Assessing the Efficacy of Immunotherapy with a Glutaraldehyde-Modified House Dust Mite Extract in Children by Monitoring Changes in Clinical Parameters and Inflammatory Markers in Exhaled Breath

Abstract

Introduction: The aim of this study was to evaluate the effectiveness of specific immunotherapy (SIT) management with allergoids in children with allergic asthma by monitoring changes in clinical parameters and inflammatory markers in exhaled breath. Methods: The study population included 43 patients (24 males) of 6-14 years of age, who had allergic asthma and were sensitized to mites. Twenty-three individuals were treated with subcutaneous SIT (PURETHALt Mites, HAL Allergy) for 8 months, i.e. the SIT group, and 20 were given medication to treat symptoms only, i.e. the control group. Before treatment and after 4 and 8 months, several clinical parameters, the levels of exhaled nitric oxide and the pH of exhaled breath condensate (EBC) were determined. Results: The SIT group presented with an improvement in asthma classification, a reduction in maintenance drug therapy and improved scores on the quality-of-life questionnaire. These changes were not observed in the control group. Both groups presented significant decreases in EBC pH values at 4 and 8 months after treatment compared to at baseline. However, analysis of the variable ‘ratio' showed an increase in the EBC pH values after 8 months of treatment in the SIT group compared with the values at 4 months. Conclusions: SIT with standardized mite extract reduces asthma symptoms in children. A decrease in EBC pH values was observed in both groups, although the SIT group presented a tendency of recovered values after 8 months. Future studies of EBC pH monitoring in the longer term are needed to determine the effectiveness of this marker. i 2014 S. Karger AG, Basel

Fractional Exhaled Nitric Oxide: A Potential Biomarker in Allergic Rhinitis?

“…In addition, the present outcomes are consistent with the most relevant literature concerning this issue [31,32,33,34]. …”

Allergen-Specific Immunotherapy in the Treatment of Pediatric Asthma: A Systematic Review

“…23 Most authors did not specify the level of asthma control, but in 1 trial, children were considered not well controlled. 18 In 5 of the trials, patients were monosensitized and received a single allergen (HDM was evaluated in 4, 17,19,20,22,23 mold was evaluated in 1 18 ); in 2 trials, polysensitized patients received multiple allergens 21,24 ; and in 1 trial, it was unclear if patients were monosensitized or polysensitized, and these patients were treated with HDM. 17 The maintenance-dosing interval varied from biweekly to every 6 weeks, and duration of therapy ranged from 3 months to 3 years.…”

“…In 2 RCTs including 57 children, authors reported on asthma-specific QoL using a validated tool (Asthma Quality of Life Questionnaire [AQLQ]) (Supplemental Table 7). 18,19 Researchers in both trials compared single allergen SCIT (HDM and mold) to pharmacotherapy in children with mild to moderate persistent asthma and found a significant improvement in AQLQ scores in the SCIT arm but no difference between study arms. Although these trials had consistent results, there is low SOE that SCIT improves asthma-related QoL based on 2 small trials with medium and high ROB.…”

Evolution of subcutaneous allergen immunotherapy (part 1): from first developments to mechanism-driven therapy concepts

“…An open prospective study on children with mite allergy demonstrated a significant improvement in asthma classification as well as a reduction in asthma medication as early as after 8 months of treatment with a mite allergoid. An improvement in quality of life was also observed [60].…”