Efficacy and safety of sublingual immunotherapy using house dust mite tablet for 1-4 years old children with perennial allergic rhinitis.

IF 4.3 2区医学 Q2 ALLERGY Pediatric Allergy and Immunology Pub Date : 2024-07-01 DOI:10.1111/pai.14203

Koki Sasamoto, Ken-Ichi Nagakura, Tomoyuki Asaumi, Naoko Fusayasu, Katsuyo Ohashi-Doi, Noriyuki Yanagida, Sakura Sato, Motohiro Ebisawa

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Abstract

Background: Sublingual immunotherapy (SLIT) for perennial allergic rhinitis (AR) has not been extensively studied in preschoolers. We investigated the efficacy and safety of house dust mite (HDM) SLIT-tablet for children aged 1-4 years.

Methods: Children aged 1-4 years with AR were divided into SLIT (n = 22) and control (n = 12) groups based on their guardians' preferences. The SLIT group received a daily dose of 10,000 JAU of HDM SLIT-tablet for 12 months, whereas the control group received symptomatic treatment only.

Results: The baseline median age was 41 and 34 months in the SLIT and control groups, respectively, and the median AR symptom score was 4 for both groups. Compared with baseline, the AR symptom score had decreased significantly in the SLIT group after 12 months (score: 3, p = .002), whereas it tended to increase in the control group (score: 6, p = .08). Adverse reactions to SLIT were mild and occurred in eight patients (36%). In the SLIT group, Dermatophagoides (D.) farinae-specific IgE (sIgE) levels increased during the first 6 months and decreased to baseline levels at 12 months. In the control group, D. farinae-sIgE levels had increased significantly at 12 months compared to baseline (p = .01). D. farinae-specific IgG₄ and HDM IgE-blocking factor levels were significantly increased at 12 months compared to baseline in the SLIT group only (p < .001). A lower wheezing frequency was seen in the SLIT group (0.3%) compared to the control group (0.7%).

Conclusion: This pilot study demonstrated the efficacy, safety, and immunomodulatory effects of HDM SLIT-tablet in preschoolers with AR.

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使用屋尘螨片对 1-4 岁常年性过敏性鼻炎儿童进行舌下免疫疗法的有效性和安全性。

背景：舌下免疫疗法（SLIT）治疗常年性过敏性鼻炎（AR）在学龄前儿童中尚未得到广泛研究。我们研究了屋尘螨（HDM）舌下含片对 1-4 岁儿童的疗效和安全性：方法：根据监护人的偏好，将患有 AR 的 1-4 岁儿童分为 SLIT 组（22 人）和对照组（12 人）。SLIT组每天服用10,000 JAU的HDM SLIT片剂，为期12个月，而对照组仅接受对症治疗：结果：SLIT组和对照组的基线年龄中位数分别为41个月和34个月，两组的AR症状评分中位数均为4分。与基线相比，SLIT 组的 AR 症状评分在 12 个月后显著下降（评分：3，p = .002），而对照组的 AR 症状评分则呈上升趋势（评分：6，p = .08）。SLIT 的不良反应轻微，有 8 名患者（36%）出现了不良反应。在 SLIT 组，法氏囊虫特异性 IgE（sIgE）水平在前 6 个月有所上升，在 12 个月时降至基线水平。在对照组中，与基线相比，12 个月时的 D. Farinae-IgE 水平显著升高（p = .01）。仅 SLIT 组的 D. farinae 特异性 IgG4 和 HDM IgE 阻断因子水平在 12 个月时与基线相比有明显增加（p 结论：该研究证明了 D. farinae 的疗效：这项试验性研究表明，HDM SLIT 片剂对患有 AR 的学龄前儿童具有疗效、安全性和免疫调节作用。

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来源期刊

Pediatric Allergy and Immunology 医学-过敏

CiteScore

9.10

自引率

9.10%

发文量

200

审稿时长

4-8 weeks

期刊介绍： Pediatric Allergy and Immunology is the world''s leading journal in pediatric allergy, publishing original contributions and comprehensive reviews related to the understanding and treatment of immune deficiency and allergic inflammatory and infectious diseases in children. Other areas of interest include: development of specific and accessory immunity; the immunological interaction during pregnancy and lactation between mother and child. As Pediatric Allergy and Immunology promotes communication between scientists engaged in basic research and clinicians working with children, we publish both clinical and experimental work.