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[Sublingual immunotherapy with cat epithelial extract. Personal experience].

A Sánchez Palacios1, F Schamann, J A García

  • 1Unidad de Alergología, Hospital Universitario Insular de Gran Canaria, Las Palmas de Gran Canaria.

Allergologia Et Immunopathologia
|July 14, 2001
PubMed
Summary

Sublingual immunotherapy using cat allergen extract (Fel d I) effectively treated allergic rhinitis and asthma in Canary Islands patients within one year. While IgE and skin tests showed no change, increased IgG4 correlated with symptom improvement, indicating good tolerance.

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Area of Science:

  • Allergy and Immunology
  • Immunotherapy
  • Environmental Allergens

Background:

  • Cat epithelium sensitization is prevalent in the Canary Islands, affecting 18.1% of cat owners with asthma.
  • Standard immunotherapy for house dust mite allergies is often ineffective due to co-sensitization to cat epithelium.
  • Perennial allergic rhinitis and bronchial asthma are common conditions exacerbated by environmental allergens like cat dander.

Purpose of the Study:

  • To assess the clinical efficacy of sublingual immunotherapy (SLIT) using cat epithelium extract.
  • To evaluate SLIT in patients with perennial allergic rhinitis and/or bronchial asthma monosensitized to cat allergen.
  • To compare outcomes between SLIT and placebo in a controlled study setting.

Main Methods:

  • A randomized, placebo-controlled trial involving 40 patients monosensitized to cat epithelium.

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  • Patients received either SLIT with cat epithelium extract (Fel d I) or a placebo for 365 days.
  • Clinical outcomes were measured using symptom scores, skin tests, nasal challenges, specific IgE, IgG4, and eosinophilic cationic protein.

    • Main Results:

    • Sublingual Fel d I therapy demonstrated clinical effectiveness after one year of treatment.
    • No significant changes were observed in IgE levels, eosinophilic cationic protein, or skin test results.
    • A notable increase in specific IgG4 levels was recorded, correlating positively with clinical improvement.
    • The treatment was generally well-tolerated, with only one patient experiencing adverse effects (urticaria, pruritus).

    Conclusions:

    • Sublingual immunotherapy with cat epithelium extract (Fel d I) is an effective treatment option for monosensitized patients.
    • Increased IgG4 levels may serve as a biomarker for treatment response in cat allergy immunotherapy.
    • SLIT for cat epithelium allergy can be a valuable complementary therapy for polysensitized individuals, particularly those with co-existing Dermatophagoides sensitization.