Effects of house dust mite subcutaneous immunotherapy in real-life. Immunological and clinical biomarkers and economic impact analysis

Cristiano Caruso, MD; Stefania Colantuono, MD, PhD; Barbara Tolusso, BSc; Clara Di Mario, BSc; Giovanni Fancello, BSc; Marilena La Sorda, BSc; Giorgio Celi, MD; Mario Caringi, MD; Anna Volterrani, MD; Desideria Descalzi, BSc; Elisa Gremese, MD, PhD; Maurizio Sanguinetti, MD, PhD; Antonio Gasbarrini, MD, PhD; Giorgio Walter Canonica, MD, PhD

World Allergy Organization Journal (Jun 2023)

Effects of house dust mite subcutaneous immunotherapy in real-life. Immunological and clinical biomarkers and economic impact analysis

Cristiano Caruso, MD,
Stefania Colantuono, MD, PhD,
Barbara Tolusso, BSc,
Clara Di Mario, BSc,
Giovanni Fancello, BSc,
Marilena La Sorda, BSc,
Giorgio Celi, MD,
Mario Caringi, MD,
Anna Volterrani, MD,
Desideria Descalzi, BSc,
Elisa Gremese, MD, PhD,
Maurizio Sanguinetti, MD, PhD,
Antonio Gasbarrini, MD, PhD,
Giorgio Walter Canonica, MD, PhD

Affiliations

Cristiano Caruso, MD: Department of Medical and Surgical Sciences, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
Stefania Colantuono, MD, PhD: Department of Medical and Surgical Sciences, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy; Corresponding author. Fondazione Policlinico A. Gemelli, IRCCS, Presidio Columbus, Via G. Moscati 31, 00168 Rome, Italy.
Barbara Tolusso, BSc: Immunology Research Core Facility, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy; Division of Clinical Immunology, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy
Clara Di Mario, BSc: Immunology Research Core Facility, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy
Giovanni Fancello, BSc: Dipartimento Scienze di Laboratorio e Infettivologiche, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy
Marilena La Sorda, BSc: Dipartimento Scienze di Laboratorio e Infettivologiche, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy
Giorgio Celi, MD: ASST Carlo Poma, Mantova, Italy
Mario Caringi, MD: Department of Medical and Surgical Sciences, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
Anna Volterrani, MD: Sapienza University of Rome, Italy
Desideria Descalzi, BSc: Personalized Medicine, Asthma and Allergy, Humanitas Research Hospital, Rozzano, MI, Italy
Elisa Gremese, MD, PhD: Immunology Research Core Facility, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy; Division of Clinical Immunology, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy
Maurizio Sanguinetti, MD, PhD: Dipartimento Scienze di Laboratorio e Infettivologiche, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy
Antonio Gasbarrini, MD, PhD: Department of Medical and Surgical Sciences, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
Giorgio Walter Canonica, MD, PhD: Personalized Medicine, Asthma and Allergy, Humanitas Research Hospital, Rozzano, MI, Italy

Journal volume & issue: Vol. 16, no. 6
p. 100789

Abstract

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Background: Etiology of allergic rhinitis and asthma is frequently associated with house dust mite sensitization and allergen immunotherapy (AIT) represents the only disease modifying treatment. In a real world setting, clinicians would benefit from biomarkers to monitor or predict response to AIT. Methods: Twenty-four consecutive house dust mite (HDM) mono-sensitized rhinitic patients, treated with subcutaneous immunotherapy (SCIT) as per clinical practice, were enrolled. Multiple in vitro biomarkers such as basophil activation (BAT), IL-10 levels, and molecular allergen-specific IgE were performed during HDM SCIT, to monitor the effects of AIT and then correlated to in vivo scores (VAS, CMSS, RQLQ). Nasal cytology was performed at baseline and after 6 and 12 months of treatment. Finally, the economic impact of SCIT in this cohort of patients was evaluated. Results: Clinical biomarkers confirmed to be useful to monitor AIT efficacy. As for laboratory biomarkers, BAT showed a reduction trend, particularly for D2C1, suggesting that this is a useful parameter in monitoring patients. IL-10 levels tend to remain stable or slightly decrease during treatment. The economic analysis confirmed the favorable impact of immunotherapy. Conclusions: In this cohort of patients, SCIT confirmed its effectiveness in reducing symptoms and drug utilization. Clinical scores confirmed to be valid in monitoring patients and their response. BAT demonstrated to be useful in monitoring more than predicting response. Further studies are needed to better explore the usefulness of these biomarkers in AIT.

Published in World Allergy Organization Journal

ISSN: 1939-4551 (Online)
Publisher: Elsevier
Country of publisher: Netherlands
LCC subjects: Medicine: Internal medicine: Specialties of internal medicine: Immunologic diseases. Allergy
Website: https://www.sciencedirect.com/journal/world-allergy-organization-journal

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