The Effect Evaluation Of Subcutaneous Immunotherapy On Allergic Rhinitis And Serum SIgG4

Purpose:1.The study is to evaluated the long-term effect of subcutaneous immunotherapy on allergic rhinitis in patients,and observe safety and compliance, provide the scientific basis for AR patients SIT in treatment.2.The specific Ig G4 level of allergic rhinitis patients at pre-therapy and post-therapy were discussed,and explore whether s Ig G4 of disease diagnosis,treatment, therapeutic evaluation, prognosis of guiding significance.Method:1.Select at Jinan University Affiliated Hospital of Zhuhai ENT clinic AR 51 patients enrolled in this study, between June 2013 to December 2014 to accept up to a year off safety standardization of house dust mite allergen-specific original formulation immunotherapy. Before treatment,the 51 patients had to detect serum s Ig E antibodies and do the skin prick test.2.Recorded and compared patients’ signs and symptoms score, visual analogue scale(VAS) score before SIT, after the initial treatment and one year treatment.3.Curative effect evaluation:Signs and symptoms of pre-treatment total score minus the total score after treatment,and divide the result by the total score before treatment.4.Patients were followed up, recording their adverse reactions, analysis of patient compliance, record the reasons for interruption of treatment.5.Ig G4-Elisa test was used to detect serum s Ig G4 before SIT, after finished the initial treatment and one year treatment of AR patient. Analyze the correlation of s Ig G4 levels with patients’ signs and symptoms score,VAS score at different timepoints.Results:1.51 cases of patients completed the initial treatment of SIT,the total effective rate was 70.6%(36/51).Among 51 patients,the markedly effective rate was2.0%(1/51);the effective rate was 68.6%(35/51);the ineffective rate was29.4%(15/51).34 cases of patients completed the one year of SIT,the total effective rate was 94.1%(32/34).Among 34 patients,the markedly effective rate was17.6%(6/34);the effective rate was 76.5%(26/34);the ineffective rate was5.9%(2/34).2.After completing initial treatment,the signs and symptoms score,VAS score were reduced compared with before(P<0.05);The signs and symptoms score,VAS score of patients who insisted on specific immunotherapy for one year were lower than the patients who insisted for about half year and before the specific immunotherapy.There were statistically significant differences among the three(P<0.05).3.The rate of compliance among the 51 AR patients is 66.67%(34/51).The main reason for discontinuing treatment is lacking of confidence in treatment,and the ratio is 64.71%(11/17);the ratio of economic factors is 17.65%(3/17);the ratio of factors who going abroad to study or work factor ratio is 11.76%(2/17);the ratio of factors because of adverse reactions is 5.88%(1/11).4.51 patients received a total of 1166 times injection, local adverse reaction rate was 11.49%(134/1166);systemic adverse reaction rate was 1.81%(21/1166);no case of fatal adverse reactions in patients.5.Concentration of serum s Ig G4 shows an increase before treatment(135.22±85.63), after the initial treatment(309.38 ± 233.47) and at the time of one year(570.79 ± 331.55).twenty-two difference was statistically significant.There were statistically significant differences among the three(P<0.05).6.Concentration of serum s Ig G4 and the signs and symptoms score(R=-0.676,P<0.001;R=-0.875,P<0.001),VAS score(R=-0.544,P<0.05;R=-0.875,P<0.001) werenegative correlation relationship at the time after the initial treatment and one year treatment.Conlusions:1.The main inhaled allergens of AR patents’ are dust mites.2.SIT can effectively control and improve the symptoms of allergic rhinitis,runny nose, sneezing, nasal congestion, nasal itching and so on.The longer the treatment, the better curative effect.3.The longer SIT treatment time, the higher the concentration of serum s Ig G4,and nasal symptoms will be reduced accordingly.Serum s Ig G4 may be an important immunological parameters to assess SIT efficacy.This need our further research.4.The ALK(503) Dermatophagoides Pteronyssinus House dust mite standardized allergen vaccine treatment is an effective method to allergic rhinitis.As conventional methods of treating allergic rhinitis,it can adjust the patient’s immune function fundamentally and improve nasal symptoms.5.Improving patients compliance and completing the entire course of immunotherapy will improve patients’ efficacy.