Introduction:

Allergen immunotherapy (AIT) is the only causal treatment for allergic rhinitis (AR). However, how different patterns of allergen sensitization influence treatment outcomes is not well understood. This study evaluated the efficacy of subcutaneous immunotherapy (SCIT) with a native house dust mite (HDM) preparation in Chinese patients with AR, based on their HDM sensitization profiles.

Methods:

  • Study Design: Prospective, multicenter study across three allergy centers in China
  • Participants: 168 patients aged 5–65 years with a diagnosis of AR
  • Sensitization Profiling: Serum specific IgE (sIgE) testing against 9 HDM components:
  • Major allergens: Der p 1, Der p 2, Der p 23, Der f 1, Der f 2
  • Intermediate/minor allergens: Der p 5, Der p 7, Der p 10, Der p 21
  • Grouping:
    • Group A: Sensitized only to major allergens
    • Group B: Sensitized to intermediate/minor components and/or major allergens
  • Treatment: All patients received SCIT for 1 year using native HDM extract (Allergopharma, Germany)
  • Assessment:
    • Efficacy: Combined Symptom and Medication Scores (CSMS)
    • Immunological Response: Serum sIgG4 levels pre- and post-treatment

Results:

Measure

Group A (n=75)

Group B (n=93)

CSMS reduction

–52.57% ± 24.14%

–61.50% ± 29.90%

sIgG4 increase (all allergens)

Significant rise

Significant rise

sIgG4 increase for Der p 21

Moderate

Significantly greater

  • Group B showed a significantly greater reduction in CSMS compared to Group A.
  • Both groups had a significant increase in sIgG4 levels against all nine HDM allergens.
  • The rise in sIgG4 to Der p 21 was significantly more pronounced in Group B, whereas responses to the other eight components were comparable between groups.

Conclusion:

Native HDM SCIT is effective in AR patients with different sensitization patterns. Greater clinical benefit was observed in those sensitized to multiple HDM components, particularly intermediate or minor allergens, supporting its use as a preferred AIT option for broader sensitization profiles.

European Academy of Allergy and Clinical Immunology 2025,13-16 June, Glasgow, United Kingdom.







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