[Sublingual immunotherapy with allergenic extract of Dermatophagoides pteronyssinus in asthmatic children].
ABSTRACT Sublingual immunotherapy is based on the treatment of distinct pathologies. It is not exempt from discomfort and hazards; thus, alternative approaches for therapy are being tested.
To assess the effectiveness of sublingual immunotherapy, with Dermatophagoides pteronyssinus in asthmatic children.
Fifty pediatric patients of both sexes between 5 and 15 years were randomly divided into two groups. The first group received sublingual immunotherapy with Dermatophagoides pteronyssinus in concentrations of 500, 1000, 2000, 5000, 8000 and 10,000 biological units. Both groups received conventional therapy, and spirometry and total IgE were measured every 30 days. The use of bronchodilators and steroids was assessed before and during the test.
Peak expiratory flow improved in the study group with a remarkable difference (p < 0.05). There were not significant differences in the control group (p > 0.05); however, at the end of the study an increase of 80% was observed. In urgency services, patients who received immunotherapy had relative risk (RR) = 0.36 and confidence interval (CI) of 95%, 0.15, 0.84. The use of steroids equally decreased in patients receiving immunotherapy RR = 0.27, CI 95%, 0.10, 0.69.
Sublingual immunotherapy does reduce the risk for asthma episodes in children.
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ABSTRACT: Sublingual immunotherapy (SLIT) is effective and safe in the treatment of allergic rhinitis. However, there is no meta-analysis in asthma treatment. The clinical efficacy of SLIT for asthma was evaluated through a systematic review with meta-analysis. MEDLINE (1966-2005), EMBASE (1974-2005), LILACS (1982-2005), and the Cochrane Library were searched for related literature in any language. Randomized-controlled clinical trials (RCT) on SLIT in asthma treatment for adults and children were selected. From 119 citations, 25 studies with 1706 patients were included in this meta-analysis. For each report, quality scores were assigned and data were extracted in relation to the outcomes analyzed: asthmatic symptoms, use of asthma medications, lung function, and bronchial provocation. According to the Jadad quality method, 64% of the studies were assigned scores of 4 or 5. Immunotherapy was seen to significantly reduce asthma severity when parameter compositions were all analyzed by categorical outcomes. There was a nonsignificant reduction in asthma symptoms when analyzed using standardized mean differences. No severe reactions were observed. This meta-analysis found that SLIT is beneficial for asthma treatment albeit the magnitude of the effect is not very large. Moreover, it is a safe alternative to the subcutaneous route. More RCT with standardization of symptom scores and medications are needed in order to contribute further to this subject.Allergy 11/2006; 61(10):1162-72. DOI:10.1111/j.1398-9995.2006.01205.x · 6.00 Impact Factor
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ABSTRACT: Sublingual immunotherapy (SLIT) appears to be the most promising alternative for a traditional injective immunotherapy. In this publication we are trying to answer the questions concerning SLIT safety and its influence on symptoms, and the evolution of allergies. Clinical effects have been analyzed, as well as possible SLIT influence on the respiratory function, specific and non-specific hyperreactivity, hypersensitivity in skin prick-tests, specific IgE and IgG, allergy inflammation markers and immune system.Pediatria polska 08/2007; 82(8):635-641. DOI:10.1016/S0031-3939(07)70357-8