Considerations in allergen immunotherapy for allergic asthma in pediatric patients under 4 years of age

Panganiban, Christine M.; Tam, Jonathan S.

doi:10.1016/j.anai.2021.02.007

Cited by 2 publications

(7 citation statements)

References 8 publications

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“…81 Currently, registered products are approved for children older than 5 years old, but few studies explored AIT benefits in younger patients too, although adherence is a main issue in pre-scholar children. 82,83 Contraindications to AIT include uncontrolled asthma, eosinophilic esophagitis and history of severe systemic or large local reactions to immunotherapy. Furthermore, some conditions potentially associated with a worst survival after an anaphylactic event or with reduced responsiveness to its treatment (ie, severe lung or heart disease, beta-blocker use, etc.)…”

Section: Immunotherapy and Its Preventive Effect On Disease Evolutionmentioning

confidence: 99%

“…89 Another debated issue is related to the ideal timing of AIT initiation in the life-course: in the light of its disease modifying effect it is reasonable to start the treatment as early as possible, although some caution is recommended in children <4 years of age. 82 As mentioned above, the early introduction of AIT has the chance to exert a preventive effect on asthma development particularly in children and adolescents with AR and grass/birch pollen allergy; in addition AIT reduces the risk of new allergen sensitization in such patients, though evidence on that is still weak. 90 Besides its preventive effect, immunotherapy is effective as a treatment in allergic asthma patients.…”

Section: Immunotherapy and Its Preventive Effect On Disease Evolutionmentioning

confidence: 99%

Section: Immunotherapy and Its Preventive Effect On Disease Evolutionmentioning

confidence: 99%

Section: Immunotherapy and Its Preventive Effect On Disease Evolutionmentioning

confidence: 99%

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Diagnosis and Management of Allergic Rhinitis in Asthmatic Children

Tenero¹,

Vaia²,

Ferrante³

et al. 2023

JAA

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Allergic rhinitis (AR) is a common upper airways inflammatory condition especially in paediatric population; its burden potentially impacts on quality of life, quality of sleep and daily performance, which can be difficult to perceive but not less relevant in the middle-long term. The present review aims to provide an updated overview on AR epidemiology, diagnosis and with a special focus on its connections with bronchial asthma. In fact, when considering asthmatic pediatric population, AR is probably the most important risk factor for asthma onset and the most impactful extra-bronchial determinant of asthma control. Under this perspective, allergen immunotherapy (AIT) should always be considered in the light of a precision medicine approach. In fact, AIT does represent a unique opportunity to specifically interfere with AR immunological background, improve both AR and bronchial asthma control and prevent allergic disease evolution. Verifying the patient's eligibility to that option should be considered as a priority for every physician managing children suffering from AR, especially when associated with bronchial asthma.

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Section: Immunotherapy and Its Preventive Effect On Disease Evolutionmentioning

confidence: 99%

Section: Immunotherapy and Its Preventive Effect On Disease Evolutionmentioning

confidence: 99%

Section: Immunotherapy and Its Preventive Effect On Disease Evolutionmentioning

confidence: 99%

Section: Immunotherapy and Its Preventive Effect On Disease Evolutionmentioning

confidence: 99%

See 2 more Smart Citations

Diagnosis and Management of Allergic Rhinitis in Asthmatic Children

Tenero¹,

Vaia²,

Ferrante³

et al. 2023

JAA

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show abstract

“…The prevention of respiratory allergies seems possible, but the effects of pAIT need to be better explored 2,15,20,50 . Currently, implementing pAIT still faces challenges due to age‐related factors 27,45 and limited data.…”

Section: Introductionmentioning

confidence: 99%

Preventive allergen immunotherapy with inhalant allergens in children

Dwivedi,

Kopanja,

Schmidthaler

et al. 2024

Allergy

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The efficacy and safety of preventive allergen immunotherapy (pAIT) in children are currently under investigation. Here, we provide an overview of pAIT with respiratory allergens concerning the prevention of new sensitizations, allergic disease onset and progression as well as further immunomodulatory effects. Three databases were searched for clinical pAIT studies in children. Selected publications were reviewed for preventive outcomes according to prevention level (primary, secondary, and tertiary), allergen type, administration route, dose, and treatment duration. The primary prevention approach appears safe but showed no allergen‐specific effect on new sensitizations. Secondary prevention seems feasible and may induce regulatory T cell‐mediated immunotolerance. The number of studies at these prevention levels is limited. Tertiary prevention with grass and/or tree pollen‐based pAIT has shown efficacy in preventing disease progression from allergic rhinitis/conjunctivitis to asthma. Data on tertiary pAIT with house dust mites and other allergen types are inconclusive. Subcutaneous and sublingual routes appear similarly effective, but head‐to‐head comparative paediatric studies are scarce. Additionally, there are fewer placebo‐controlled studies. Nevertheless, immunomodulatory outcomes of pAIT are encouraging. Currently, limited but favourably suggestive evidence is available for preventing respiratory allergic diseases in children by pAIT. Primary and secondary prevention have potential and warrant further investigation through well‐designed studies.

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Considerations in allergen immunotherapy for allergic asthma in pediatric patients under 4 years of age

Cited by 2 publications

References 8 publications

Diagnosis and Management of Allergic Rhinitis in Asthmatic Children

Diagnosis and Management of Allergic Rhinitis in Asthmatic Children

Preventive allergen immunotherapy with inhalant allergens in children

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