Low-dose sublingual immunotherapy compared to subcutaneous immunotherapy and conventional therapy in childhood asthma
Keywords:
childhood asthma, sublingual immunotherapy, subcutaneous immunotherapy, efficacy, moderate asthma
Abstract
Background Evidence begin to accumulate that high-dose sub-lingual immunotherapy (SLIT) is as effective as subcutaneous
immunotherapy (SIT) in the treatment of childhood asthma.
Since the capacity of sublingual area is similar whether the dose
is high or low, the efficacy of low dose may be important to be
studied.
Objective To investigate the efficacy of low-dose sublingual im-
munotherapy in the treatment of childhood asthma.
Methods Parents signed informed consent prior to enrollment,
after having received information about the study. Patients were
moderate asthma aged 6-14 years with disease onset of less
than 2 years before the commencement of the study and peak
expiratory flow rate (PEFR) variability of more than 15%. Pa-
tients were randomly allocated into group A, B, and C who
received subcutaneous immunotherapy, low-dose sublingual
immunotherapy, and conventional asthma therapy, respectively.
Randomization was stratified into two strata according to age
i.e., 6-11 years or 11-14 years. Patients of each stratum were
randomized in block of three for each group. At the end of three
months, lung function tests were repeated. The primary outcome
was PEFR variability at the end of the study. The study was
approved by the Ethics Committee of Soetomo Hospital
Surabaya.
Results Distribution of variants as represented by sex, age,
eosinophil count, and total IgE concentration were normal in
the three groups. PEFR variability decreased significantly from
16.97+0.81 to 8.50+5.08 and 17.0+0.87 to 8.40+4.72 in group
receiving SIT and SLIT, respectively (p<0.05), but decreased
not significantly from 17.00+0.83 to 10.82+0.5.41 in control group
(p>0.05).
Conclusion Low-dose SLIT is as efficacious as SIT in the treat-
ment of moderate asthma in children
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bers. Allergen immunotherapy: therapeutic vaccines for
allergic diseases, a WHO position paper. J Allergy Clin
Immunol 1998;102:658-62.
2. Finegold I. Analyzing meta-analyses of specific immu-
notherapy in the treatment of asthma. Ann Allergy
Asthma Immunol 2001;87:33-7.
3. Frew AJ, White PJ, Smith HE. Sublingual immunotherapy.
J Allergy Clin Immunol 1999;104:267-70.
4. Conanica GW, Passalacqua G. Non injection routes of im-
munotherapy. J Allergy Clin Immunol 2003;111:437-48.
5. Frew AJ, Smith HE. Sublingual immunotherapy. J Al-
lergy Clin Immunol 2001;104:441-4.
6. Frew AJ. Immunotherapy of allergic disease. J Allergy
Clin Immunol 2003;111(Suppl): 172-9.
7. Holt PG, McMenamin C. Defense against allergic sen-
sitization in healthy lung: the role of inhalation toler-
ance. Clin Exp Allergy 1989;19:55-62.
8. Van-Willem EJ, van Hoogstraam IM, Breve J, Scheper
RJ, Krat G. Dendritic cells of the oral mucosa and
the induction of oral tolerance. Immunology
1994;83:128-32.
9. Bagnasco M, Mariani G, Passalcqua G. Absorption and
distribution kinetics of the major Purietaria judaica al-
lergen (Par j 1) administered by non-injectable route to
healthy human being. J Allergy Clin Immunol
1997;100:122-9.
10. La Rosa M, Ranno C, Andre C, Cart F, Tosca MA,
Canonica GW. Double-blind placebo-controlled evalu-
ation of sublingual-swallowed immunotherapy with
standardized Parietaria judaica extract in children with
rhinoconjunctivitis. J Allergy Clin Immunol
1999;104:425-32.
11. Tari MG, Mancino M, Monti G. Efficacy of sublingual
immunotherapy in patients with rhinitis and asthma
due to house dust mite. A double-blind study. Allergol
Immunopathol 1990;18:277-84.
Published
2016-10-10
How to Cite
1.
Harsono A. Low-dose sublingual immunotherapy compared to subcutaneous immunotherapy and conventional therapy in childhood asthma. PI [Internet]. 10Oct.2016 [cited 18Apr.2024];44(6):243-. Available from: https://paediatricaindonesiana.org/index.php/paediatrica-indonesiana/article/view/786
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Received 2016-10-03
Accepted 2016-10-03
Published 2016-10-10
Accepted 2016-10-03
Published 2016-10-10
