinical Immunology, Institute of Biomedical Sciences, Federal University of Uberlandia, Uberlandia, Brazil
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  • Núbia S. Araújo,

    1. Laboratory of Allergy and Clinical Immunology, Institute of Biomedical Sciences, Federal University of Uberlandia, Uberlandia, Brazil
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  • Fernando L. Pereira,

    1. Laboratory of Allergy and Clinical Immunology, Institute of Biomedical Sciences, Federal University of Uberlandia, Uberlandia, Brazil
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  • Karine C. Almeida,

    1. Laboratory of Allergy and Clinical Immunology, Institute of Biomedical Sciences, Federal University of Uberlandia, Uberlandia, Brazil
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  • Juliana S. Miranda,

    1. Laboratory of Allergy and Clinical Immunology, Institute of Biomedical Sciences, Federal University of Uberlandia, Uberlandia, Brazil
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  • Janethe D. O. Pena,

    1. Department of Global Clinical Development, Novartis Laboratories, Hanover, NJ, USA
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  • Jair P. Cunha-Junior,

    1. Laboratory of Allergy and Clinical Immunology, Institute of Biomedical Sciences, Federal University of Uberlandia, Uberlandia, Brazil
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  • Ernesto A. Taketomi

    Corresponding author
    1. Laboratory of Allergy and Clinical Immunology, Institute of Biomedical Sciences, Federal University of Uberlandia, Uberlandia, Brazil
    • Correspondence

      Ernesto A. Taketomi, Laboratório de Alergia e Imunologia Clínica, Instituto de Ciências Biomédicas, Universidade Federal de Uberlândia, Av. Pará 1720, Campus Umuarama, Uberlândia 38400-902, Brazil

      Tel.: +55 34 3218-2394

      Fax: +55 34 3232-8620

      E-mail: etaketomi@gmail.com

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Abstract

Background

There have been no data on sublingual immunotherapy (SLIT) in Brazilian patients sensitized to house dust mites. This study aimed to evaluate the mucosal/systemic antibody response changes and clinical efficacy after SLIT using Dermatophagoides pteronyssinus (Dpt) allergens with or without bacterial extracts in mite-allergic Brazilian children.

Methods

Patients with allergic rhinitis and asthma were selected for a double-blind, placebo-controlled trial randomized to three groups: DPT (Dpt extract, n = 34), DPT+MRB (Dpt plus mixed respiratory bacterial extracts, n = 36), and Placebo (n = 32). Total symptom and medication scores for rhinitis/asthma, skin prick test (SPT) to Dpt, and measurements of Dpt-, Der p 1-, Der p 2-specific serum IgE, IgG4, IgG1, and specific salivary IgA were evaluated at baseline and after 12 and 18 months of treatment.

Results

A significant long-term decline in total symptom/medication scores was observed only in active groups (DTP and DPT+MRB). There was no significant change in SPT results in all groups. SLIT using Dpt allergen alone induced increased levels of serum IgG4 to Dpt, Der p 1, and Der p 2, serum IgG1 and salivary IgA to Dpt and Der p 1. SLIT with Dpt plus bacterial extracts was able to decrease IgE levels, particularly to Der p 2, to increase salivary IgA levels to Der p 1, but had no changes on specific IgG4 and IgG1 levels.

Conclusions

All children undergoing SLIT showed clinical improvement, but a long-term reduction in symptom/medication scores with modulation of mucosal/systemic antibody responses were seen only in active groups (DPT and DPT+MRB).

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