The Effect of Injection Immunotherapy on Mucociliary Clearance in Allergic Patients

Abstract

OBJECTIVE: To assess the effect of injection immunotherapy on mucociliary clearance in allergic patients with the use of the saccharin test. METHODS: In this prospective cohort study, mucociliary clearance in 42 allergic patients treated with injection immunotherapy was determined with the saccharin test. Of these patients, 23 were retested 1 year later to assess changes in mucociliary clearance times. Mean results for historical controls were determined in a review and meta-analysis of the existing literature. RESULTS: Saccharin clearance times (SCTs) were initially prolonged in allergic patients who received injection immunotherapy when compared to historical controls (one-sided P value < 0.05). However, after 1 year of immunotherapy, there was a significant reduction in SCTs in our patient population. This finding was independent of other evaluated patient characteristics, with the exception of nasal steroid use, which was also significantly associated with a decrease in SCT. CONCLUSIONS: After 1 year of injection immunotherapy, there was a significant reduction in mean SCT in our patient population. Of the other factors studied, only nasal steroid was associated with decreased mucociliary clearance times. To our knowledge, this is the first report in the literature documenting the beneficial effect of injection immunotherapy on mucociliary clearance as measured by saccharin clearance times. Nevertheless, further research is warranted, given the confounding effect of nasal steroid use.