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Clinical efficacy and immunological mechanisms of sublingual and subcutaneous immunotherapy in asthmatic/rhinitis children sensitized to house dust mite: an open randomized controlled trial
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 mec...
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Published in: | Clinical and experimental allergy 2010-06, Vol.40 (6), p.922-932 |
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creator | Eifan, A. O. Akkoc, T. Yildiz, A. Keles, S. Ozdemir, C. Bahceciler, N. N. Barlan, I. B. |
description | 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 |
doi_str_mv | 10.1111/j.1365-2222.2009.03448.x |
format | article |
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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<0.05) when compared with pharmacotherapy. A significant reduction of serum‐specific HDM‐IgE in SCIT and SLIT were observed. Moreover, titrated nasal provocative dose significantly increased in both immunotherapy groups when compared with the pharmacotherapy group. No adverse effects were reported in SLIT, while two patients demonstrated serious adverse events in SCIT. After 1 year of treatment, Der p 1‐driven IL‐10 significantly increased in SLIT compared with pharmacotherapy, whereas Bet v 1‐driven TGF‐β (negative control) increased significantly in SLIT only. No changes were observed for Th1–Th2 cytokines.
Conclusion
Both SLIT and SCIT demonstrated clinical improvement compared with pharmacotherapy in asthma/rhinitis children sensitized to HDM.</description><identifier>ISSN: 0954-7894</identifier><identifier>EISSN: 1365-2222</identifier><identifier>DOI: 10.1111/j.1365-2222.2009.03448.x</identifier><identifier>PMID: 20100188</identifier><language>eng</language><publisher>Oxford, UK: Blackwell Publishing Ltd</publisher><subject>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</subject><ispartof>Clinical and experimental allergy, 2010-06, Vol.40 (6), p.922-932</ispartof><rights>2010 Blackwell Publishing Ltd</rights><rights>2015 INIST-CNRS</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c6128-fa11192718203c61a05f902fcdc67b04c493b2ae62b0807ceaa819e84b3691263</citedby><cites>FETCH-LOGICAL-c6128-fa11192718203c61a05f902fcdc67b04c493b2ae62b0807ceaa819e84b3691263</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=22694418$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/20100188$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Eifan, A. O.</creatorcontrib><creatorcontrib>Akkoc, T.</creatorcontrib><creatorcontrib>Yildiz, A.</creatorcontrib><creatorcontrib>Keles, S.</creatorcontrib><creatorcontrib>Ozdemir, C.</creatorcontrib><creatorcontrib>Bahceciler, N. N.</creatorcontrib><creatorcontrib>Barlan, I. B.</creatorcontrib><title>Clinical efficacy and immunological mechanisms of sublingual and subcutaneous immunotherapy in asthmatic/rhinitis children sensitized to house dust mite: an open randomized controlled trial</title><title>Clinical and experimental allergy</title><addtitle>Clin Exp Allergy</addtitle><description>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<0.05) when compared with pharmacotherapy. A significant reduction of serum‐specific HDM‐IgE in SCIT and SLIT were observed. Moreover, titrated nasal provocative dose significantly increased in both immunotherapy groups when compared with the pharmacotherapy group. No adverse effects were reported in SLIT, while two patients demonstrated serious adverse events in SCIT. After 1 year of treatment, Der p 1‐driven IL‐10 significantly increased in SLIT compared with pharmacotherapy, whereas Bet v 1‐driven TGF‐β (negative control) increased significantly in SLIT only. No changes were observed for Th1–Th2 cytokines.
