D1.214 - Analysis of the time to achieve a maintenance dose of tree pollen allergen in specific immunotherapy of allergic rhinitis

: Specific immunotherapy (SIT) has been performed usually with standard allergens produced by limited number of companies. Recommended period for SIT was adopted as three years duration.  Specific immunotherapy was performed according to EAACI guidelines. The maintenance dose is achieved when, with progressive dose increases, adequate redness and swelling occur at the allergen injection site, with a diameter greater than 5 mm. At the beginning of the therapy, the periods of allergen administration were once a week, and after reaching the maintenance dose, once a month. The aim of the study was analysis of time to achieve maintenance dose of tree pollen allergen in specific immunotherapy of patients with allergic rhinitis.

Patients with diagnostically confirmed allergic rhinitis were analyzed using PRICK tests and determination of total IgE in the blood and specific IgE to respiratory allergens. Total IgE as well as specific IgE was determined by immunoblot method

We treated 56 patients with allergic rhinitis by subcutaneous SIT, 34 female and 22 male, average aging 31.8 (±5) years. PRICK test were performed for all patients before start of SIT. Measurement of total IgE and specific IgE against tree pollen allergen were performed so.  Average time to obtain satisfied wheal was 4.6 week (±0.7). Shorter time was for those patients with more intensive PRICK test, and those with higher total and specific IgE against trees pollen allergen. Skin test performed by PRICK method had the main importance for decision making for SIT. Since SIT is very long and demanding for patients, the diagnostic procedure must be completely reliable.

Achieving maintenance dose was shorter for those patients with more intensive PRICK test, as well as level of total and specific IgE was higher. Level of IgE was variable, and, in some patients, intensity of PRICK test was very high even if the IgE level was not high.