Improvement of clinical and immunological parameters after allergen specific immunotherapy in atopic dermatitis

Hajdu, K. and Kapitány, A. and Dajnoki, Zs. and Soltész, L. and Baráth, S. and Hendrik, Z. and Veres, I. and Szegedi, A. and Gáspár, K. (2021) Improvement of clinical and immunological parameters after allergen specific immunotherapy in atopic dermatitis. JOURNAL OF THE EUROPEAN ACADEMY OF DERMATOLOGY AND VENEREOLOGY, 35 (6). pp. 1357-1361. ISSN 0926-9959 (print); 1468-3083 (online)

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Abstract

Background: Allergen immunotherapy (AIT) is considered a curative treatment in some atopic diseases, but in AD contradictory clinical results exist and the action of AIT has not been elucidated. In the literature there is no evidence for parallel investigations of permeability barrier, cutaneous, and blood immune responses after AIT in AD. Objectives: The objective was to investigate immune parameters in the blood and skin and to detect clinical, and barrier changes after AIT in AD. Methods: Mild-to-moderate AD patients (n=14) with concomitant allergic rhinitis to house dust mites were selected. All patients received topical treatment, while eight patients were randomly selected for adjuvant AIT also. At baseline and after 6 months clinical, barrier and immunological investigations (serum and skin tests) were performed. In selected patients, biopsies from atopy patch tests (APT) were analysed by immunohistochemistry for ADrelevant immune cells and mediators. Results: In the adjuvant AIT-group, clinical parameters and barrier functions improved significantly. Blood immune parameters displayed no significant changes. Post-AIT APT became negative in all patients in the AIT-group, but remained positive in the non-AIT group. Cutaneous dendritic cell and T cell recruitment decreased significantly after allergen challenge in the AIT-group, but no significant changes in skin or serum immunoglobulin E levels or prick test (SPT) reactivity were detected. Conclusions: AIT is a beneficial adjuvant treatment for sensitized AD patients. AIT improves not only clinical symptoms, but also permeability barrier functions. The effect of AIT on sensitization should be detected by APT, not by SPT.

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