Immunotherapy has been considered as secondary strategy of IgE mediated allergic disease. It decreases delayed airway inflammation and blocks irreversible airway change but many controversies still exist despite of its remarkable effect.

The purpose of this study was to estimate clinical effectiveness of immunotherapy in patients with asthma sensitized to house dust mite and to evaluate related factors.

Thirty asthmatic patients visiting allergy clinic of Mock-Dong hospital of Ewha woman university enrolled from March, 1996 to February. All patients were received the D. farinae and D. pteronyssinus standardized extract by a immunotherapy(IT) schedule and we measured clinical parameters.

1) Symptom-medication score was significantly improved after treatment (8.9±0.29 ; before IT vs. 3.4±0.20 ; after IT, p<0.05).

2) Methacholine challenge test demonstrated significant improvement (PC20 0.78± 0.09 before IT vs. 1.l8±0.17 after I year of IT, p<0.05). After we divided patients into two groups, group I that showed more than twice increasing in PC20 after I year IT and group II that did not. There was no significant difference between the groups in pre-treatment PC20s (8.75±2.75mg/ml in group I vs. 7.08±1.84mg/ml in group II, p<0.05).

3) Skin prick test demonstrated no significant change (wheel flare ratio in D. farinae 2.44±0.24 before IT vs. 2.11±0.26 after IT, in D. pteronyssinus 2.33±0.29 before IT vs. 2.22±0.22 after IT, p>0.05).

4) There were no significant correlations for any combination among these three parameters (symptomatic improvement, change of PC20 and disease duration of asthma).

5) In view of side effects, no fatal systemic reaction occurred during treatment period. Only one patient experienced injection-related dyspnea and urticaria that were easily controlled by medication.

This study demonstrated that patients with asthma sensitized to house dust mite benefit from specific immunotherapy through symptomatic improvement and reduced nonspecific bronchial hyperreactivity. As for side reactions immunotherapy might be relatively safe if allergen is carefully administered a controlled and supervised environment.

The granulation tissue, which are found in nonspecific inflammation, occasionally seemed like round mass. We experienced and report four cases in which the granulation tissue presented as endobronchial mass on the bronchoscopy. The masses obstructing lobar or segmental bronchial oriface were round, smooth surfaced and pinkish except whitish one case. The granulation tissue caused by acute or chronic inflammations, should be considered to differentiate endobronchial mass.