Clinical and immunologic effects of long‐term sublingual immunotherapy in asthmatic children sensitized to mites:a double‐blind, placebo‐controlled study

Pajno, Giovanni Battista; Morabito, L.; Barberio, G; Parmiani, S.

doi:10.1034/j.1398-9995.2000.00495.x

Cited by 203 publications

(196 citation statements)

References 28 publications

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“…It was reported that allergenspecific immunotherapy briefly increases the IgE level and subsequently reduces it. Fujimura et al reported that SLIT was more effective for JC pollinosis when the serum cedar allergen-specific IgG4/total IgE ratio was low before treatment than when the ratio was high [20]. In the present study, we found a significant increase of allergen-specific IgE after the pollen season in the SLIT group.…”

Section: Igg4/iggsupporting

confidence: 74%

“…Allergen-specific immunotherapy was reported to increase the blood level of IgG4, and Gleich proposed that allergen-specific IgG4 acts as a blocking antibody [18]. SLIT increases serum levels of antigen-specific IgG4 and also increases the antigen-specific IgG4/IgE ratio [19,20], and it has been suggested that serum IgG acts as blocking antibody and is associated with symptomatic improvement [21]. In Japan, it was reported that allergen-specific SLIT increases serum Cry j 1-specific IgG4 antibody in patients with JC pollinosis [22].…”

Section: Igg4/iggmentioning

confidence: 99%

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Sublingual immunotherapy for Japanese cedar pollinosis: potential biomarkers predicting therapeutic responses

Masuno¹,

Okubo²

2016

Otorhinolaryngol Head Neck Surg

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Objective: Sublingual immunotherapy (SLIT) for allergic rhinitis due to Japanese cedar ( JC) pollisosis was investigated to examine its clinical efficacy and adverse effects, as well as the changes of serum antibodies.Research design and methods: A placebo-controlled, double-blind study was performed with 12 patients in the SLIT group and 16 patients in the placebo group. Treatment was started before the JC pollen season and was continued until after the pollen season. The SLIT group received daily up-titration of a JC pollen allergen extract over 2 weeks, followed by maintenance therapy twice weekly. The placebo group received the vehicle of the allergen extract at the same dosage. Subjects kept symptom diaries during the JC pollen season.Main outcome measures: Scores were assigned for nasal symptoms (sneezing, itching, rhinorrhea, and obstruction) and the total nasal symptom score (TNSS) was calculated during the pollen season. Immunoglobulin levels were measured before and after treatment.Results: During the 90-day period from February 1 to April 30, the sneezing score, nasal itching score, rhinorrhea score, nasal congestion score, and TNSS were significantly lower in the SLIT group than the placebo group for 15, 15, 33, 22, and 37 days, respectively. Serum levels of JC allergen-specific IgG and IgE showed no significant difference between the 2 groups before treatment, but were significantly higher in the SLIT group than the placebo group after the pollen season. Although JC allergen-specific IgG4 was also higher in the SLIT group after the pollen season, there was no significant difference. The IgG4/IgG ratio showed no significant difference between the two groups either before treatment or after the pollen season. Adverse events were only Grade 1 in both groups and resolved spontaneously.Conclusions: SLIT suppressed symptoms of JC pollinosis and increased the JC-specific IgG4/IgG ratio in the first season of treatment.

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Section: Igg4/iggsupporting

confidence: 74%

Section: Igg4/iggmentioning

confidence: 99%

Sublingual immunotherapy for Japanese cedar pollinosis: potential biomarkers predicting therapeutic responses

Masuno¹,

Okubo²

2016

Otorhinolaryngol Head Neck Surg

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“…The risk of bias was low in 3 studies. 22,32,34 Therefore, the strength of evidence is high that SLIT improves asthma symptoms, compared with placebo.…”

Section: Asthmamentioning

confidence: 99%

“…[22][23][24][32][33][34][35]37,38 Seven studies evaluated dust mite allergen. [22][23][24][32][33][34]38 The SLIT-treated children in the placebo-controlled studies demonstrated moderate to strong improvement in asthma symptoms. The risk of bias was low in 3 studies.…”

Section: Asthmamentioning

confidence: 99%

Allergen-Specific Immunotherapy for Pediatric Asthma and Rhinoconjunctivitis: A Systematic Review

