Immunotherapy with mosquito ( XXXX ) extract: a double-blind, placebo-controlled study.

@entity1 @entity566 @entity565 @entity2490 @entity2957 @entity112
BACKGROUND: Mosquito @entity566 is well established, but mosquito immunotherapy requires validation using clinical and immunologic variables. OBJECTIVE: To evaluate the tolerability and efficacy of specific immunotherapy with @entity2957 (mosquito) extract. METHODS: We performed a randomized, double-blind, placebo-controlled trial of immunotherapy for 1 year in 40 @entity1 with @entity565 , @entity2490 , or both. @entity1 were evaluated by means of intradermal testing, symptom and drug scores, and @entity112 provocation testing before and after 1 year of immunotherapy. Mosquito specific IgE and IgG subclass antibody responses were evaluated at the basal level and after 1 year. RESULTS: @entity1 receiving allergen immunotherapy for 1 year showed a significant improvement compared with baseline and @entity1 receiving placebo regarding skin reactions, symptom scores ( @entity2490 and @entity565 ), and forced expiratory volume in 1 second. Provocation concentration of @entity112 that caused a decrease in forced expiratory volume in 1 second of 20% by inhalation was elevated in the group receiving immunotherapy. In the active group serologic analysis showed a slight reduction in IgE levels (P = .02) but a significant elevation in IgG4 levels (P = .001), with a significant decrease in the IgE/IgG4 ratio (P = .001). All these changes in the placebo group were nonsignificant. CONCLUSIONS: Allergen immunotherapy with mosquito extract was well tolerated, with improvement in symptoms and airway reactivity. Good clinical outcome was associated with increased IgG4 antibody levels.
