Table of Contents
Journal of Allergy
Volume 2012, Article ID 106069, 6 pages
Clinical Study

A Randomised, Double-Blind Pilot Study of Enzyme-Potentiated Desensitisation for Prophylaxis of Large Local Reactions to Mosquito Bites

1Royal London Hospital for Integrated Medicine, University College London Hospital NHS Foundation Trust, 60 Great Ormond Street, London WC1N 3HR, UK
2Disease Control & Vector Biology Unit, Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, Keppel Street, London WC1E 7HT, UK
3Sarum Road Hospital, Allergy Clinic, Sarum Road, Winchester SO22 5HA, UK
4Joint UCLH/UCL Biomedical Research Unit, Ground Floor, Rosenheim Wing, 25 Grafton Way, London WC1E 6DB, UK

Received 29 November 2011; Accepted 31 January 2012

Academic Editor: Ting Fan Leung

Copyright © 2012 S. Berkovitz et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Primary Objective. To test the hypothesis that two injections of enzyme-potentiated mosquito antigen significantly reduce the size of experimental mosquito bites in participants with LLR-MB. Design. Randomised, double-blind, placebo-controlled, parallel group comparison over 3 months. Setting. Hospital outpatient clinic. Participants. Fifty adult participants of both sexes. Interventions. Two injections of mosquito antigen or matching placebo, 6 weeks apart. Main Outcome Measures. Early (1 hour) and late (24 hours) mean square root of erythema area (SREA) following controlled mosquito bite with the second bite given at least 6 weeks following the final injection. Results. At 1 hour, mean SREA was slightly higher in the EPD group compared to placebo after adjusting for baseline values (0.46, 95% CI  to 7.03), but this was not statistically significant ( , ANCOVA analysis); neither were the results at 24 hours ( , 95% CI  to 6.57) ( ). The proportion of participants experiencing a decrease in wheal size at 1 or 24 hours was similar between groups. Conclusions. EPD was not demonstrated to be effective for immediate or delayed LLR-MB. Methodological problems included a high variability in LLR-MB between subjects, suggesting that a crossover design should be used in future.