Kim¹,

Lin²,

et al. 2013

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BACKGROUND AND OBJECTIVE: Subcutaneous immunotherapy (SCIT) is approved in the United States for the treatment of pediatric asthma and rhinitis; sublingual immunotherapy (SLIT) does not have regulatory approval but is used in clinical practice. The objective of this study was to systematically review the evidence regarding the efficacy and safety of SCIT and SLIT for the treatment of pediatric asthma and allergic rhinoconjunctivitis. METHODS:Two independent reviewers selected articles for inclusion, extracted data, and graded the strength of evidence for each clinical outcome. All studies were randomized controlled trials of children with allergic asthma or rhinoconjunctivitis treated with SCIT or an aqueous formulation of SLIT. Data sources were Medline, Embase, LILACS, CENTRAL, and the Cochrane Central Register of Controlled Trials through May 2012. RESULTS:In 13 trials, 920 children received SCIT or usual care; in 18 studies, 1583 children received SLIT or usual care. Three studies compared SCIT with SLIT head-to-head in 135 children. The strength of evidence is moderate that SCIT improves asthma and rhinitis symptoms and low that SCIT improves conjunctivitis symptoms and asthma medication scores. Strength of evidence is high that SLIT improves asthma symptoms and moderate that SLIT improves rhinitis and conjunctivitis symptoms and decreases medication usage. The evidence is low to support SCIT over SLIT for improving asthma or rhinitis symptoms or medication usage. Local reactions were frequent with SCIT and SLIT. There was 1 report of anaphylaxis with SCIT.CONCLUSIONS: Evidence supports the efficacy of both SCIT and SLIT for the treatment of asthma and rhinitis in children. Pediatrics

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“…While the lack of allergen exposure for 12 months may have been responsible for the decrease of CADESI scores, it is important to note that it did not lead to a decrease of the allergen specific IgE, which remained in the positive range. Interestingly, other studies in humans have also reported clinical improvement in glycerin (vehicle) treated patients [33]. In one study on the effect of SLIT in children with mild to moderate asthma sensitized to DM a 30% improvement was reported in the control group after 12 months of treatment.…”

Section: Discussionmentioning

confidence: 87%

Clinical and Immunologic Effects of Allergen-Specific Sublingual Immunotherapy in a Canine Model of Atopic Dermatitis: A Double Blind, Randomized, Controlled Study

K¹

2013

J Allergy Ther

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Sublingual Allergen Specific Immunotherapy (SLIT) has been advocated for the treatment for allergies. Controlled studies are difficult to perform in humans due to the variety of allergies, diet, and allergenic exposure. This prospective, randomized, controlled study evaluated clinical and immunological effects of one year of SLIT using an experimental model of atopic dermatitis in dogs. Eighteen Beagles, sensitized to dust mites, timothy grass and ragweed were divided into control (n=6, vehicle) and active (n=12, 3 allergens) groups. Allergen challenge and scoring of clinical signs was done before and at the end of one year of SLIT. Blood was drawn at baseline, 4,8, and 12 months of SLIT and 2 months after stopping SLIT to measure allergen-specific IgE, IL-10, and TGF-beta.After 12 months of SLIT, ANOVA showed significant decrease of clinical scores for both groups (p<.0001) but no significant differences between groups. T tests within each group comparing pre vs. post treatment scores showed statistically significant decrease in the control (p=0.042) and in the SLIT group (p=0.00027). Effect size using Cohen's d was 1.182 for control and 2.1 for allergen group. Thus, decrease from baseline to post-treatment was nearly twice as large in the allergen as in the control group.Mixed results were found for allergen-specific IgE with significant decrease for dust mites (p=0.0242) and increase for ragweed (p=0.0074) at the end of the study. SLIT induced significant increase of TGF-beta (p=0.03) and IL-10 (p=0.0009) after ragweed stimulation compared to baseline and to the control group. TGF-beta increase abated after SLIT discontinuation results consistent with SLIT induced T regulatory response. Interestingly a significant increase for IL-10 after timothy stimulation was seen for both groups at the end of study (p<.0001).It is concluded that this experimental model is useful to investigate treatments for atopic dermatitis and their immunologic effects.

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Clinical and immunologic effects of long‐term sublingual immunotherapy in asthmatic children sensitized to mites:a double‐blind, placebo‐controlled study

Cited by 203 publications

References 28 publications

Sublingual immunotherapy for Japanese cedar pollinosis: potential biomarkers predicting therapeutic responses

Sublingual immunotherapy for Japanese cedar pollinosis: potential biomarkers predicting therapeutic responses

Allergen-Specific Immunotherapy for Pediatric Asthma and Rhinoconjunctivitis: A Systematic Review

Clinical and Immunologic Effects of Allergen-Specific Sublingual Immunotherapy in a Canine Model of Atopic Dermatitis: A Double Blind, Randomized, Controlled Study

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