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Background: Specific immunotherapy (SIT) is the only causative method of treatment in the case of IgE-mediated allergic disease. There is extensive literature on the use of SIT in the management of respiratory allergies and insect venom hypersensitivity, but a paucity of published data concerning its use as a therapeutic approach in atopic dermatitis (AD)., Objective: A double blind placebo controlled trial was conducted over a period of 12 months in order to evaluate the efficacy of SIT in the management of atopic dermatitis attributable to house dust mites or grass pollens., Methods: A total of 20 patients (5-40 years) with AD and monovalent sensitization to airborne allergens (house dust mites or grass pollens) were enrolled in the study. SIT was performed using aluminium hydroxide adsorbed allergen preparations administered by subcutaneous injection. Clinical efficacy of the treatment was assessed using the clinical score--W-AZS index. Serum concentration of total IgE and allergen specific IgE were measured, as were various immunological parameters including ECP, sIL-2R, IFN-gamma, IL-4, IL-5 and IL-10)., Results: The mean value of W-AZS index in the SIT group before treatment was 87.6 +/- 15.8 pts, and this decreased to 38.8 +/- 34.4 pts after 12 months of therapy (p < 0.01). In the placebo group the mean W-AZS index before treatment was 86.3 +/- 15.7 pts and after 12 months of therapy it increased to 111.9 +/- 41.7 pts. Comparative statistical analysis indicated a significant difference between the two groups in favour of patients treated with the active allergy vaccines (p < 0.01). Serum levels of specific IgE in the SIT group showed a tendency to decrease, whilst those in the placebo group tended to increase. Serum concentrations of selected immunological parameters including ECP, sIL-2R, IFN-gamma, IL-4, IL-5 and IL-10 were monitored before and after treatment, but did not show significant differences., Conclusion: Allergen specific immunotherapy appeared to be an effective method of treatment for atopic dermatitis as judged by significant improvement in clinical index in cases with well documented IgE-mediated allergic disease.

Patients with atopic disorders present an increased production of IgE, which is usually limited to specific antibodies against various environmental allergens. It has also been suggested that the production of these antibodies may be influenced by effective specific immunotherapy (SIT). Of course, a decline of serum antigen specific IgE in the course of such a treatment cannot explain the clinical efficacy of SIT and is probably not a key mechanism. However, SIT may at least participate in the final clinical result. In this study, 37 patients with atopic dermatitis were treated with allergy vaccines (Novo-Helisen Depot) for a time period of 48 months. The control group consisted of 29 patients with atopic dermatitis who were treated with classical methods. The clinical score (W-AZS), total IgE and antigen specific IgE (asIgE) in the sera of patients were assessed before treatment and after 24 and 48 months of therapy (FEIA CAP System, Pharmacia). There was a significant difference between the two investigated groups from both the clinical and immunological standpoints after 2 and 4 years of observation. There was a significant decrease of serum total IgE and asIgE (directed against airborne allergens) in the course of specific immunotherapy. In the control group, the total IgE level tended to increase, and this tendency was also recorded in case of asIgE measurements. We also evaluated the influence of specific immunotherapy on the serum level of IFN-G, sIL-2R, IL-4, IL-5 and IL-10 before treatment and after 4 years of therapy with the quantitative 2-step colorimetric sandwich ELISA method (R and D Systems). In the group of patients treated with allergy vaccines, a significant decrease of the serum sIL-2R level was observed after 48 months of therapy (p<0.01). In the control group, a significant increase of serum IL-4 (p<0.01) as well as IL-5 (p<0.05) was registered at the end of the observation period. There was no significant correlation between the clinical score and serum level of any of the investigated cytokines in either group of patients before the treatment or after 48 months of therapy.

Unlabelled: Atopic dermatitis (AD) is a chronic inflammatory skin disease associated with sensitivity to common airborne allergens. The aim of the study was to evaluate the immediate type of immunological reaction initiated by main types of airborne allergens in the pathomechanism of atopic dermatitis in relation to the age of patients., Material and Methods: 529 patients with AD aged (0.5-60 years) who fulfilled basic Hanifin and Rajka criteria and 60 healthy volunteers in the control group were investigated. In order to IgE-mediated allergy to common airborne allergens skin prick tests (SPT) were performed (26 airborne allergens) and concentration of serum antigen specific IgE (asIgE) was measured., Results: Our results indicated increasing prevalence to sensitisation to airborne allergens in patients with AD in relation to the age of these patients (age 0.5-4--17 cases; 5-12 years--127 cases; 13-18 years--88 cases; above 18 of age--173 cases). The sensitisation to grass pollen and house dust mite allergens was predominant., Conclusions: We conclude, that predominance to sensitization to airborne allergens tends to increase with the age of patients.

