A pre-seasonal birch/hazel sublingual immunotherapy can improve the outcome of grass pollen injective treatment in bisensitized individuals. A case-referent, two-year controlled study

• Published in: Allergologia et immunopathologia Vol. 31; no. 1; p. 31
• Main Authors: Cirla, A M, Cirla, P E, Parmiani, S, Pecora, S
• Format: Journal Article
• Language: English
• Published: Spain 01.01.2003
• Subjects: Administration, Sublingual; Adolescent; Adult; Allergens - administration & dosage; Allergens - therapeutic use; Anti-Allergic Agents - therapeutic use; Anti-Asthmatic Agents - therapeutic use; Antibody Specificity; Asthma - drug therapy; Asthma - etiology; Asthma - immunology; Asthma - prevention & control; Betula; Bronchial Hyperreactivity - etiology; Bronchial Hyperreactivity - immunology; Bronchial Provocation Tests; Combined Modality Therapy; Conjunctivitis, Allergic - drug therapy; Conjunctivitis, Allergic - etiology; Conjunctivitis, Allergic - immunology; Conjunctivitis, Allergic - prevention & control; Corylus; Cough; Desensitization, Immunologic; Drug Administration Schedule; Drug Utilization; Female; Humans; Immunoglobulin E - blood; Immunoglobulin E - immunology; Immunoglobulin G - blood; Immunoglobulin G - immunology; Injections, Subcutaneous; Italy; Male; Methacholine Chloride; Nasal Provocation Tests; Poaceae; Pollen - adverse effects; Pollen - immunology; Rhinitis, Allergic, Seasonal - drug therapy; Rhinitis, Allergic, Seasonal - etiology; Rhinitis, Allergic, Seasonal - immunology; Rhinitis, Allergic, Seasonal - prevention & control; Seasons; Treatment Outcome; Italy
• ISSN: 0301-0546; 1578-1267
• DOI: 10.1157/13042841

The study tests the hypothesis of a reduction of priming due to tree allergy in patients sensitised to both birch/hazel and grass pollen undergoing an associated preseasonal Sublingual/Injective immunotherapy. 36 out of 49 bisensitized candidates were pair-matched into 18 case-referent couples. During two years all patients were administered preseasonal grass-SIT and one patient in each couple received also birch/hazel-SLIT. Diary cards were fulfilled for three consecutive grass pollen seasons. Specific Nasal Provocation Test (NPT) for grass and aspecific bronchial challenge were done; sera were analyzed for specific IgE and IgG. During the peak of the grass pollen season both groups showed a significant improvement in total symptom-score. Conjunctivitis and cough improved significantly more in patients with associated therapies. While antihistamine score decreased significantly in both groups, antiasthmatics did only in the SLIT-SIT group. The follow-up documented a significant increase in grass- and birch-specific IgG and a decrease in grass-specific IgE. Grass-NPT threshold was clearly higher in SLIT-SIT-group (p = 0.01) and only in this group PD20 methacholine improved significantly (p < 0.05). Combined birch/hazel-SLIT and grass-SIT are safe and improve clinical outcomes of SIT alone in young bisensitized patients. Priming reduction is supported by specific NPT and bronchial hyperresponsiveness.