Ying-Yang Xu

and 12 more

Background Allergen-specific immunotherapy (AIT) is the only disease-modifying treatment for IgE mediated disease. In china, AIT has been applied over 60 years and subcutaneous immunotherapy (SCIT) is the major route. This study analyzed the relatively comprehensive status of SCIT in our country. Methods Patients who initiated SCIT between January 1, 2015, and December 31, 2016 at Peking Union Medical College Hospital were collected and their medical records from January 1, 2015, to December 31, 2019 were obtained. The formulation and adherence of SCIT in different age groups and regions were analyzed. Results A total of 4731 patients receiving SCIT were analyzed, including 459 children (5-12 years), 624 adolescent (13-18 years) and 3648 adults. On a per-species allergen extract basis, multi-allergen SCIT were prescribed in 83% of patients. Mugwort, house dust mite and firebush were most frequently administered. On per-group allergen extract basis, 49% of SCIT were mixing formulations and weed pollen, tree pollen and house dust mite were most frequently used. The most common component of SCIT was mold in children (53%), whereas weed pollen in adolescents (59%) and adults (68%). Overall, 35% of patients completed at least 3-year SCIT. Children had the highest adherence of SCIT, followed by adolescents and adults (49%, 47% and 31%, respectively). Conclusions The majority of patients were prescribed SCIT of mixing formulation. Weed pollen was the most frequently used allergen group in SCIT, especially in Northern China. Real-life adherence in SCIT was still low which desiderate improvement of current procedure of SCIT.

Guang Peng Xi

and 2 more

Humulus pollen is an important cause of allergic asthma in East Asia. There have been some murine models for Humulus pollen allergy established by intraperitoneal (IP) sensitization and nasal drip stimulation, but they were not comprehensive enough. Here, we used atomized inhalation for challenge and compared the subcutaneous (SC) and IP sensitization routes to determine the optimal method to establish a model of asthma induced by Humulus pollen. Subsequently, we tried to develop a rapid subcutaneous immunotherapy (SCIT) model. Mice were sensitized through the SC or IP route and challenged with Humulus pollen extract to induce asthma. To compare the two sensitization methods, airway hyperresponsiveness (AHR), inflammatory cell infiltration, allergen-specific serum immunoglobulin (Ig)E (sIgE) levels, cytokine levels, and lung histopathology were assessed. The effects of SCIT (once every other day for 16 days) on airway inflammation, AHR, sIgE, and allergen-specific serum IgG2a (sIgG2a) levels were evaluated by using the model established. Although mice sensitized by the SC or IP routes both showed AHR and airway inflammation, the SC route elicited significantly higher levels of sIgE, eosinophil inflammation, and T helper type 2 cytokines, compared with the IP route. SCIT in the treatment group significantly reduced the titers of sIgE, enhanced the titers of sIgG2a, and effectively alleviated pulmonary inflammation and AHR, compared with the vehicle group. These observations indicate that the SC route can be a better sensitization route than IP route for establishing a murine model of Humulus pollen allergy; short-term SCIT improved symptoms and pathophysiology in asthmatic mice.