Unlabelled: Atopic dermatitis (AD) is a chronic inflammatory skin disease associated with sensitivity to common airborne allergens. The aim of the study was to evaluate immediate type of immunological reaction initiated by main types of airborne allergens in the pathomechanism of atopic dermatitis. The exacerbation of skin inflammation of patients with AD in relation to the seasons was also evaluated., Material and Methods: 529 patients with AD aged (0.5-60 years) who fulfilled basic Hanifin and Rajka criteria and 60 healthy volunteers in the control group were investigated. In order to evaluate IgE-mediated allergy to common airborne allergens skin prick tests (SPT) were performed (26 airborne allergens) and concentration of serum antigen specific IgE (asIgE) was measured. Evaluation of exacerbation of skin inflammation of patient with AD in for patient with monovalent allergy of airborne allergens., Results: Our results indicated predominance of grass pollen (63.2%) and house dust mite (57.0%) allergens of all patients sensitive to airborne allergens (n-405). In the group of patients sensitive to pollen allergens seasonal exacerbation of skin inflammation was predominant (over 90% of patients) and in the groups of patients sensitive to house dust mite and animal allergens the clinical manifestation of allergy for the whole year was observed in the most patients (77.1% and 57.1%)., Conclusions: We conclude, that house dust mite and plant pollen allergens play an important role in the pathomechanism of atopic dermatitis.

Atopic dermatitis (AD) still remains a difficult clinical problem in terms of effective therapy. The aim of our study was to evaluate efficacy of specific immunotherapy performed with Novo-Helisen Depot allergy vaccines in the group of 36 children and youngsters with atopic dermatitis allergic to house dust mites (24 persons) and grass pollen allergens (12 patients), for the time period of 3 years. Skin reactivity (skin prick tests) and serum concentrations of antigen specific IgE were monitored in the course of treatment. The control group consisted of 20 patients with atopic dermatitis and IgE-mediated airborne allergy who were treated with conventional methods. Specific immunotherapy resulted in negativization of skin prick tests results and decrease of serum antigen specific IgE concentrations. On the contrary in the control group there was no tendency for negativization of skin prick tests and we observed an increase of serum concentration of antigen specific IgE directed against grass pollen allergens. Specific immunotherapy seems to be an effective therapeutic approach in selected cases of atopic dermatitis.

Unlabelled: Atopic dermatitis (AD) is a disease with a complex pathomechanism, in which immunoglobulin E plays an important role. The aim of the study was to evaluate the immediate allergic response to airborne allergens in patients with AD, with consideration of serum level of total immunoglobulin E (total IgE). Severity of AD clinical symptoms was analyzed and correlated with the results of allergological diagnostics., Material and Method: 529 patients with AD (aged 0.5-60 years) who fulfilled basic Hanifin and Rajka criteria were included in the study. The control group comprised 60 healthy volunteers. Both groups were comparable in terms of age and gender of subjects. All subjects had total serum IgE measured. Severity of AD symptoms was measured in the AD group using an atopic dermatitis index., Results: Similar values of the AD index were found in AD patients with negative results of allergological diagnostics and those with positive results. The levels of total serum IgE were highest in the group of AD patients sensitive to airborne and food allergens (1271.1 +/- 792.0 kU/l) and in the group sensitive only to airborne allergens (750.9 +/- 680.3 kU/l). The levels of total IgE in these groups were significantly higher than in patients sensitive only to food allergens (184.3 +/- 250.1 kU/l)., Conclusions: AD clinical picture does not allow identification of potential provoking factors. A high level of total serum IgE suggests participation of airborne allergens in the development of the disease.

The study involved 22 patients with seasonal allergic rhinitis between 13 and 53 years of age. The level of antigen specific IgE (AS IgE) to 5 grass and 3 weed pollens was determined with the use of CAP FEIA (Pharmacia, Uppsala, Sweden). The control group consisted of 20 persons. All above AS IgE were significantly higher in the patients with seasonal allergic rhinithis than in the control group. The most commonly present hypersensitivities were to Meadow fescue (Festuca elatior), Meadow grass (Poa pratensis), Cocksfoot (Dactylis glomerata), Ribwort (Plantago lanceolata) and Mugwort (Artemisia vulgaris) allergens. The authors believe that the pathomechanism of the development of seasonal allergic rhinithis is governed to a large degree by hypersensitivity to grass and weed pollens and suggest that precise determination of AS IgE to these allergens in patients blood sera should form the basis of the construction of the vaccine used in their immunotherapy.