Intradermal Immunoglobulin E (IgE) Injection in a Specific Interval With Emollient in the Control of Chronic Idiopathic Urticaria and Allergic Rhinitis

Sumi F, Bhuiyan M A, Mukit M, et al. (November 06, 2023)  Cureus 15(11): e48358. doi:10.7759/cureus.48358

Abstract

Background and objective: Urticaria is distinguished by the activation of mast cells and basophils via degranulation, predominantly induced by the cross-linkage of allergens with specific immunoglobulin E (IgE) antibodies. Several hypotheses propose that intradermal injections of IgE stimulate the production of antibodies that are specifically targeted towards the histamine/immunoglobulin complex. Subsequently, these antibodies exhibit binding affinity towards and exert inhibitory effects on the generation of histamine during the occurrence of allergic responses. The administration of many histaglobulin injections results in an increase in the concentration of these specific antibodies. Consequently, the present study was devised to assess the effectiveness of intradermal IgE injection in conjunction with an emollient for managing chronic idiopathic urticaria and allergic rhinitis at varying time intervals.

Methods: This study employed a cross-sectional design and included a sample of 104 participants. The sample was divided into two groups: persons diagnosed with chronic idiopathic urticaria (n=54) and individuals diagnosed with both allergic rhinitis and chronic urticaria (n=50). A 1 ml intradermal IgE injection was provided on a weekly basis over a duration of six months. A total of 49 patients were treated with intradermal IgE injection alone, while 93 patients were treated with intradermal IgE injection combined with emollient application. The evaluation of the treatment's efficacy involved the utilization of the urticaria activity score (UAS) for chronic urticaria, as well as the assessment of symptomatic improvement in cases of allergic rhinitis. The weekly examination was conducted over a span of three consecutive weeks, followed by subsequent evaluations after four, 12, and 24 weeks of attendance, culminating in the final assessment.

The reduction in number and UAS three
and six months later

Results: Within the sample of 104 participants, a substantial majority of 93 individuals exhibited good outcomes in the management of their condition with the utilization of emollients, whereas a minority of 11 patients experienced inadequate control. In contrast, a group of 49 participants had a therapy regimen that did not include the application of emollients, while another group of 55 persons displayed symptoms that were not effectively managed. Based on recent research findings, a noticeable decrease in symptoms of modest magnitude was observed by the end of the third month. Furthermore, it is important to note that all symptoms were successfully alleviated during a six-month therapeutic regimen, but there was a minor residual dissatisfaction with the impairment of the sense of smell. 

Conclusion: Following the administration of six intradermal IgE injections, a significant improvement in symptoms was observed in over 97% of patients, regardless of whether their IgE levels remained unaltered, decreased, or rose.

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