SPECIFIC IMMUNOTHERAPY WITH DERMATOPHAGOIDES-PTERONYSSINUS AND DERMATOPHAGOIDES-FARINAE RESULTS IN DECREASED BRONCHIAL HYPERREACTIVITY

To evaluate the tolerability and efficacy of specific immunotherapy wi th mite extracts, we performed a double-blind, placebo-controlled immu notherapy study in 30 patients with proven allergy to mite allergens. The specific immunotherapy with standardized extracts of Dermatophagoi des pteronyssinus and D. farinae by a clustered rush protocol was well tolerated. After 1 year of treatment, the actively treated group show ed a significant improvement compared to their starting value as well as to the placebo-treated patients with regard to skin prick test, con junctival provocation test, and subjective rhinitis score. The subject ive asthma score and bronchial hyperreactivity, measured by the methac holine provocation test, was improved in comparison to the starting va lue, but not to the placebo group, after 12 months. However, a further , open comparison of the placebo- and verum-treated groups at 18 month s revealed a significant reduction. The drug intake was not increased in the verum-treated group. Exposure to mite levels was constant throu ghout this time period, as revealed by antigen measurement. We conclud e that specific immunotherapy in perennial, miteallergen-induced asthm a may reduce not only immediate, IgE-mediated symptoms but, after a ra ther long time period of 12-18 months, also the inflammatory component of bronchial asthma, thus leading to a reduction of unspecific hyperr eactivity.