Dust mite specific immunotherapy: fight against dust mites and get rid of allergies!

Author: Tang Zhiyuan: Deputy Chief Physician of Otolaryngology Head and Neck Surgery/Allergic Disease Diagnosis and Treatment Center, Shenzhen University General Hospital

Reviewer: Li Liming, Chief Physician of Otolaryngology and Head and Neck Surgery/Allergic Diseases Diagnosis and Treatment Center, Shenzhen University General Hospital

Specific immunotherapy is one of the first-line methods for treating allergic diseases recommended by the World Health Organization (WHO) and domestic and international diagnosis and treatment guidelines. Since dust mites cannot be completely avoided in life, dust mite-specific immunotherapy should be the first choice for allergic diseases caused by dust mites. It includes sublingual specific immunotherapy and subcutaneous specific immunotherapy. The principle of subcutaneous specific immunotherapy (hereinafter referred to as "subcutaneous desensitization") is relatively simple. It is to use proteins extracted from dust mites to perform periodic subcutaneous injections on patients allergic to dust mites. During this process, the injection dose and concentration are gradually increased to improve the patient's tolerance to dust mites. The core of this treatment method is to gradually improve the patient's systemic immune imbalance, thereby controlling or alleviating the patient's symptoms of dust mite allergy.

Figure 1 Copyright image, no permission to reprint

Subcutaneous desensitization plays an important role in the natural course of allergic diseases. It not only changes the traditional symptomatic treatment model, but also fundamentally changes the development trend of allergic diseases by directly intervening on allergens. This method is highly targeted and has long-term effects, which can significantly improve patients' symptoms and quality of life.

However, subcutaneous desensitization is not suitable for all patients with dust mite allergies. Some patients may not be able to accept this treatment due to individual differences or other factors. Therefore, before choosing subcutaneous desensitization, a professional doctor is required to conduct a comprehensive evaluation and diagnosis to ensure that the patient is suitable for this treatment.

Subcutaneous desensitization can fundamentally change the natural course of allergic diseases and improve the quality of life of patients. However, patients need to fully consider their own conditions and the doctor's advice when choosing and using this treatment method.

1. Which groups of people are suitable for subcutaneous desensitization?

Subcutaneous desensitization is suitable for people who are allergic to dust mites and have clinical symptoms, including: ① patients with allergic rhinitis (symptoms: sneezing, runny nose, nasal itching, nasal congestion); ② patients with allergic dermatitis (symptoms: redness, swelling, itching, wheals, peeling); ③ patients with allergic conjunctivitis (symptoms: itchy eyes, swollen and congested eyes, etc.);

④ Patients with allergic asthma (symptoms: chest tightness, shortness of breath, and even wheezing); ⑤ Patients with allergic diseases who cannot tolerate long-term use of medications or are worried about adverse drug reactions.

A professional doctor needs to conduct corresponding examinations and combine clinical symptoms and allergen test results to determine whether subcutaneous desensitization can be performed.

Figure 2 Copyright image, no permission to reprint

2. What is the effect of subcutaneous desensitization?

Subcutaneous desensitization can produce the following effects: ① Allergic symptoms are significantly alleviated or even disappear; ② The dosage of symptomatic drugs is reduced or even stopped; ③ It can reduce the number of new allergens and have a desensitizing effect on existing allergens; ④ Prevent rhinitis from progressing to asthma, and asthma from progressing to chronic obstructive pulmonary disease; ⑤ Reduce the probability of new allergies.

3. Why does subcutaneous desensitization treatment take so long?

During the subcutaneous desensitization process, the doctor will inject specific allergen preparations subcutaneously to allow people who are allergic to such substances to repeatedly contact the allergens. In this process, the concentration of allergens is gradually increased, thereby gradually improving the tolerance of the immune system of the allergic person to the allergen. When sufficient tolerance is generated, an immune response will occur and the corresponding "antibodies" will be produced. In this way, the human body will no longer have an allergic reaction after contacting such allergens in daily life, achieving the effect of "transforming" its own immune system. However, this "transformation" process is relatively long and is not "accomplished overnight". It usually takes about 3 years or even longer, but the specific treatment time is determined by the doctor based on the specific situation of the patient. During the treatment process, the patient must strictly follow the doctor's instructions to receive treatment and must not interrupt the treatment on his own. Because unauthorized interruption of treatment may affect the treatment effect and may even cause the allergic reaction to recur.

During treatment, it is also very important to maintain a healthy lifestyle and a stable mentality. Patients should actively exercise to improve their own immunity. A healthy lifestyle includes a balanced diet, adequate sleep and proper exercise. At the same time, maintaining a stable mentality can also help reduce stress and anxiety, which is conducive to the recovery of the body and the balance of the immune system. Only in this way can the best treatment effect be achieved.

Figure 3 Copyright image, no permission to reprint

4. Are there any adverse reactions to subcutaneous desensitization?

Subcutaneous desensitization preparations are usually made from dust mite protein extracts. Unlike traditional drugs, they are not metabolized by the human body and therefore do not affect organs such as the liver and kidneys.

However, patients also need to pay attention to some matters before and after subcutaneous desensitization treatment. First, before and after subcutaneous injection, patients should avoid participating in strenuous exercise, as this may cause excessive fatigue of the body and affect the normal function of the immune system. Secondly, patients should avoid eating high-protein foods such as meat, seafood, eggs, milk, etc., as these foods may cause allergic reactions and interact with preparations for treating dust mite allergies, affecting the treatment effect. In addition, patients should also be careful not to perform subcutaneous desensitization on the day of fever or injection of other vaccines. Fever may be caused by infection or other reasons, and subcutaneous desensitization at this time may aggravate the condition. The injection of other vaccines may interfere with dust mite preparations, affecting the effectiveness of the vaccine or causing adverse reactions.