THE COMBINED INFLUENCE OF IMMUNOTHERAPY AND MITE ALLERGEN REDUCTION ON BRONCHIAL HYPERRESPONSIVENESS IN MITE-SENSITIVE ASTHMATIC-CHILDREN

Encasings for mattresses, blankets and pillows in combination with mit e allergen reduction on the floor have proved effective in reducing br onchial hyperreactivity of mite-allergic children. We studied the effe ct of combining the use of encasings with specific immunotherapy in co mparison to the use of encasings alone (control group). Twenty mite-al lergic children (Skin Prick Test, PAST, mean age 10 years) with asthma and high domestic mite allergen exposure (>2 mu g Der p 1 + f1/g matt ress dust) were included in. our study. The concentration of these maj or allergens as well as specific and nonspecific bronchial hyperreacti vity (PC20 FEV1 histamine) were assessed before, 6 months after and 1 year after start of treatment. All children received elongated polytet rafluorethylene (ePTFE; Goretex/Intervent Allergy Bedding System) - en casings. A subgroup of eight children were treated additionally by spe cific immunotherapy with a partially purified mite extract (ALK Schera x) and a maximum dose of 100000 SQ-U Der p + f. Initially both groups were comparable with respect to the parameters assessed. In 80% of chi ldren, encasings reduced Der p 1 and Der f 1 concentrations on the mat tress to below 3% of the initial values (P < 0.01). The median reducti on was 99%. PC20 FEV1 histamine increased from 0.4 to 1.4 mg/dl (media n) in the combined group with immunotherapy and encasings (P < 0.05) a nd remained essentially unchanged in the control group. PC20 FEV1 Der p did not increase significantly in either group. Conclusion. Specific immunotherapy with allergen extracts is an effective adjunct to encas ings. Encasings, a key factor for reducing Der p 1 and Der f 1 on the mattress; should be used in combination with other avoidance measures (e.g. removal of carpets) in order to improve allergen-induced bronchi al hyperreactivity.