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Master's Dissertation
DOI
https://doi.org/10.11606/D.5.2023.tde-08022024-162545
Document
Author
Full name
Priscilla Rios Cordeiro Macedo
E-mail
Institute/School/College
Knowledge Area
Date of Defense
Published
São Paulo, 2023
Supervisor
Committee
Galvão, Clóvis Eduardo Santos (President)
Arruda, Luisa Karla de Paula
Kokron, Cristina Maria
Pereira, Veridiana Aun Rufino
Title in Portuguese
Avaliação da segurança e eficácia terapêutica da imunoterapia sublingual com alérgenos perenes (Dermatophagoides pteronyssinus e Blomia tropicalis) em pacientes com rinite alérgica através de dados clínicos e laboratoriais
Keywords in Portuguese
Ácaros da poeira doméstica
Eficácia
Imunoterapia sublingual
Rinite alérgica
Segurança
Abstract in Portuguese
O objetivo deste estudo foi avaliar a segurança e eficácia clínica da imunoterapia sublingual (ITSL), com extratos de Dermatophagoides pteronyssinus (Dpt) e Blomia tropicalis (Bt), em paciente com rinite alérgica (RA) persistente moderada/grave. Métodos: Este foi um estudo duplo-cego, randomizado, controlado por placebo de ITSL no tratamento de RA induzida por ácaros da poeira doméstica. Um total de 65 pacientes com RA, entre 12 e 60 anos, foram tratados por 12 meses e randomizados em dois grupos: ITSL e o grupo placebo. O grupo ITSL recebeu uma combinação de extratos contendo 1 mcg do alérgeno Dermatophagoides pteronyssinus 1 (Der p 1)/dia e 753 UBE do alérgeno Blomia tropicalis (Blo t)/dia). Todos tiveram sua sensibilização confirmada por teste de punção de leitura imediata ou IgE específica sérica para D. pteronyssinus e B. tropicalis. Escore de sintomas nasais (TNSS), questionário de qualidade de vida RQLQ, tratamento em uso e necessidade de medicamentos para controle dos sintomas foram registrados durante o estudo. Níveis de IgE total sérica, IgE e IgG4 específica séricas para Der p 1 e Blo t foram avaliados no início do estudo, 6 e 12 meses após o tratamento. O tratamento medicamentoso foi mantido em todos os pacientes. Resultados: Não houve diferença estatisticamente significativa quanto ao número de eventos adversos entre os grupos. O grupo ITSL apresentou redução estatisticamente significativa no consumo de anti-histamínicos para controle dos sintomas (p < 0,0001, Teste Qui-quadrado) quando comparado ao placebo. Não houve diferença estatisticamente significativa quanto ao consumo de budesonida, montelucaste e olopatadina. Não houve alteração estatisticamente significativa na IgE total sérica, IgE e IgG4 específica sérica para ambos os alérgenos quando comparados os grupos ITSL e placebo. Conclusão: Após um ano, a dose de 1 mcg de Der p 1/dia e 753 UBE de Blo t/dia, revelou-se segura no tratamento de ITSL e eficaz no controle das crises de RA
Title in English
Evaluation of the safety and therapeutic efficacy of sublingual immunotherapy with perennial allergens (Dermatophagoides pteronyssinus and Blomia tropicalis) in patients with allergic rhinitis through clinical and laboratory data
Keywords in English
Allergic rhinitis
Efficacy
House dust mite
Safety
Sublingual immunotherapy
Abstract in English
The aim of this study was to evaluate the safety and clinical efficacy of sublingual immunotherapy (SLIT) with extracts of Dermatophagoides pteronyssinus (D. pteronyssinus) and Blomia tropicalis (B. tropicalis) in a patient with moderate/severe persistent allergic rhinitis (AR). Methods: This was a double-blind, randomized, placebo-controlled trial of SLIT in the treatment of house dust mite-induced AR. A total of 65 RA patients, aged between 12 and 60 years, were treated for 12 months and randomized into two groups: SLIT and the placebo group. The SLIT group received a combination of extracts containing 1 mcg of the allergen Dermatophagoides pteronyssinus 1 (Der p 1)/day and 753 UBE of the allergen Blomia tropicalis (Blo t)/day. All had their sensitization confirmed by immediate reading puncture test or serum specific IgE for D. pteronyssinus and Blo t. Nasal Symptom Score (TNSS), RQLQ quality of life questionnaire, current treatment, and need for medication to control symptoms were recorded during the study. Total serum IgE, serum IgE and specific IgG4 levels for Der p 1 and Blo t were assessed at baseline, 6 and 12 months after treatment. Pharmacotherapy in use was maintained in all patients. Results: There was no statistically significant difference in the number of adverse events between groups. The SLIT group showed a statistically significant reduction in the consumption of antihistamines to control symptoms (p < 0.0001, Chi-square test) when compared to placebo. There was no statistically significant difference regarding the consumption of budesonide, montelukast and olopatadine. There was no statistically significant change in serum total IgE, serum specific IgE and IgG4 for both allergens when comparing the SLIT and placebo groups. Conclusion: After one year, a dose of 1 mcg of Der p 1/day and 753 UBE of Blo t/day proved to be safe in the treatment of SLIT and effective in controlling AR crises
 
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Publishing Date
2024-02-19
 
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