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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
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.
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.
- 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.