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The Frequency and Intensity of Bronchial Hyper-Reactivity in Patients with Allergic Asthma on Immunotherapy

Neziri-Ahmetaj Luljeta, Bakir Mehic, Refet Gojak, Zhjeqi Valbona and Neziri Arber

Allergen immunotherapy significantly reduced asthma symptoms and medications requirements. Treated patients were significantly less likely to report symptomatic deterioration and less likely to require increased medication. This immunotherapy showed no consistent effect on lung function.

The aim of study: In this study, we have determined the difference in the frequency and intensity of bronchial hyper-reactivity in patients with allergic asthma on immunotherapy compared to the patients with allergic asthma receiving only anti-asthmatic pharmacotherapy during one year period of time.

Methods: 60 patients were included with allergic asthma, where genders were subsequently divided into two treatment groups. The study group included 30 patients who had received immunotherapy (immunotherapy group) and control group of 30 patients treated with standard pharmacotherapy, but not with immunotherapy (GINA proposal). Each patient in the immunotherapy group was treated with subcutaneous specific immunotherapy (SCIT). The criteria for the inclusion of the patients were clinical diagnosis of allergic asthma, age between 15 and 30 years, and both sexes. The criteria for the exclusion of the patients were the presence of other acute and chronic diseases of respiratory airways, other allergic diseases (skin allergies, nutritive allergies etc.), and acute and chronic diseases of other organic systems.

Results: During the 1st trimester, the median FEV1 values in control group of patients was 60.5% (46.7-78.25%) and following bronchodilators therapy, it was 81% (56-82.2%), which was a significant (p=0.005). In the immunotherapy group, median FEV1 value was 74% (66.0-77.0%) and following bronchodilator therapy it was 84% (76-89.5%), which was a significant increase (p=0.005). During the 2nd trimester, the median FEV1 value in control group of patients was 75% (50-79.5%) and following bronchodilators therapy it increased up to 84% (66-88.5%) but the difference was not significantly different (p=0.08). In immunotherapy group, median FEV1 value was 78% (75.5-79.0%) and following bronchodilator therapy, it increased to 82% (79.5-83.75%) but the difference was not significant (p=0.066). During the 3rd trimester, the median FEV1 value in control group of patients was 70% (43-75%) and not significantly increased following bronchodilators therapy up to 84% (51-85%) (p=0.08). In experimental (immunotherapy) group, median FEV1 value was 77% (70-79%) and following bronchodilator therapy, it did not significantly change 76% (68-85%) (p=0.273). During the 4th trimester, the median FEV1 value in control group of patients was 65% (54-75%) and significantly increased following bronchodilators therapy to 79% (55-83%) (p=0.018). In immunotherapy group, median FEV1 value was 79% (68-79.5%) and did not change significantly following bronchodilator therapy 90% (67.5-95.75%)) (p=0.18).

Conclusion: In this study, the frequency of bronchial hyper reactivity was not significantly different in patients with allergic asthma treated with immunotherapy compared to the patients receiving only anti-asthmatic pharmacotherapy during one year period of time. Although the decrease was not significant (χ2=3.166 p=0.065) in our sample, there was a trend toward a decrease in BHR in our patients treated with specific immunotherapy.