Allergen immunotherapy (AIT) is the only treatment that can change the course of allergic diseases. However, there has not been any research on metabolic reactions in relation to AIT with single or mixed
allergens. In this study, patients with
allergic rhinitis caused by Dermatophagoides pteronyssinus (Der p) and Dermatophagoides farinae (Der f) were treated with single-mite (Der p) and double-mite (Der p:
Der f = 1:1) subcutaneous
immunotherapy (SCIT), respectively. To compare the efficacy and the dynamic changes of
inflammation-related single- and double-species mite subcutaneous
immunotherapy (SM-SCIT and DM-SCIT), we performed visual analogue scale (VAS) score, rhinoconjunctivitis quality of life questionnaire (RQLQ) score and serum metabolomics in
allergic rhinitis patients during SCIT. VAS and RQLQ score showed no significant difference in efficacy between the two treatments. A total of 57 metabolites were identified, among which downstream metabolites (5(S)-
HETE (Hydroxyeicosatetraenoic
acid), 8(S)-
HETE, 11(S)-
HETE, 15(S)-
HETE and 11-hydro TXB2) in the ω-6-related
arachidonic acid and
linoleic acid pathway showed significant differences after approximately one year of treatment in SM-SCIT or DM-SCIT, and the changes of the above serum metabolic components were correlated with the magnitude of RQLQ improvement, respectively. Notably, 11(S)-HETE decreased more with SM-SCIT, and thus it could be used as a potential
biomarker to distinguish the two treatment schemes. Both SM-SCIT and DM-SCIT have
therapeutic effects on patients with
allergic rhinitis, but there is no significant difference in efficacy between them. The reduction of
inflammation-related metabolites proved the
therapeutic effect, and potential
biomarkers (
arachidonic acid and its downstream metabolites) may distinguish the options of SCIT.