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Specific immunotherapy has long-term clinical effects and the potential of preventing development of asthma in children with allergic rhino conjunctivitis up to 7 years after treatment termination.

Immunotherapy for 3 years with standardized allergen extracts of grass and/or birch shows long-term clinical effect and preventive effect on development of asthma in children with seasonal rhinoconjunctivitis.

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– In an earlier study, we found that chronic treatment with β2‐adrenoceptor agonists in asthmatic subjects gave an impaired saliva secretion and a higher caries prevalence than in healthy controls. Twenty‐one of the asthmatics and their matched controls were examined 4 yr later in a follow‐up study. Samples of whole saliva stimulated by chewing and parotid saliva stimulated by citric acid were collected and dental caries was scored. In the asthmatic group the secretory rates of stimulated whole and parotid saliva decreased by 20% and 35%, respectively, compared to the control group. The number of lactobacilli increased. The asthmatic subjects had a decreased output per minute of total protein, amylase, hexosamine, salivary peroxidase, lysozymc, secretory IgA, a bacteria‐aggregating glycoprotein, potassium, and calcium in stimulated parotid saliva. Initial and manifest caries lesions as well as the number of DFS were significantly increased in the asthma group. We conclude that asthmatic patients treated with β2‐adrenoccptor agonists have an increased caries susceptibility due to an impaired saliva secretion caused by the use of β‐adrenergic agonists.

Repeated conjunctival provocation tests (CPT) were done in 20 children with rhino-conjunctivitis due to birch pollen allergy. Compared with the first open challenge, three successive blinded CPTs were reproducible within an allergen strength difference of one 10-potency in 92% of the tests. Based on the data, a power function was constructed, making it possible to determine the number of patients needed to discriminate CPT sensitivity of a given magnitude between two populations. During the study period specific serum-IgE increased in only three of 19 patients, indicating that stimulation of IgE antibody production is not a common consequence of repeated tests. We conclude that CPT is useful in clinical research. When indicated in clinical routine, CPT is a safe and easy test with good precision.

We investigated the levels of mite (Der p I and Der f I) allergen in dust from bedrooms, living rooms, kitchens, and bathrooms from 130 homes of asthmatic children in three climatic zones of Sweden. Bedroom dust samples included the child's mattress, carpets, floors, and other plain surfaces. Living-room dust samples were taken from sofas and other furniture, carpets, floors, and other plain surfaces. The allergen levels were related to home characteristics, including absolute indoor humidity (AIH), relative humidity (RH), and air changes per hour (ach). Mite allergen was detected in 62% of the homes. Levels of Der p I varied between < 16 ng and 50 micrograms/g dust, and Der f I between < 16 ng and 73 micrograms/g dust. Because we have designed a composite type of dust collection in our study, the allergen levels found tend to average down the results. Mite allergen levels were higher in homes with dampness problems, in homes with a smoker, and in homes without a basement. Homes with high absolute humidity (> or = 7 g/kg) or relative humidity (> or = 45%) and poor ventilation (< 0.5 ach) contained higher levels of mite allergens than homes with lower humidity and better ventilation. However, the number of ach measurements in homes was not high, and few homes had > 0.5 ach. Sensitization to house-dust mites was more common in southern than in northern and central Sweden. High levels of house-dust mite allergen in a temperate climate where mites are not ubiquitous are thus associated with dampness problems in homes and with tobacco smoking. Our data confirm and extend previous findings that high AIH and RH and poor ventilation increase the risk of mite infestation in homes. It seems to be important and necessary to control indoor humidity and ventilation levels, to avoid high mite allergen exposure in a temperate climate, because 34% of mite-sensitized asthmatic children were exposed to levels of mite allergen < 2 micrograms/g dust in their homes. The study also shows that mite allergen levels below the suggested threshold level (2 micrograms/g dust) are associated with mite sensitivity in children with perennial symptoms of asthma.

Twenty-four children, from 10 to 20 years old, with asthma treated with beta 2-adrenoceptor agonists were matched with healthy controls of the same age, sex, and social background. Stimulated whole and parotid saliva was collected, and decayed and filled tooth surfaces as well as oral hygiene habits were recorded. The dietary and sugar intake was carefully checked by a four-day dietary record. The asthmatic children had a 26% lower (p less than 0.05) value for secretion rate of whole saliva. Seventy percent of the children with Streptococcus mutans counts greater than 2 X 10(5) colony-forming units/mL of whole saliva belonged to the asthmatic group (p less than 0.05). The concentrations of total protein and amylase in parotid saliva were significantly lower for the asthmatic children. The concentrations of potassium, salivary peroxidase, bacteria-aggregating glycoproteins, and secretory IgA were not affected, but the secretion rate of parotid saliva was 36% lower in the asthma group (p less than 0.05). Oral hygiene and dietary habits did not differ between the groups. The asthmatic children had higher DFS scores, but these were not significantly different from those of the healthy controls (p = 0.07). We suggest that subjects with asthma treated with beta 2-receptor agonists should receive special prophylactic attention.