Conclusion
Both SLIT and SCIT demonstrated clinical improvement compared with pharmacotherapy in asthma/rhinitis children sensitized to HDM.</description><subject>Administration, Sublingual</subject><subject>Allergies</subject><subject>Animals</subject><subject>Antigens, Dermatophagoides - administration & dosage</subject><subject>Antigens, Dermatophagoides - immunology</subject><subject>Arthropod Proteins</subject><subject>Asthma</subject><subject>Asthma - therapy</subject><subject>Biological and medical sciences</subject><subject>Child</subject><subject>Child, Preschool</subject><subject>Chronic obstructive pulmonary disease, asthma</subject><subject>Cysteine Endopeptidases</subject><subject>cytokines</subject><subject>Dermatophagoides pteronyssinus</subject><subject>Dermatophagoides pteronyssinus - immunology</subject><subject>Female</subject><subject>Fundamental and applied biological sciences. Psychology</subject><subject>Fundamental immunology</subject><subject>Humans</subject><subject>Hypersensitivity - therapy</subject><subject>Immunotherapy</subject><subject>Immunotherapy - adverse effects</subject><subject>Immunotherapy - methods</subject><subject>Injections, Subcutaneous</subject><subject>Male</subject><subject>Medical sciences</subject><subject>nasal provocation</subject><subject>Non tumoral diseases</subject><subject>Otorhinolaryngology. Stomatology</subject><subject>Pneumology</subject><subject>Pyroglyphidae - immunology</subject><subject>rhinitis</subject><subject>Rhinitis - therapy</subject><subject>sublingual-subcutaneous immunotherapy</subject><subject>Treatment Outcome</subject><subject>Upper respiratory tract, upper alimentary tract, paranasal sinuses, salivary glands: diseases, semeiology</subject><issn>0954-7894</issn><issn>1365-2222</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2010</creationdate><recordtype>article</recordtype><recordid>eNqNkt2K1DAUgIso7rj6ChIQ8aqz-W8ieLEM6yos6sWK4E1I03SbsW1mkxRnfDffzXRmHMEbzU2anO_LaXJOUQAElyiPi_USEc5KnMcSQyiXkFAqltsHxeIUeFgsoGS0rISkZ8WTGNcQQsKkeFycYYggREIsip-r3o3O6B7Yts2z2QE9NsANwzT63t_tQ4M1nR5dHCLwLYhTnZ27KQdmNC_NlPRo_RSPXups0JsdcCPQMXWDTs5chC4nSi4C07m-CXYE0Y4x7_ywDUgedNm3oJliAoNL9nU-HPhNxkLO4oc9ZvyYgu_72QhO90-LR63uo312nM-Lz2-vblfvypuP1-9Xlzel4QiLstX50SSukMCQ5C0NWSshbk1jeFVDaqgkNdaW4xoKWBmrtUDSCloTLhHm5Lx4dTh3E_z9ZGNSg4vG9v3h2qqinMAKcvFvkhACGWc0ky_-Itd-CmO-hkKMsqpikslMiQNlgo8x2FZtght02CkE1dwLaq3mkqu55GruBbXvBbXN6vNjgqkebHMSfxc_Ay-PgI65zG1-aOPiHw5zSSmauTcH7rvr7e6_f0Ctri7nr-yXB9_FZLcnX4dvilekYurLh2vFxddbROQnxcgvhMLiKw</recordid><startdate>201006</startdate><enddate>201006</enddate><creator>Eifan, A. O.</creator><creator>Akkoc, T.</creator><creator>Yildiz, A.</creator><creator>Keles, S.</creator><creator>Ozdemir, C.</creator><creator>Bahceciler, N. N.</creator><creator>Barlan, I. B.</creator><general>Blackwell Publishing Ltd</general><general>Blackwell</general><general>Wiley Subscription Services, Inc</general><scope>BSCLL</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7T5</scope><scope>H94</scope><scope>K9.</scope><scope>7X8</scope></search><sort><creationdate>201006</creationdate><title>Clinical efficacy and immunological mechanisms of sublingual and subcutaneous immunotherapy in asthmatic/rhinitis children sensitized to house dust mite: an open randomized controlled trial</title><author>Eifan, A. O. ; Akkoc, T. ; Yildiz, A. ; Keles, S. ; Ozdemir, C. ; Bahceciler, N. N. ; Barlan, I. B.