Affiliation:
1. Department of Allergy, Tongji Hospital, Tongji Medical College Huazhong University of Science and Technology Wuhan China
2. Department of Allergology Zhongnan Hospital of Wuhan University Wuhan China
3. Institute of Allergy and Clinical Immunology, Tongji Hospital, Tongji Medical College Huazhong University of Science and Technology Wuhan China
4. Department of Hematology, Tongji Hospital, Tongji Medical College Huazhong University of Science and Technology Wuhan China
Abstract
AbstractBackgroundSubcutaneous immunotherapy (SCIT) can induce systemic reactions (SRs) in certain patients, but the underlying mechanisms remain to be fully elucidated.MethodsAR patients who were undergoing standardized HDM SCIT (Alutard, ALK) between 2018 and 2022 were screened. Those who experienced two consecutive SRs were included in the study group. A control group was established, matched 1:1 by gender, age, and disease duration with the study group, who did not experience SRs during SCIT. Clinical and immunological parameters were recorded and analyzed both before SCIT and after 1 year of treatment.ResultsA total of 161 patients were included, with 79 (49.07%) in the study group. The study group had a higher proportion of AR combined asthma (26.8% vs. 51.8%, p < 0.001) and higher levels of sIgE to HDM and HDM components (all p < .001). Serum IL‐4 and IL‐13 levels in the study group were higher than those in the control group (p < .05). The study group received a lower maintenance dosage of HDM extracts injections than control group due to SRs (50000SQ vs. 100000SQ, p < .05). After 1 year of SCIT, the VAS score, the lung function parameters of asthmatic patients over 14 years old significantly improved in both groups (all p < .05). After a 7‐day exposure to 20 μg/mL HDM extracts, the percentages of Th1, Th17, Tfh10, and Th17.1 in PBMCs decreased, while the Tfh13 cells significantly increased in the study group (p < .05).ConclusionThe type 2 inflammatory response is augmented in HDM‐induced AR patients who experienced SRs during SCIT. Despite this, SCIT remains effective in these patients when administered with low‐dosage allergen extracts.