Secondary and Tertiary Prevention: Medical Rehabilitation

Fieten, Karin B.; John, Swen Malte; Nowak, Dennis

doi:10.1007/164_2021_511

Cited by 1 publication

(4 citation statements)

References 92 publications

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“…Having a sensitization, especially polysensitizations, at school age already elevates the risk of adulthood asthma 100,101 . Therefore, subjects between 5 months 28,52 and preschool age, 55 with a high risk of developing allergies due to positive family history, 22 having a lower degree of sensitization and no or mild allergic symptoms would appear optimal for pAIT 5,11,28,55,89,102 …”

Section: Discussionmentioning

confidence: 99%

“…Thus, sensitized but asymptomatic preschool children might be targeted for achieving pro-tolerogenic effects (mediated by regulatory T-cells, cytokines and sIgG), 55 as also suggested by others. 14,28,29,51,89,90 Though considered promising, 5,89 the impact of primary and secondary prevention requires further investigation due to very limited data. [51][52][53][54][55] Current guidelines do not recommend these approaches.…”

Section: Discussionmentioning

confidence: 99%

“…However, this effect was not shown to be allergen-specific. 52 Despite wide speculations, 11,18,28,38,87,88 this approach faces challenges, including subject identification 89 (mainly infants), risk of unintentional sensitization, 5 and optimization of effective dose and duration.…”

Section: Discussionmentioning

confidence: 99%

“…100,101 Therefore, subjects between 5 months 28,52 and preschool age, 55 with a high risk of developing allergies due to positive family history, 22 having a lower degree of sensitization and no or mild allergic symptoms would appear optimal for pAIT. 5,11,28,55,89,102 HDM pAIT is most commonly studied. [52][53][54]57,[59][60][61][64][65][66]68,70,72,[79][80][81][82] Still, definitive evidence on its preventive benefits is missing.…”

Section: Preventive Outcomes For Tertiary Prevention Studiesmentioning

confidence: 99%

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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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