Sublingual immunotherapy in treatment of perennial allergic rhinitis with or without allergic asthma

SUNDAY, 18 JUNE 2017 LB TPS 01 ALLERGEN IMMUNOTHERAPY: FROM VACCINES TO EFFICACY AND SAFETY 1517 | The effect of azoximer bromide in treatment irritable bowel syndrome Sheikh Sajjadieh M; Edalati M; Ajami A; Sheikh Sajjadieh E Nobel Medical Laboratory, Isfahan, Iran Introduction: Some evidence suggests that irritable bowel syndrome (IBS) is affected by the immune system. This study focused effect of Azoximer bromide in concert with Probiotics in treatment of IBS. Objectives: Our study included 16 children treated by probiotic and azoximer bromide (study group), and 10 children treated only by probiotic (control group). Lymphocytes subset was analyzed by flow cytometric, phagocytic activity was assessed by latex article, IgE and serum cytokine were evaluated by ELISA. The intestinal bacterial microbiota was assessed by medical microbiologic method. Results: The change of immune status in IBS patient is holistic description in our articles. After therapy in group study the percentage of all lymphocyte phenotype subsets, phagocytic activity, IgE, cytokine level and intestinal microbiota were near of healthy subjects compare with control group. In control group the mean percentage of CD3 and CD4 were less than in healthy subjects (P<.05), the mean percentage of CD8, CD16 and CD22 were more than in healthy subjects (P<.05). The mean level of IL-4 and TNF-a were significantly lower when compared with before therapy (P<.001). No significant difference between before and after therapy was observed in serum concentration of the mean level of IFN-c, IL-1 and phagocytic activity. Intestinal dysbiosis is corrected after therapy in both groups. Conclusions: Immunomodulator as Azoximer bromide when contributed with probiotic can to elicit or amplify an immune response in patient have suppressed immune system Probiotic is a prescription medication for treatment of irritable bowel syndrome and in addition for correct immune status may be prescribed azoximer bromide. 1518 | Sublingual immunotherapy in treatment of perennial allergic rhinitis with or without allergic asthma Rudenko M; Boyle R London Allergy & Immunology Centre, London, UK Introduction: Sublingual immunotherapy is an effective treatment for perennial allergic rhinitis with or without allergic asthma (1), however real-world data on adverse effects, adherence and clinical outcomes are not commonly reported (2). Here we summarise patientreported symptoms, adherence and adverse effects from using sublingual immunotherapy to perennial allergens, in a single specialised allergy centre in London, UK Objectives: Online questionnaire responses from 44 patients (37 adults, 7 children) receiving sublingual immunotherapy with perennial allergens were collated as part of a service evaluation. Questionnaires were administered prior to initiation of immunotherapy, and then at monthly intervals. This project was not funded by the pharmaceutical industry. Results: Products used varied according to patient and clinician preference, and were manufactured by Allergy Therapeutics, UK, and Inmunotek, Spain. Treatment was initiated and supervised according to the manufacturers’ instructions. Routine premedication was not used. Three patients (6.81%) reported local symptoms during the first 14 days, that resolved with antihistamines. There were no adverse events reported. Adherence levels were high, and were confirmed monthly, with just one adult patient terminating treatment after one year due to personal reasons not related to treatment. All patients reported improvement in symptoms on average after 3.2 +/0.3 months with reduction in nasal and ocular symptoms frequency of asthma exacerbations. Conclusions: Analytics of the received data showed improvement in nasal ocular and asthma symptoms, reduction in medication score after three months of treatment, that continued during the three year course. Assessment of patients’ progress post treatment is ongoing. (1) Bousquet J, Khaltaev N, Cruz AA, et al. Allergic Rhinitis and its Impact on Asthma (ARIA) 2008 update (in collaboration with the World Health Organization, GA(2)LEN and AllerGen) Allergy. 2008;63 (Suppl 86):8-160. (2) Wheatley LM, Togias A. Allergic Rhinitis. The New England Journal of Medicine. 2015;372(5):456-463. https://doi.org/10.1056/nejmcp. DOI: 10.1111/all.13249 758 | © 2017 EAACI and John Wiley and Sons A/S. Published by John Wiley and Sons Ltd. wileyonlinelibrary.com/journal/all Allergy. 