Specific Immunotherapy in Children: The Evidence

Rosa, Mario La; Lionetti, Elena; Leonardi, ﻿Salvatore; Salpietro, Annamaria; Bianchi, Luigi; Salpietro, Carmelo; Giudice, M. Miraglia Del; Ciprandi, Giorgio; Marseglia, Gian Luigi

doi:10.1177/03946320110240s413

Cited by 36 publications

(26 citation statements)

References 82 publications

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“…Only a few cases of anaphylaxis have been reported in children receiving SLIT, although none was found in our review. [52][53][54] One important benefit of SIT specific to children may be the potential to modify the response to allergens at an early stage and thus prevent disease progression. 16,20,21,24,28,31 SIT is currently the only treatment with this potential to modify and prevent progression of disease from allergic rhinitis to asthma.…”

Section: Discussionmentioning

confidence: 99%

Allergen-Specific Immunotherapy for Pediatric Asthma and Rhinoconjunctivitis: A Systematic Review

Kim¹,

Lin²,

et al. 2013

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BACKGROUND AND OBJECTIVE: Subcutaneous immunotherapy (SCIT) is approved in the United States for the treatment of pediatric asthma and rhinitis; sublingual immunotherapy (SLIT) does not have regulatory approval but is used in clinical practice. The objective of this study was to systematically review the evidence regarding the efficacy and safety of SCIT and SLIT for the treatment of pediatric asthma and allergic rhinoconjunctivitis. METHODS:Two independent reviewers selected articles for inclusion, extracted data, and graded the strength of evidence for each clinical outcome. All studies were randomized controlled trials of children with allergic asthma or rhinoconjunctivitis treated with SCIT or an aqueous formulation of SLIT. Data sources were Medline, Embase, LILACS, CENTRAL, and the Cochrane Central Register of Controlled Trials through May 2012. RESULTS:In 13 trials, 920 children received SCIT or usual care; in 18 studies, 1583 children received SLIT or usual care. Three studies compared SCIT with SLIT head-to-head in 135 children. The strength of evidence is moderate that SCIT improves asthma and rhinitis symptoms and low that SCIT improves conjunctivitis symptoms and asthma medication scores. Strength of evidence is high that SLIT improves asthma symptoms and moderate that SLIT improves rhinitis and conjunctivitis symptoms and decreases medication usage. The evidence is low to support SCIT over SLIT for improving asthma or rhinitis symptoms or medication usage. Local reactions were frequent with SCIT and SLIT. There was 1 report of anaphylaxis with SCIT.CONCLUSIONS: Evidence supports the efficacy of both SCIT and SLIT for the treatment of asthma and rhinitis in children. Pediatrics

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Section: Discussionmentioning

confidence: 99%

Allergen-Specific Immunotherapy for Pediatric Asthma and Rhinoconjunctivitis: A Systematic Review

Kim¹,

Lin²,

et al. 2013

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“…These results suggest that long-term SCIT may alleviate asthma symptoms and reduce the required dose of ICS. Previous studies have demonstrated that subcutaneous injection immunotherapy is effective in the treatment of allergic rhinitis and asthma, which may improve the symptom scores by >40% (11–15). A previous study indicated that SCIT treatment may alleviate the clinical symptoms of allergic rhinitis as early as 6 weeks following the initiation of treatment (16).…”

Section: Discussionmentioning

confidence: 99%

Efficacy analysis of three-year subcutaneous SQ-standardized specific immunotherapy in house dust mite-allergic children with asthma

Qian

et al. 2014

Experimental and Therapeutic Medicine

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The present study aimed to evaluate the efficacy of three-year subcutaneous SQ-standardized specific immunotherapy (SCIT) in house dust mite (HDM)-allergic children with asthma. Ninety children with allergic asthma to HDMs, with or without allergic rhinitis, were randomly divided into two groups, the treatment group and the control group. The treatment group received SCIT combined with standardized glucocorticoid management and the control group received standardized glucocorticoid management alone for a period of three years. The mean daily dose of inhaled corticosteroids (ICSs), a four-week diary recording the symptom scores of asthma, peak expiratory flow (PEF) measurements, skin prick test results and serum immunoglobulin E (IgE) levels were assessed prior to treatment and following one, two and three years of treatment. The median dose of ICS was reduced in the treatment group after two and three years of treatment compared with that of the control group. After three years of treatment, the discontinuation percentage of ICS in the treatment group was higher than that in the control group. The treatment group demonstrated significantly reduced daytime and night-time asthmatic symptom scores, increased PEF values and reduced serum IgE levels after two and three years of treatment compared with those in the control group (P<0.05). In conclusion, three-year SCIT treatment combined with ICS is an effective immunotherapy for children with allergic asthma and resulted in a reduction of the required ICS dose.

