Ann Dermatol.  2017 Feb;29(1):1-5. 10.5021/ad.2017.29.1.1.

Effectiveness of Specific Sublingual Immunotherapy in Korean Patients with Atopic Dermatitis

• You HS
• Yang MY
• Kim GW
• Cho HH
• Kim WJ
• Mun JH
• Song M
• Kim HS
• Ko HC
• Kim MB
• Kim BS

• KMID: 2368020
• DOI: http://doi.org/10.5021/ad.2017.29.1.1

Abstract

BACKGROUND
Sublingual immunotherapy (SLIT) with house dust mites (HDM) preparation has recently been proven to be beneficial for treating allergic rhinitis and asthma. However, there has been no report regarding the efficacy and safety of SLIT in Korean patients with atopic dermatitis (AD).
OBJECTIVE
We intended to investigate the efficacy and safety of SLIT in Korean patients with AD.
METHODS
A total of 34 patients with AD and immunoglobulin E (IgE)-proven HDM sensitization (Class ≥3) were recruited. Eczema area and severity index (EASI) score, total serum IgE level, specific IgE assays to Dermatophagoides pteronyssinus, D. farinae, and adverse effects were recorded during follow-up. "Responder" was defined as a patient with ≥30% improvement in EASI score after SLIT.
RESULTS
Twenty-three patients continued SLIT for 12 months or more, whereas 3 patients (8.8%) dropped out because of exacerbation of dermatitis, and 8 patients (23.5%) were lost to follow-up. The average duration of SLIT treatment was 22.4 months (range, 12~32 months). EASI scores reduced significantly after 6 months of treatment (p<0.05) compared with those at baseline. A total of 18 patients were determined to be responders to SLIT after 6 months. Total and specific IgE serum levels did not significantly reduce after SLIT. No patients experienced serious adverse events, with the exception of two patients who developed transient lip and tongue swelling.
CONCLUSION
Our study demonstrated that SLIT with HDM extracts is effective and tolerable in Korean patients with AD. Further controlled long-term trials are required to reinforce the current results.

Keyword

Atopic dermatitis; House dust mites; Sublingual immunotherapy

MeSH Terms

Asthma
Dermatitis
Dermatitis, Atopic*
Dermatophagoides pteronyssinus
Eczema
Follow-Up Studies
Humans
Immunoglobulin E
Immunoglobulins
Lip
Lost to Follow-Up
Pyroglyphidae
Rhinitis, Allergic
Sublingual Immunotherapy*
Tongue
Immunoglobulin E
Immunoglobulins

Figure

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  Fig. 1 Changes in eczema area and severity index (EASI) scores during sublingual immunotherapy (n=23). *Statistical analysis was performed using using Mann-Whitney test showing significant difference (p<0.05).

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  Fig. 2 Changes of the numbers of responders during sublingual immunotherapy (n=23).

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  Fig. 3 Changes of total immunoglobulin E (IgE) serum levels during sublingual immunotherapy (SLIT) (n=23). *Statistical analysis was performed using Mann-Whitney test.

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  Fig. 4 Changes of specific anti-house dust mite immunoglobulin E serum levels during sublingual immunotherapy (SLIT) (n=23). *Statistical analysis was performed using Mann-Whitney test. DP: Dermatophagoides pteronyssinus, DF: D. farinae.

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  Fig. 5 Changes of specific anti-house dust mite immunoglobulin E serum levels during sublingual immunotherapy. *The differences of reduction in eczema area and severity index (EASI) score between monosensitized and polysensitized group was analyzed statistically by using Mann-Whitney test. Mono-sensitized patients: sensitized to only Dermatophagoides pteronyssinus and D. farinae. Poly-sensitized patients: simultaneously sensitized to house dust mite and other allergens proven by multiple allergen simultaneous test (Grade ≥3).

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