A pediatric randomized, controlled trial of German cockroach subcutaneous immunotherapy
Recommended Citation
Zoratti E, Wood R, Pomés A, Da Silva Antunes R, Altman MC, Benson B, Wheatley LM, Cho K, Calatroni A, Little FF, Pongracic J, Makhija M, Khurana Hershey GK, Sherenian MG, Rivera-Spoljaric K, Stokes JR, Gill MA, Gruchalla RS, Chambliss J, Liu AH, Kattan M, Busse PJ, Bacharier LB, Sheehan W, Kim H, Glesner J, Gergen PJ, Togias A, Baucom JL, Visness CM, Sette A, Busse WW, and Jackson DJ. A pediatric randomized, controlled trial of German cockroach subcutaneous immunotherapy. J Allergy Clin Immunol 2024.
Document Type
Article
Publication Date
9-1-2024
Publication Title
The Journal of allergy and clinical immunology
Abstract
BACKGROUND: Cockroach allergy contributes to morbidity among urban children with asthma. Few trials address the effect of subcutaneous immunotherapy (SCIT) with cockroach allergen among these at-risk children.
OBJECTIVES: We sought to determine whether nasal allergen challenge (NAC) responses to cockroach allergen would improve following 1 year of SCIT.
METHODS: Urban children with asthma, who were cockroach-sensitized and reactive on NAC, participated in a year-long randomized double-blind placebo-controlled SCIT trial using German cockroach extract. The primary endpoint was the change in mean Total Nasal Symptom Score (TNSS) during NAC after 12 months of SCIT. Changes in nasal transcriptomic responses during NAC, skin prick test wheal size, serum allergen-specific antibody production, and T-cell responses to cockroach allergen were assessed.
RESULTS: Changes in mean NAC TNSS did not differ between SCIT-assigned (n=28) versus placebo-assigned (n=29) participants (p=0.63). Nasal transcriptomic responses correlated with TNSS, but a treatment effect was not observed. Cockroach serum specific IgE (sIgE) decreased to a similar extent in both groups, while decreased cockroach SPT wheal size was greater among SCIT participants (p=0.04). A 200-fold increase in cockroach sIgG4 was observed among subjects receiving SCIT (p<0.001) but was unchanged in the placebo group. T-cell interleukin-4 responses following cockroach allergen stimulation decreased to a greater extent among SCIT versus placebo (p=0.002), while no effect was observed for interleukin-10 or interferon-gamma.
CONCLUSIONS: A year of SCIT failed to alter NAC TNSS and nasal transcriptome responses to cockroach allergen challenge despite systemic effects on allergen-specific skin tests, induction of serum-specific IgG
Medical Subject Headings
Humans; Animals; Child; Desensitization, Immunologic; Female; Male; Allergens; Asthma; Adolescent; Immunoglobulin E; Double-Blind Method; Blattellidae; Injections, Subcutaneous; Skin Tests
PubMed ID
38718950
ePublication
ePub ahead of print
Volume
154
Issue
3
First Page
735
Last Page
744
