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Original Article
 

Long-Term Effect of Sublingual and Subcutaneous Immunotherapy in Dust Mite–Allergic Children With Asthma/ Rhinitis: A 3-Year Prospective Randomized Controlled Trial
 

Karakoc-Aydiner E1*, Eifan AO1,2*, Baris S1, Gunay E1, Akturk H1, Akkoc T1, Bahceciler NN1,3, Barlan IB1

1Pediatric Allergy and Immunology, Marmara University Medical Faculty, Istanbul, Turkey
2Allergy and Clinical Immunology, National Heart and Lung Institute, Imperial College London, UK
3Pediatric Allergy and Immunology, Near East University, Faculty of Medicine, North Nicosia, Cyprus
*These authors contributed equally to this work

J Investig Allergol Clin Immunol 2015; Vol. 25(5): 334-342
 

 Abstract


Background and Objective: Specific allergen immunotherapy is the only treatment modality that might change the natural course of allergic diseases in childhood. We sought to prospectively compare the long-term clinical and immunological effects of sublingual (SLIT) and subcutaneous (SCIT) immunotherapy compared with pharmacotherapy alone.

Methods: In this single-center, prospective randomized controlled trial, 48 children with mild persistent asthma with/without rhinitis, monosensitized to house dust mites (HDMs) were followed for 3 years. At baseline and years 1 and 3 of follow-up, patients were evaluated and compared for total rhinitis (TRSS) and asthma (TASS) symptom scores, total symptom scores (TSS), total medication scores (TMS), safety profiles, skin-nasal-bronchial reactivity, and immunological parameters.

Results: A significant reduction was observed in TASS for both HDM-SCIT and HDM-SLIT at year 3 of treatment compared with baseline and controls (P<.05 for both), with significant improvement in rhinitis symptoms for both groups compared with controls (P=.01 for both). TSS decreased significantly in both HDM-SCIT and HDM-SLIT at year 3 compared with baseline (P=.007 and P=.04, respectively) and controls (P<.01 for both). A significant reduction in TMS was observed in HDM-SCIT and HDM-SLIT compared with baseline and controls (P=.01 in all cases), with a reduction in skin reactivity to HDM (P<.05). Finally, a significant increase in allergen specific IgG4 was observed in the SCIT group at year 3 compared with baseline, the SLIT group, and controls (P<.001 in all cases).

Conclusions: HDM-sensitized asthmatic children treated for at least 3 years with either SCIT or SLIT showed sustained clinical improvement.

Key words: Asthma. Children. House dust mites. Immunotherapy. Subcutaneous immunotherapy. Sublingual immunotherapy.