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“…Cyclosporine and tacrolimus are useful in steroid resistant cases, with no significant side effects, except for a burning sensation during administration having been reported (Utine, Stern, & Akpek, 2010). While immunotherapy is delivered via subcutaneous injection and sublingual (oral) route, ocular symptoms respond less well than nasal symptoms to sublingual route (La Rosa et al, 2011). Oral cyclosporines are however ineffective in treating ocular h e a l t h s a g e s o n d h e i d 2 2 ( 2 0 1 7 ) 1 1 2 e1 2 2 allergies (Utine et al, 2010).…”

Section: Immunosupressivesmentioning

confidence: 99%

Ocular allergy

Mashige

2017

Health SA Gesondheid

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Method: The Medline, PubMed, Elsevier Science Direct, and Google Scholar databases were used to search for evidence-based literature on ocular allergy.Main outcome measures: Classification and nomenclature, epidemiology and pathophysiological mechanisms, diagnosis and management of ocular allergy. Results:The search retrieved 5200 number of studies of which 6 met the criteria. IntroductionOcular allergies encompass a group of hypersensitivity disorders to normally harmless substances, known as allergens and can be observed as the only dominant presentation of an allergic sensitisation, or are associated with rhinitis, asthma, atopic dermatitis or food allergy (Leonardi et al., 2012). The most common clinical presentations of ocular allergy are conjunctival hyperaemia (redness) and chemosis (swelling), itching and tearing, and vision loss in severe cases (Chowdhury, 2013;Leonardi, De Dominicis, & Motterle, 2007). Management of this condition is based on minimising contact of the causal allergen with the conjunctiva using a series of protective measures, with medication assisting in controlling the symptoms produced by the allergic inflammatory process (Chowdhury, 2013;La Rosa et al., 2013). There is currently no universal standard nomenclature and classification, making an estimation of ocular allergy prevalence challenging. In addition, as most ocular allergic diseases are comorbidities of rhinitis, available prevalence data encompasses both ocular and nasal symptoms, making it impossible to separate ocular allergy and allergic rhinitis (La Rosa et al., 2013). Moreover, controversy continues to surround the exact pathophysiological mechanisms involved in ocular allergic diseases. The purpose of this paper is therefore E-mail address: mashigek@ukzn.ac.za. Peer review under responsibility of Johannesburg University. to systematically review scientific and published research studies on the classification and nomenclature, epidemiology and pathophysiological mechanisms, diagnosis and management of ocular allergy.h e a l t h s a g e s o n d h e i d 2 2 ( 2 0 1 7 ) 1 1 2 e1 2 Method and scope of reviewThe initial search term was 'ocular allergy' by the Information Specialist (IS). An article was considered for review if it met the inclusion criteria of reporting on the classification, nomenclature, epidemiology, pathophysiology, clinical presentation, or an approach to diagnosis and management of ocular allergy. Articles published between 1994 and 2015 years in English, and indexed in the following electronic databases were searched: Medline, PubMed, Elsevier Science Direct, and Google Scholar. The standard process for a systematic literature review was adopted:1. Titles were reviewed and those which were not relevant were rejected. 2. Abstracts of publications that were not rejected were obtained. 3. Two individuals reviewed the abstracts independently and rejected further papers that were not eligible. A third individual adjudicated if there were any differences. 4. Full text of the abstracts selected was obtained...

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Specific Immunotherapy in Children: The Evidence

Cited by 36 publications

References 82 publications

Allergen-Specific Immunotherapy for Pediatric Asthma and Rhinoconjunctivitis: A Systematic Review

Allergen-Specific Immunotherapy for Pediatric Asthma and Rhinoconjunctivitis: A Systematic Review

Efficacy analysis of three-year subcutaneous SQ-standardized specific immunotherapy in house dust mite-allergic children with asthma

Ocular allergy

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