The Evaluation Value of the Modified Lund-Kennedy Nasal Endoscopy Score on the Efficacy of Sublingual Immunotherapy for Allergic Rhinitis.

Abstract

Objective: Allergic rhinitis (AR) is a growing public health problem worldwide. Respecting the significance of the modified Lund-Kennedy (MLK) score in rhinitis assessment, we delved into its evaluation value on the sublingual immunotherapy (SLIT) efficacy in AR patients.

Methods: Totally 100 AR patients were enrolled, with pre- and post-SLIT MLK score, total nasal symptoms score (TNSS), total medication score (TMS), visual analogue scale (VAS), inflammatory cytokines, and immune function-related parameters compared. The correlations of MLK score with TNSS/TMS/VAS, as well as with IL-4/INF-γ/eosinophil (EOS)/percentage/specific immunoglobulin (sIgE)/sIgG were assessed by Spearman correlation analysis. The value of MLK score on assessing SLIT efficacy in AR patients was analyzed.

Results: SLIT treatment reduced MLK/TNSS/TMS/VAS scores, abated IL-4 level/EOS percentage/sIgE, and elevated INF-γ/sIgG levels. MLK score was positively correlated with pre- and post-SLIT TNSS score (r_{pre-treatment}= 0.592, r_{post-treatment}= 0.756), TMS score (r_{pre-treatment}= 0.385, r_{post-treatment}= 0.718), VAS score (r_{pre-treatment}= 0.369, r_{post-treatment}= 0.704), IL-4 (r_{pre-treatment}= 0.553, r_{post-treatment}= 0.639), EOS percentage (r_{pre-treatment}= 0.511, r_{post-treatment}= 0.632), and sIgE (r_{pre-treatment}= 0.472, r_{post-treatment}= 0.524), and negatively with INF-γ (r_{pre-treatment}= -0.418, r_{post-treatment}= -0.578) and sIgG4 (r_{pre-treatment}= -0.460, r_{post-treatment}= -0.613). The MLK score had an area under curve of 0.846 (77.01% sensitivity, 76.92% specificity, 4 cut-off value) and 0.944 (91.67% sensitivity, 92.11% specificity, 2 cut-off value) for assessing SLIT treatment as effective and markedly effective for the patients, respectively.

Conclusion: The MLK score had good evaluation value on the efficacy of SLIT treatment in AR patients.