2017;72:758–823. Proportion of patients reporting symptom improvement. Month Number of patients % 1 2 adults; 1 child 6.82 2 13 adults; 4 children 38.3 3 30 adults; 6 children 81.8 4 35 adults; 7 children 95.4 1519 | Real life study on the therapeutic criteria and adverse events in the course of sublingual allergen immunotherapy in 150 patients with allergic rhinitis and asthma Christoff GC Medical University Sofia, Faculty of Public Health, Sofia, Bulgaria Introduction: Allergen immunotherapy is the only etiological treatment of atopic diseases and the only available disease modifying approach which makes its implementation in everyday practice very important. The use of the subcutaneous route is well established for more than a century but at the same time restricted by the high frequency of local and systemic adverse reactions. It is well known and generally accepted that all these disadvantages are not characteristic for the sublingual route of administration (SLIT). However good quality real-life evidence on that matter is scarce. Objectives: The study is designed to assess the type and frequency of adverse reactions in patients with allergic rhinitis and asthma in the course of SLIT in an everyday clinical setting. The aim of the study is to estimate 1) the proportion of patients experiencing at least one systemic adverse reaction, 2) the incidence rate of systemic reactions in a real life setting and, 3) the possible risk factors involved in these reactions. Material and methods: Patients, 145, women (43, 29.7%) and men (102, 70.3%), referred to the outpatient clinic of a major private hospital in Sofia, Bulgaria, for a suspected IgE-mediated allergic disease were included. Patients were diagnosed with an atopic disease on the basis of their medical history, SPT results and serum specific IgE levels. Upon meeting the criteria for starting SLIT, they were put on a regimen with the actual allergen extract (Stallergenes, Antony, France). Appointments were made for regular visits to doctor’s office. Patients were instructed to contact their doctor as soon as they experienced whatever kind of an adverse event. Results: On the basis of medical history, several atopic diseases were identified: atopic dermatitis (1.4%), asthma (32.4%), conjunctivitis (82.8%), rhinitis (99.3%). 125 (86.2%) persons were identified as sensitized to pollen. Sensitization was clinically significant in 116 (90.6%) patients. In 62 (84.95%) patients sensitization to house dust mites (HDM) was found. Sensitization was clinically significant in 52 (71.2%) patients. Adverse reactions were 20/145 (13.7%). Local reactions were 17/145 (11.7%) and systemic—2/145 (2.06%). The most common local reactions were twinkling, itching, redness in oral cavity (106.7%), edema in oral cavity (60%). Conclusions: Our data confirm on the basis of real-life evidence that SLIT is a safe AIT regimen. Adverse reactions are predominantly local, mild with low seriousness; systemic reactions are moderate, grade I and II. 1520 | A novel H4R-based epitope vaccine screening by phage display peptide library change the unbalance of the Th1 /Th2 in an allergic rhinitis model Li L; Cui N; An L; Meng C; Sha J China-Japan Union Hospital of Jilin University, Changchun, China Introduction: Histamine receptor 4 (H4R) was suggested as a new therapeutic target because of its wide expression on almost all the immune-related cells. Objectives: To construct a vaccine based on histamine receptor 4 and evaluate its therapeutic effect on the allergic rhinitis. Results: FNKWMDCLSVTH, the 12 peptide named as P-FN12, could decrease the allergic symptoms such as sneezing and nasal rubbing. It also elicited increased levels of IFN-c, IL-2 but decreased levels of IL-6, Th1 /Th2 cells ratio in the PBMCs cultures. Conclusions: P-FN12+CTB@Lipo could suppress Th2 response and enhanced induction of Th1 in an allergic rhinitis model. 1521 | Preseasonal grass pollen SLIT in at risk individuals confers protection from epidemic thunderstorm asthma O’Hehir RE; Varese N; Heeringa JJ; Deckert K; Rolland JM; Van Zelm MC; Hew M Allergy, Immunology & Respiratory Medicine, Monash University and Alfred Health, Melbourne, Australia; Immunology & Pathology, Monash University, Melbourne, Australia Introduction: Epidemic thunderstorm asthma in Australia is triggered when ryegrass pollen (RGP) grains rupture in storm moisture releasing respirable 3 lm starch granules impregnated by major allergens. Thunderstorm downdrafts draw granules to ground level mimicking aerosol challenges. Susceptibility to thunderstorm asthma is conferred by RGP allergy, which affects >20% of people in south-east Australia. Asthma risk correlates with the elevation of specific IgE in serum. Last November, a springtime thunderstorm in Melbourne triggered the most devastating recorded thunderstorm asthma event worldwide. In a city of 4.5 ABSTRACTS | 759