Desensitization Efficacy by Sublingual Immunotherapy of Shrimps Extract in Asthmatic, Rhinitis and Urticaria Allergic Patients

Abstract

RATIONALE: Crustaceans, such as shrimp, crab, crayfish and lobster, play important role in human nutrition; they also can be important causes of severe acute hypersensitivity reactions. For patients diagnosed with a crustacean allergy, strict avoidance is the only proven therapy, highlighting the need for more specific treatment. Our aim was to evaluate the efficacy and tolerance of sublingual shrimp immunotherapy in Egyptian patients allergic to shrimp. METHODS: This study was intended to help in diagnosis of shrimps allergen in 60 allergic patients (subdivided to 3 groups Urticaria (G1), rhinitis (G2) & asthma (G3)) and evaluate the sublingual immunotherapy by employing skin prick test, specific Immunoglobulin E, Total Immunoglobulin E, Immunoglobulin G, Eosinophilis and Peak Expiratory Flow Rate (PEFR), before and after therapy. Inclusion criteria were a history of shrimp allergy and positive skin prick test to crude shrimp extract from two species [Penaeus semisulcatus and Metapenaeus stebbingi] at allergy and clinical immunology unit, in-Shams Hospitals. They underwent immunotherapy with extract of shrimp species and administered sublingually (SLIT). The measurement of all latter investigations for shrimp allergen on the start and 6 months after immunotherapy, as compared to placebo control, were performed. Results: The clinical response and laboratory improvement of the patients was correlated with their decline in the eosinophils (p < 0.001), total Immunoglobulin E (p < 0.001) and specific Immunoglobulin E test (p < 0.001) and with their increased in PEFR (p < 0.001) and Immunoglobulin G (p < 0.001). This study suggests that the most desenstized responsed group was rhinitis group followed by Urticaria group. Also,The more effective season induce allergy in summer (48.3%) followed by springs (28.3%) and genatic predisposition of allergic diseases was highly accepted in patients had a family history (68%). In conclusion, sublingual immunotherapy for shrimp allergy was safe, simple, uncostly, well tolerated and efficacious, gave a good results especially in the treatment of patients with allergic rhinitis.