3 Double-blind Study of the Use of Transfer Factor (TF) Combined With Sublingual Immunotherapy in Management of Patients With Allergic Rhinitis in Mexican Population

BACKGROUND: Allergic diseases affect 20% of world population and allergic rhinitis (AR) is the most common, alone or associated with asthma. Antigen-specific immunotherapy has been world-desensitizing type studied showing that it is capable of modifying the natural history of the disease through changes in the immune response increasing the role of clones of lymphocytes T helper type I (LTh1) and inhibiting the activity of type 2 (LTh2). Dialyzable leukocyte extract or transfer factor (TF) has shown the same stimulatory effect. OBJECTIVE: Evaluate the synergistic effect of TF associated with SLIT in patients with RA. MATERIAL AND METHODS: We studied 94 patients with RA. We included randomized into 2 groups (47 each one) both received antigen-specific sublingual immunotherapy (SLITAE) and also in group 1 was given oral TF Unit at one 200 mg monthly for 3 months, and group 2 placebo. We used a control group only to compared the normal results. All patients underwent complete blood count (BHC), immunoglobulins, quantification of cell-type lymphocyte CD3, CD4, CD8, interleukin (IL2, IL4, IL5, IL10, TNF and IFN). The nasal symptoms were evaluated monthly for 3 months, with test score symptoms questionary 4 (TSSQ4) and auto-evaluation by scale Linker. RESULTS: We studied 94 AR patients (50% women and 50% men, range age between 5 and 40 years). Indoor antigens (mites, house dust and cockroach) were the main cause of allergy. Allergic patients had more eosinophiles and IgE than the healthy controls (P < 0.05). The number of CD8+ lymphocytes was slightly reduced in group 2 after treatment (P < 0.05), whereas the amount of IL-4 and IFN ƒnwere increased in both groups (P < 0.005) and the amount of IL-10 was significantly increased in group 1 (P < 0.01) after treatment. Clinical evaluation was with initial TSSQ4 of 11.6 before handling and 5.1 (44%) after, with significant improvement (P < 0.0001) and Likert score was reduced 69% than the star the treatment. CONCLUSIONS: The TF along with SLITAE in the treatment of patients with RA did not alter the clinical improvement induced by SLITAE alone for 3 months of treatment, but the combination increased production of IL 10 and production of IFNg.