Dust Mite–Induced Perennial Allergic Rhinitis in Pediatric Patients and Sublingual Immunotherapy

Anderson, Halie M.; Wood, Robert A.; Busse, William W.

doi:10.1016/j.jaip.2016.07.013

Cited by 9 publications

(11 citation statements)

References 23 publications

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“…The main unsolved problem is when to start SLIT, and on which basis. The only clear fact is that the previously suggested limitation of >5 years is no more valid in an absolute way and probably, the age of 4 years or greater would be the best choice especially to achieve the optimal adherence …”

Section: Present Future and Unmet Needs Of Slitmentioning

confidence: 98%

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30 years of sublingual immunotherapy

Passalacqua

Bagnasco

Canonica

2019

Allergy

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Allergen Immunotherapy (AIT) was introduced in clinical practice on an empirical basis more than 100 years ago. Since the first attempts, AIT was administered subcutaneously. Indeed, other routes of administration were proposed and studied, in particular to improve the safety, but only the sublingual route (SLIT) achieved a credibility based on evidence and was then accepted as a viable “alternative” option to the subcutaneous route. SLIT was largely used in clinical trials and clinical practice in this last 30 years. Thus, a large amount of data is available, coming from either controlled trials and postmarketing surveillance studies. It is clear that SLIT is overall effective, but it is also clear that the efficacy is not “class‐related,” as derived from meta‐analyses, but restricted to each specific product. The 30‐year lasting use of SLIT allowed to clarify many clinical aspects, such as efficacy, safety, use in asthma, regimens of administration, and optimal doses. In parallel, the mechanisms of action of AIT were elucidated, and new indications were proposed (eg food allergy, atopic dermatitis). In addition, the introduction of molecular‐based diagnosis, allowed to better refine the prescription of SLIT, based on specific sensitization profiles. The present article will describe the origin and evolution of SLIT for respiratory allergy, taking into account the clinical context that suggested this form of treatment, the recently developed aspects, the future perspectives and unmet needs, This is not, therefore, a systematic review, rather a narrative historical description of the past history, and a look forward to the future opportunities.

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Section: Present Future and Unmet Needs Of Slitmentioning

confidence: 98%

“…This remains a fundamental part of the “history” that persists in the present. The use of SLIT in children is well accepted by paediatricians, at least in those countries which are familial with this route . The main unsolved problem is when to start SLIT, and on which basis.…”

Section: Present Future and Unmet Needs Of Slitmentioning

confidence: 99%

30 years of sublingual immunotherapy

Passalacqua

Bagnasco

Canonica

2019

Allergy

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“…While the efficacy of specific allergen immunotherapy and, even more, sublingual immunotherapy (SLIT) were previously disputed 7 , a change of paradigms has taken place with the increasing number of controlled clinical trials conducted in HDM allergy patients using various formulations of HDM SLIT, such as tablets or drops. The clinical efficacy and long-term effects of HDM SLIT in AR is today undisputable in adults in European 8, 9 and US 10 studies, as well as in elderly patients 11 and in children 12–15 .…”

Section: Introductionmentioning

confidence: 99%

Sublingual house dust mite immunotherapy has no impact on decrease of circulating erythrocytes upon airway allergen challenge in allergic rhinitis

Jordakieva

Kundi

Lemell

et al. 2017

Sci Rep

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House dust mite (HDM) allergy is a predominant cause for perennial allergic rhinitis (AR) in Europe. We recently reported that circulating erythrocyte numbers decrease after airway allergen challenge in a murine asthma model and in grass-pollen sensitized AR subjects. Consequently, we aimed to evaluate these findings in HDM sensitized AR subjects and the influence of preceding allergen immunotherapy. Seventy-seven (age 26.8 ± 7.3 years; 54.5% female) HDM-allergic rhinitis subjects previously enrolled in a randomized, monocentric sublingual immunotherapy (SLIT) trial at the Vienna Challenge Chamber (VCC) were included. Subjects had either received placebo (n = 22), low-dose HDM (n = 29) or high-dose HDM specific sublingual immunotherapy (n = 26) daily for 24 weeks. Blood sampling was performed before and after 6 hours of HDM allergen exposure. Overall, specific airway allergen challenge resulted in a significant decrease in circulating erythrocytes and hematocrit (p < 0.001), and elevation of leukocytes (p < 0.001), particularly segmented neutrophils (p < 0.001). Gender had no significant effect on the observed changes in circulating blood cells. Erythrocytes decreased and neutrophil counts increased significantly after airway allergen challenge regardless of preceding immunotherapy. These findings imply a rapid systemic mobilization of neutrophils occurring within immediate type hypersensitivity response upon a specific allergen challenge, which is possibly inversely linked with the erythrocyte numbers.

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“…However, because of the suboptimal drug delivery routes and poor compliance by children, it might take a long time to show a curative effect [15]. The application of SLIT is very convenient and D. farinae drops can inhibit the degranulation of T lymphocytes in the human body, reduce the tension bronchial smooth muscles, and alleviate symptoms such as breathlessness and cough [16].…”

Section: Discussionmentioning

confidence: 99%

Efficacy of Sublingual Administration of Dermatophagoides Farinae Drops for Treatment of Pediatric Allergic Rhinitis Accompanied by Adenoid Hypertrophy and Improvement of Immune Function

Mao

Pan

et al. 2019

Med Sci Monit

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BackgroundThe aim of this study was to determine the efficacy of sublingual administration of Dermatophagoides farinae drops for the treatment of allergic rhinitis (AR) accompanied by adenoid hypertrophy and the effect on immune function in children.Material/MethodsEosinophil counts in peripheral blood before and after treatment were determined; serum levels of immunoglobulin E (IgE), total IgE (T-IgE), immunoglobulin G4 (IgG4), interleukin-2 (IL-2), and interleukin-6 (IL-6) before and after treatment were detected by enzyme-linked immunosorbent assay.ResultsThe total effective rate in the study group was significantly higher than that in the control group (P<0.05). In both the study and control groups, symptom scores, medication scores, eosinophil counts in the peripheral blood, and serum levels of IgE, T-IgE, and IL-6 were significantly lower than those before treatment (P<0.05), while the serum levels of IgG4 and IL-2 were significantly higher than those before treatment (P<0.05). After treatment, symptom scores, medication scores, eosinophil counts in the peripheral blood, and serum levels of IgE, T-IgE, and IL-6 in the study group were significantly lower than those in the control group (P<0.05), while the serum levels of IgG4 and IL-2 were significantly higher in the study group than those in the control group (P<0.05).ConclusionsSublingual administration of D. farinae drops improved the clinical symptoms of pediatric AR caused by Dermatophagoides mites and improved the immune functions in children.

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Dust Mite–Induced Perennial Allergic Rhinitis in Pediatric Patients and Sublingual Immunotherapy

Cited by 9 publications

References 23 publications

30 years of sublingual immunotherapy

30 years of sublingual immunotherapy

Sublingual house dust mite immunotherapy has no impact on decrease of circulating erythrocytes upon airway allergen challenge in allergic rhinitis

Efficacy of Sublingual Administration of Dermatophagoides Farinae Drops for Treatment of Pediatric Allergic Rhinitis Accompanied by Adenoid Hypertrophy and Improvement of Immune Function

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