Clinical efficacy and immunological mechanisms of sublingual and subcutaneous immunotherapy in asthmatic/rhinitis children sensitized to house dust mite: an open randomized controlled trial

• Published in: Clinical and experimental allergy 2010-06, Vol.40 (6), p.922-932
• Main Authors: Eifan, A. O., Akkoc, T., Yildiz, A., Keles, S., Ozdemir, C., Bahceciler, N. N., Barlan, I. B.
• Format: Article
• Language: English
• Subjects: Administration, Sublingual; Allergies; Animals; Antigens, Dermatophagoides - administration & dosage; Antigens, Dermatophagoides - immunology; Arthropod Proteins; Asthma; Asthma - therapy; Biological and medical sciences; Child; Child, Preschool; Chronic obstructive pulmonary disease, asthma; Cysteine Endopeptidases; cytokines; Dermatophagoides pteronyssinus; Dermatophagoides pteronyssinus - immunology; Female; Fundamental and applied biological sciences. Psychology; Fundamental immunology; Humans; Hypersensitivity - therapy; Immunotherapy; Immunotherapy - adverse effects; Immunotherapy - methods; Injections, Subcutaneous; Male; Medical sciences; nasal provocation; Non tumoral diseases; Otorhinolaryngology. Stomatology; Pneumology; Pyroglyphidae - immunology; rhinitis; Rhinitis - therapy; sublingual-subcutaneous immunotherapy; Treatment Outcome; Upper respiratory tract, upper alimentary tract, paranasal sinuses, salivary glands: diseases, semeiology
• ISSN: 0954-7894; 1365-2222
• DOI: 10.1111/j.1365-2222.2009.03448.x

Summary Background In children, the clinical efficacy and immunological mechanisms of sublingual immunotherapy (SLIT) compared with subcutaneous immunotherapy (SCIT) is still to be elucidated. Objectives To compare SLIT, SCIT and pharmacotherapy in relation to clinical efficacy and immunological mechanisms that govern its effect in asthmatic/rhinitis children who were sensitized to house dust mite (HDM). Methods In this single centre, prospective, randomized, controlled, open labelled, three parallel group trial, 48 patients mono‐sensitized to HDM were randomized to receive either SLIT (n=16), SCIT (n=16) or pharmacotherapy alone (n=16). Symptom, medication and visual analogue score (VAS) were collected and bronchial‐nasal hyper‐reactivity, skin prick tests, total‐specific IgE were performed at baseline and 12 months after treatment. In addition, peripheral blood mononuclear cells were cultured with recombinant Der p 1 and Bet v 1 extracts and allergen‐specific IL‐4, IL‐5, IL‐13, IFN‐γ, IL‐10, and TGF‐β secretions were measured. Results SLIT and SCIT demonstrated a significant reduction of total rhinitis and asthma symptom score, total medication score, VAS and skin reactivity to HDM (P