Efficacy of Immunotherapy Based on Skin End-Point Titration

Abstract

OBJECTIVE: The purpose of this study is to examine the efficacy of skin end-point titration (SET) as a method of assessing skin responsiveness, selecting antigens, and initiating treatment for successful inhalant immunotherapy.

STUDY DESIGN: This study is a prospective, randomized, controlled, double-blind investigation. Eighteen patients were randomly assigned to 1 of 2 groups: an experimental group treated for all positive antigens, and a control group treated for all positive antigens, with the exception of the study antigens. Quality of life was assessed with 3 dependent measures, and response to nasal challenge and nasal endoscopic evaluations were conducted. Ten patients completed the 6-month study.

RESULTS: There were significant improvements in the emotional component of sinus-related disability, in response to nasal challenge, and in the endoscopic appearance of the mucosa, regardless of patient group. There was a trend toward improved quality of life among experimental subjects.

CONCLUSIONS: SET-based immunotherapy reduces self-rated disability over time. In addition, SET-based immunotherapy allows decrease in nasal reactivity and normalizes the endoscopic appearance of the nose.

Get full access to this article

View all access options for this article.

References

Turkeltaub

Rastogi

Baer

A standardized, quantitative skin-test assay of allergen potency and stability: Studies on the allergen dose-response curve and effect of wheal, erythema, and patient selection on assay results. Allergy Clin Immunol 1982; 70:343–52.

Keenan

Jp.

History of skin testing and evolution of skin endpoint titration. In: Mabry

, editor. Skin endpoint titration. New York: Thieme; 1992: p. 12–6.

Phillips

Ew.

Relief of hayfever by intradermal injections of pollen extract. JAMA 1926; 86:182–4.

Rinkel

Hj.

The management of clinical allergy. Part II, etiologic factors and skin titration. Arch Otolaryngol 1963; 77:42–75.

King

Hc.

Skin endpoint titration. Still the standard? Otolaryngol Clin North Am 1992; 25:13–25.

Council on Scientific Affairs (AMA). In vivo diagnostic testing and immunotherapy for allergy. JAMA 1987; 258:1363–7.

Benninger

Senior

Ba.

The development of the Rhinosinusitis Disability Index. Arch Otolaryngol Head Neck Surg 1997; 123:1175–9.

Piccirillo

Edwards

Haiduk

Psychometric and clinimetric validity of the 31-item rhinosinusitis outcome measure (RSOM31). Am J Rhinol 1995; 9:297–306.

Krouse

Hj.

Patient use of traditional and complementary therapies in treating rhinosinusitis prior to consulting an otolaryngologist. Laryngoscope 1999; 109:1223–7.

10.

Naclerio

Meier

Kagey-Sabotka

Mediator release after nasal airway challenge with allergen. Am Rev Respir Dis 1983; 128:597–602.