A pediatric randomized, controlled trial of German cockroach subcutaneous immunotherapy.
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История · было → стало
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Zoratti Edward, Wood Robert, Pomés Anna, Da Silva Antunes Ricardo, Altman Matthew C, Benson Basilin, Wheatley Lisa M, Cho Kate, Calatroni Agustin, Little Frederic F, Pongracic J, Makhija Melanie, Khurana Hershey Gurjit K, Sherenian Michael G, Rivera-Spoljaric Katherine, Stokes Jeffrey R, Gill Michelle A, Gruchalla Rebecca S, Chambliss Jeffrey, Liu Andrew H, Kattan Meyer, Busse Paula J, Bacharier Leonard B, Sheehan William, Kim Haejin, Glesner Jill, Gergen Peter J, Togias Alkis, Baucom Jessica L, Visness Cynthia M, Sette Alessandro, Busse William W, Jackson Daniel J, Inner-City Asthma and Childhood Asthma in Urban Settings Consortia
Аннотация
OBJECTIVES: We sought to determine whether nasal allergen challenge (NAC) responses to cockroach allergen would improve following 1 year of SCIT.
METHODS: Urban children with asthma, who were cockroach-sensitized and reactive on NAC, participated in a year-long randomized double-blind placebo-controlled SCIT trial using German cockroach extract. The primary endpoint was the change in mean Total Nasal Symptom Score (TNSS) during NAC after 12 months of SCIT. Changes in nasal transcriptomic responses during NAC, skin prick test wheal size, serum allergen-specific antibody production, and T-cell responses to cockroach allergen were assessed.
RESULTS: Changes in mean NAC TNSS did not differ between SCIT-assigned (n = 28) versus placebo-assigned (n = 29) participants (P = .63). Nasal transcriptomic responses correlated with TNSS, but a treatment effect was not observed. Cockroach serum-specific IgE decreased to a similar extent in both groups, while decreased cockroach skin prick test wheal size was greater among SCIT participants (P = .04). A 200-fold increase in cockroach serum-specific IgG4 was observed among subjects receiving SCIT (P < .001) but was unchanged in the placebo group. T-cell IL-4 responses following cockroach allergen stimulation decreased to a greater extent among SCIT versus placebo (P = .002), while no effect was observed for IL-10 or IFN-γ.
CONCLUSIONS: A year of SCIT failed to alter NAC TNSS and nasal transcriptome responses to cockroach allergen challenge despite systemic effects on allergen-specific skin tests, induction of serum-specific IgG4 serum production and down-modulation of allergen-stimulated T-cell responses.