Friday, 16 October 2015
Hall D1 Foyer (Floor 3) (Coex Convention Center)
Sang Min Lee, MD, PhD
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Division of Pulmonology and Allergy, Department of Internal Medicine, Gachon University Gil Medical Center, Incheon, South Korea
Background: Recently, several clinical trials reported that intralymphatic immunotherapy (ILIT) for some allergens including cat dander and birch or grass pollen induces tolerance faster than conventional subcutaneous immunotherapy with comparable duration of effect after only 3 injections, but without serious local or systemic reaction. However, the efficacy and safety of ILIT for various allergens in allergic rhinitis still remains to be investigated. We evaluated the efficacy and adverse effect of ILIT for house dust mite, cat, and dog allergy in patients with allergic rhinitis. Methods: A total of 9 subjects with allergic rhinitis sensitized to Dermatophagoides farinae, Dermatophagoides pteronyssinus, cat, and/or dog allergen were treated with 3 intralymphatic inguinal injections of causal allergen extract (HollisterStier, New Orleans, USA). Rhinoconjunctivitis quality of life questionnaire (RQLQ), sino-nasal outcome test 20 (SNOT-20), and rhinitis symptoms during exposure to causal allergen were evaluated before, 4 and 12 months after 1st injection of ILIT. Results: RQLQ and SNOT-20 were significantly improved 4 months after ILIT from 71.2 (range 50-105) and 34.3 (range 3-70) to 52.3 (range 37-89) and 22.7 (range 8-52), respectively (P < 0.05). Allergy symptom during exposure to causal allergen including rhinorrhea, sneezing, nasal obstruction, and itching sensation on eye, nose, and contacted skin were also significantly reduced (P < 0.05, respectively). In five subjects who visited hospital 12 months after 1st injection of ILIT, rhinorrhea, sneezing, and nasal obstruction during exposure to causal allergen remained to be alleviated also (P < 0.05). We observed two cases of anaphylaxis and one case of severe cutaneous erythema and edema at injection site after ILIT. Conclusions: ILIT can rapidly improve allergy symptoms in daily life, especially those provoked by allergen exposure, and this effect lasts for a year. However ILIT can also cause severe systemic or local hypersensitivity reaction. Acknowledgement: This work was supported by the Gachon University Gil Medical Center (Grant number: 2013-11). We thank to ThermoFisher Scientific Korea for support in measuring serum total and allergen-specific IgE/IgG4 (ImmunoCAP®). For providing allergen extracts which were used for NPT, we also appreciate Research Center for Standardization of Allergic Diseases (RCSAD) of Yonsei University supported by a grant from the Korea Healthcare Technology R&D Project, Ministry of Health, Welfare & Family Affairs, Republic of Korea (A092076).