Local nasal immunotherapy for ragweed-allergic rhinitis |
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Authors: | J. A. NICKELSEN J. W. GEORGITIS U. R. MUELLER J. KANE J. I. WYPYCH S. GOLDSTEIN R. E. REISMAN C. E. ARBESMAN |
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Affiliation: | Allergy Research Laboratory, The Buffalo General Hospital. Division of Allergy, Department of Medicine, State University of New York at Buffalo, Buffalo, New York;Division of Allergy and Clinical Immunology, Department of Pediatrics, School of Medicine. East Carolina University, Greenville, North Carolina, U.S.A. |
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Abstract: | In 1979, pre-seasonal local nasal immunotherapy (LNIT) was found to be an effective treatment for ragweed hay fever. In 1980. this study was continued to evaluate the clinical and immunologic responses of a second year of LNIT. Patients received either pre-seasonal treatment with an unmodified ragweed extract (RW) or a polymerized ragweed extract (PRW), or no treatment. The results of the second year of treatment were the same as the first year. Adverse reactions were significantly higher in the RW-treated group than in the PRW-treated group (P < 0.001), Symptom/medication scores (SMS) in the RW-treated group were significantly lower than in the control group (P < 0.005). Although SMS in the PRW-treated group were lower than in the control group, this difference was not significant. The immunologic response was evaluated by measurements of serum (S) RW-specific IgE and IgG and nasal secretory (NS) RW-specific IgE, IgG, and IgA, After treatment, serum IgE titres and secretory IgA titres rose in the RW-treated patients. Nasal secretory-IgG and NS-IgA titres increased with PRW treatment. The only immunologic response observed in the control group was a rise in S-IgE titres after the ragweed season. There was no substantial difference in immunologic measurements observed in the 1979 and 1980 seasons, except that the pre-treatment NS-IgE level was higher in 1980 (P < 0.02). No significant correlations were found between antibody response and SMS. This study supports the efficacy of LNIT but does not support the protective role for NS-ragweed-specific IgA or IgG. |
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