Preventive Effect of Allergen Immunotherapy on Asthma and New Sensitizations

Gradman, Josefine; Halken, Susanne

doi:10.1016/j.jaip.2021.03.010

Cited by 35 publications

(44 citation statements)

References 40 publications

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“…Given the impairment of preschool and school children during daytime activities as well as during sleep, given the increased risk of allergen induced asthma in this age period, it should be recommended to consider allergen specific immunotherapy at the latest after 2 years of allergic symptoms. During recent years the robust clinical effects of SLIT and SCIT in patients with seasonal allergic rhinitis could be confirmed by real world data obtained from data banks in Germany and France (68,69).…”

Section: Allergen Specific Immunotherapymentioning

confidence: 77%

Allergic Rhinitis in Childhood and the New EUFOREA Algorithm

Scadding

Smith²,

Blaiss

et al. 2021

Front. Allergy

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Allergic rhinitis in childhood has been often missed, mistreated and misunderstood. It has significant comorbidities, adverse effects upon quality of life and educational performance and can progress to asthma or worsen control of existing asthma. Accurate diagnosis and effective treatment are important. The new EUFOREA algorithm provides a succinct but wide- ranging guide to management at all levels, based on previous guidelines with updated evidence and has been adjusted and approved by experts worldwide.

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Section: Allergen Specific Immunotherapymentioning

confidence: 77%

Allergic Rhinitis in Childhood and the New EUFOREA Algorithm

Scadding

Smith²,

Blaiss

et al. 2021

Front. Allergy

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“…Allergen immunotherapy induces allergen‐specific immune tolerance and suppresses allergic inflammation by inducing changes in the profile of T‐ and B‐cell responses to allergens, by decreasing activation and degranulation of effector cells, and by reducing effector cells pro‐inflammatory mediators in mucosal tissues 10,11 . Studies evaluating the effectiveness of AIT in patients with allergic rhinitis suggest a reduction in the risk of developing asthma 12,13 …”

Section: Introductionmentioning

confidence: 99%

“…10,11 Studies evaluating the effectiveness of AIT in patients with allergic rhinitis suggest a reduction in the risk of developing asthma. 12,13 Asthma affects more than 300 million people worldwide and it is expected to increase in the upcoming years, being one of the most common non-communicable diseases with a high impact on patient's lives and healthcare systems. 14 Thus, there is interest in gathering information from all studies investigating this potential preventive effect of AIT in asthma onset.…”

Section: Introductionmentioning

confidence: 99%

Allergen immunotherapy for asthma prevention: A systematic review and meta‐analysis of randomized and non‐randomized controlled studies

Farraia

Paciência

Mendes

et al. 2022

Allergy

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Background: Allergen immunotherapy (AIT) is a disease-modifying treatment for IgEmediated diseases. Randomized controlled trials (RCTs) support AIT's potential role in asthma prevention but evidence from non-randomized studies of interventions (NRSI) and longitudinal observational studies has been poorly addressed. Therefore, we aimed to conduct a systematic review and meta-analysis to assess clinical data from all study types to evaluate quantitatively the preventive role of AIT in asthma onset. Methods:We search three databases. Studies were screened, selected and evaluated for quality using risk-of-bias (ROB) tools. Data were descriptively summarized and meta-analysed using random effects. We performed a sensitivity, influence and subgroup analyses. Publication bias and heterogeneity were assessed. Results:From the 4549 identified studies, 24 (12 RCTs and 12 NRSI) were included in the qualitative synthesis and 18 underwent meta-analysis. One study was at low ROB, seven had moderate ROB, and 15 were proven of high ROB. Random-effects analysis showed a significant decrease in the risk of developing asthma following AIT by 25% (RR, 95% CI: 0.75, 0.64-0.88). This effect was not significant in the sensitivity analysis. Publication bias raised concerns, together with the moderate heterogeneity between studies (I 2 = 58%). Subgroup analysis showed a remarkable preventive effect of AIT in children (RR, 95% CI: 0.71, 0.53-0.96), when completing 3 years of therapy (RR, 95% CI: 0.64, 0.47-0.88), and in mono-sensitized patients (RR, 95% CI: 0.49, 0.39-0.61). Conclusions:Our findings support a possible preventive effect of AIT in asthma onset and suggest an enhanced effect when administered in children, mono-sensitized, and for at least 3 years, independently of allergen type.

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“…Substantial evidence supports the effectiveness of AIT for AR in reducing the symptoms and medication requirements, and its safety and cost-effectiveness ( 12 ). AIT applied in the early stage of allergic disease had an excellent preventive effect on disease progression to asthma, especially in young children ( 13 ). However, significant limiting factors for AIT were the long duration of treatment, cost, poor patient compliance, and severe life-threatening adverse reactions to the treatment ( 14 ).…”

Section: Introductionmentioning

confidence: 99%

Allergic Rhinitis: What Do We Know About Allergen-Specific Immunotherapy?

et al. 2021

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Allergic rhinitis (AR) is an IgE-mediated disease that is characterized by Th2 joint inflammation. Allergen-specific immunotherapy (AIT) is indicated for AR when symptoms remain uncontrolled despite medication and allergen avoidance. AIT is considered to have been effective if it alleviated allergic symptoms, decreased medication use, improved the quality of life even after treatment cessation, and prevented the progression of AR to asthma and the onset of new sensitization. AIT can be administered subcutaneously or sublingually, and novel routes are still being developed, such as intra-lymphatically and epicutaneously. AIT aims at inducing allergen tolerance through modification of innate and adaptive immunologic responses. The main mechanism of AIT is control of type 2 inflammatory cells through induction of various functional regulatory cells such as regulatory T cells (Tregs), follicular T cells (Tfr), B cells (Bregs), dendritic cells (DCregs), innate lymphoid cells (IL-10+ ILCs), and natural killer cells (NKregs). However, AIT has a number of disadvantages: the long treatment period required to achieve greater efficacy, high cost, systemic allergic reactions, and the absence of a biomarker for predicting treatment responders. Currently, adjunctive therapies, vaccine adjuvants, and novel vaccine technologies are being studied to overcome the problems associated with AIT. This review presents an updated overview of AIT, with a special focus on AR.

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Preventive Effect of Allergen Immunotherapy on Asthma and New Sensitizations

Cited by 35 publications

References 40 publications

Allergic Rhinitis in Childhood and the New EUFOREA Algorithm

Allergic Rhinitis in Childhood and the New EUFOREA Algorithm

Allergen immunotherapy for asthma prevention: A systematic review and meta‐analysis of randomized and non‐randomized controlled studies

Allergic Rhinitis: What Do We Know About Allergen-Specific Immunotherapy?

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