Therapeutic efficacy of 3-year subcutaneous immunotherapy in asthmatic children allergic to mite

LI Ling; HUI Yu; QIAN Jun; GUO Yun; ZHANG Xi-Lian; ZHANG Xiao-Juan

doi:10.7499/j.issn.1008-8830.2013.05.012

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Chinese Journal of Contemporary Pediatrics ›› 2013, Vol. 15 ›› Issue (5) : 368-371. DOI: 10.7499/j.issn.1008-8830.2013.05.012

CLINICAL RESEARCH

Therapeutic efficacy of 3-year subcutaneous immunotherapy in asthmatic children allergic to mite

LI Ling, HUI Yu, QIAN Jun, GUO Yun, ZHANG Xi-Lian, ZHANG Xiao-Juan

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Abstract

OBJECTIVE: To evaluate the therapeutic efficacy of 3-year subcutaneous immunotherapy (SCIT) in asthmatic children allergic to mite. METHODS: Ninety asthmatic children allergic to house dust mite (with or without allergic rhinitis) and aged 5-14 years were randomized into SCIT treatment group (n=45) and control group (n=45). The SCIT treatment group received SCIT combined with standardized treatment for asthma, while the control group received the standardized treatment alone. The therapeutic effects were assessed based on the daytime and nighttime symptom scores, mean daily doses of inhaled corticosteroids (ICS), skin prick test results, peak expiratory flows and total serum IgE at baseline and in the 3-year treatment. RESULTS: In both groups, the daytime and nighttime symptom scores in the first, second, and third years of treatment were significantly lower than the baseline values (P<0.01), and the scores decreased year by year during the 3-year treatment (P<0.01). Also, the mean daily doses of ICS in the first, second, and third years of treatment were significantly lower than the baseline values (P<0.01), and the doses decreased year by year during the 3-year treatment (P<0.01). The mean daily dose was significantly lower in the SCIT treatment group than in the control group in the second and third years of treatment (P<0.05). After 3-year treatment, the SCIT treatment group had a significantly higher proportion of children who discontinued use of ICS due to remission of symptoms compared with the control group (29% vs 20%, P<0.05). At the end of the 3-year treatment, the total serum IgE was significantly lower than the baseline value in the SCIT treatment group (P<0.01), and it was significantly lower in the SCIT treatment group than in the control group (P<0.05). CONCLUSIONS: Three-year SCIT is effective in asthmatic children allergic to house dust mite and allows reduction in the dosage of ICS.

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Subcutaneous immunotherapy / Allergic asthma / Child

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LI Ling, HUI Yu, QIAN Jun, GUO Yun, ZHANG Xi-Lian, ZHANG Xiao-Juan. Therapeutic efficacy of 3-year subcutaneous immunotherapy in asthmatic children allergic to mite[J]. Chinese Journal of Contemporary Pediatrics. 2013, 15(5): 368-371 https://doi.org/10.7499/j.issn.1008-8830.2013.05.012

References

［1］Eifan AO, Akkoc T, Yildiz A, Keles S, Ozdemir C, Bahceciler NN, et al. Clinical efficacy and immunological mechanisms of sublingual and subcutaneous immunotherapy in asthmatic/rhinitis children sensitized to house dust mite: an open randomized controlled trial［J］. Clin Exp Allergy, 2010, 40(6): 922-932.

［2］Blumberga G, Groes L, Dahl R. SQ-standardized house dust mite immunotherapy as an immunomodulatory treatment in patients with asthma［J］. Allergy, 2011, 66(2):178-185.

［3］中华医学会儿科学分会呼吸学组，中华医学会《中华儿科杂志》编辑委员会. 儿童支气管哮喘防治常规（试行）［J］. 中华儿科杂志,2004,42(2):100-106.

［4］Basomba A, Tabar AI, de Rojas DH, Garcia BE, Alamar R, Olaguibel JM, et al. Allergen vaccination with a liposomeencapsulated extract of Dermatophagoides pteronyssinus: a randomized, double-blind, placebo-controlled trial in asthmatic patients［J］. J Allergy Clin Immunol, 2002, 109(6): 943-948.

［5］Klimek L, Mewes T, Wolf H, Hansen I, Schnitker J, Mann WJ. The effects of short-term immunotherapy using molecular standardized grass and rye allergens compared with symptomatic drug treatment on rhinoconjunctivitis symptoms, skin sensitivity, and specific nasal reactivity［J］. Otolaryngol Head Neck Surg, 2005, 133(4): 538-543.

［6］谭永强, 曹兰芳, 沈瑾, 陈柳, 叶桂云, 徐决平. 粉尘螨特异性免疫治疗联合规范化防治在哮喘控制中的作用［J］. 实用儿科临床杂志，2011，26（4）：241-243.

［7］Creticos PS. The consideration of immunotherapy in the treatment of allergic asthma［J］. J Allergy Clin Immunol, 2000, 105(2): 559-575.

［8］Cox L, Cohn JR. Duration of allergen immunotherapy in respiratory allergy: when is enough, enough?［J］. Ann Allergy Asthma Immunol, 2007, 98(5): 416-426.

［9］黄娅娜, 黄英, 代继宏, 杨方方. 哮喘儿童中止皮下特异性免疫治疗原因分析［J］.中国当代儿科杂志，2012,14（9）:671-674.

［10］Frew AJ. Immunotherapy of allergic disease［J］. J Allergy Clin Immunol, 2003, 111(2 Suppl): S712-S719.

［11］Mellerup MT, Hahn GW, Poulsen LK, Malling H. Safety of allergen-specific immunotherapy. Relation between dosage regimen, allergen extract, disease and systemic sideeffects during induction treatment［J］. Clin Exp Allergy, 2000, 30(10): 1423-1429.