D1.156 - Early Immunologic Parameters Predicting Response to Sublingual Immunotherapy in Allergic Rhinitis Patients

Despite extensive efforts to identify biomarkers for the clinical effects of allergen immunotherapy, no definitive markers have been established. This study aims to evaluate immunologic marker changes during sublingual immunotherapy (SLIT) and identify early predictors of treatment success, facilitating personalized treatment approaches.

A retrospective chart review was conducted on 29 allergic rhinitis patients receiving SLIT tablets. Serologic markers including Dp-/Df-specific IgE, Dp-/Df-specific IgG4, total IgE, and eosinophil count were collected at baseline, 3, 6, 12, and 24 months. Three questionnaires were administered to evaluate treatment response: the Total Nasal Symptom Score (TNSS), Rhinoconjunctivitis Quality of Life Questionnaire (RQLQ), and Rhinitis Control Score. Assessments were conducted at each follow-up, and patients were categorized into responder (n=10) and non-responder (n=8) groups based on their 6-month results. Logistic regression, including univariate analysis (p < 0.1) and multivariate logistic regression with Firth correction, was performed to identify early predictors of treatment success.

Dp-/Df-specific IgE levels peaked at 3 months and gradually decreased by 24 months (both p <0.001), while Dp-/Df-specific IgG4 levels showed a consistent increase (both p < 0.001). Patients with higher baseline Dp-specific IgE (OR, 1.066; 95% CI, 1.001–1.170) and Df-specific IgE (OR, 1.015; 95% CI, 1.001–1.038) were more likely to be in the responder group. Additionally, a larger baseline Dp wheal size on the skin prick test was associated with higher odds of success (OR, 1.272; 95% CI, 1.003–1.828).

Early serologic markers and skin prick test results are associated with increased odds of SLIT response. These findings may help predict SLIT outcomes early in treatment, enabling more individualized treatment for allergic rhinitis patients.