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c6128-fa11192718203c61a05f902fcdc67b04c493b2ae62b0807ceaa819e84b3691263</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2010</creationdate><topic>Administration, Sublingual</topic><topic>Allergies</topic><topic>Animals</topic><topic>Antigens, Dermatophagoides - administration & dosage</topic><topic>Antigens, Dermatophagoides - immunology</topic><topic>Arthropod Proteins</topic><topic>Asthma</topic><topic>Asthma - therapy</topic><topic>Biological and medical sciences</topic><topic>Child</topic><topic>Child, Preschool</topic><topic>Chronic obstructive pulmonary disease, asthma</topic><topic>Cysteine Endopeptidases</topic><topic>cytokines</topic><topic>Dermatophagoides pteronyssinus</topic><topic>Dermatophagoides pteronyssinus - immunology</topic><topic>Female</topic><topic>Fundamental and applied biological sciences. Psychology</topic><topic>Fundamental immunology</topic><topic>Humans</topic><topic>Hypersensitivity - therapy</topic><topic>Immunotherapy</topic><topic>Immunotherapy - adverse effects</topic><topic>Immunotherapy - methods</topic><topic>Injections, Subcutaneous</topic><topic>Male</topic><topic>Medical sciences</topic><topic>nasal provocation</topic><topic>Non tumoral diseases</topic><topic>Otorhinolaryngology. Stomatology</topic><topic>Pneumology</topic><topic>Pyroglyphidae - immunology</topic><topic>rhinitis</topic><topic>Rhinitis - therapy</topic><topic>sublingual-subcutaneous immunotherapy</topic><topic>Treatment Outcome</topic><topic>Upper respiratory tract, upper alimentary tract, paranasal sinuses, salivary glands: diseases, semeiology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Eifan, A. O.</creatorcontrib><creatorcontrib>Akkoc, T.</creatorcontrib><creatorcontrib>Yildiz, A.</creatorcontrib><creatorcontrib>Keles, S.</creatorcontrib><creatorcontrib>Ozdemir, C.</creatorcontrib><creatorcontrib>Bahceciler, N. N.</creatorcontrib><creatorcontrib>Barlan, I. B.</creatorcontrib><collection>Istex</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Immunology Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><jtitle>Clinical and experimental allergy</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Eifan, A. O.</au><au>Akkoc, T.</au><au>Yildiz, A.</au><au>Keles, S.</au><au>Ozdemir, C.</au><au>Bahceciler, N. N.</au><au>Barlan, I. B.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Clinical efficacy and immunological mechanisms of sublingual and subcutaneous immunotherapy in asthmatic/rhinitis children sensitized to house dust mite: an open randomized controlled trial</atitle><jtitle>Clinical and experimental allergy</jtitle><addtitle>Clin Exp Allergy</addtitle><date>2010-06</date><risdate>2010</risdate><volume>40</volume><issue>6</issue><spage>922</spage><epage>932</epage><pages>922-932</pages><issn>0954-7894</issn><eissn>1365-2222</eissn><abstract>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<0.05) when compared with pharmacotherapy. A significant reduction of serum‐specific HDM‐IgE in SCIT and SLIT were observed. Moreover, titrated nasal provocative dose significantly increased in both immunotherapy groups when compared with the pharmacotherapy group. No adverse effects were reported in SLIT, while two patients demonstrated serious adverse events in SCIT. After 1 year of treatment, Der p 1‐driven IL‐10 significantly increased in SLIT compared with pharmacotherapy, whereas Bet v 1‐driven TGF‐β (negative control) increased significantly in SLIT only. No changes were observed for Th1–Th2 cytokines.
Conclusion
Both SLIT and SCIT demonstrated clinical improvement compared with pharmacotherapy in asthma/rhinitis children sensitized to HDM.</abstract><cop>Oxford, UK</cop><pub>Blackwell Publishing Ltd</pub><pmid>20100188</pmid><doi>10.1111/j.1365-2222.2009.03448.x</doi><tpages>11</tpages><oa>free_for_read</oa></addata></record> |
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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 |
title | Clinical efficacy and immunological mechanisms of sublingual and subcutaneous immunotherapy in asthmatic/rhinitis children sensitized to house dust mite: an open randomized controlled trial |
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