Clinical efficacy and immunological mechanisms of sublingual and subcutaneous immunotherapy in asthmatic/rhinitis children sensitized to house dust mite: an open randomized controlled trial
Clinical efficacy and immunological mechanisms of sublingual and subcutaneous immunotherapy in asthmatic/rhinitis children sensitized to house dust mite: an open randomized controlled trial
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DOI：
10.1111/j.1365-2222.2009.03448.x
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发表时间：
2010-06-01
影响因子：
6.1
通讯作者：
Barlan, I. B.
中科院分区：
文献类型：
--
作者：
Eifan, A. O.;Akkoc, T.;Barlan, I. B.
背景 在儿童中，舌下免疫疗法 (SLIT) 与皮下免疫疗法 (SCIT) 相比的临床疗效和免疫学机制仍有待阐明。 目的 比较 SLIT、SCIT 和药物治疗在对屋尘螨 (HDM) 敏感的哮喘/鼻炎儿童中的临床疗效和免疫学机制。方法 在这项单中心、前瞻性、随机、对照、开放标签、三平行组试验中，48 名患者参与对 HDM 单一敏感的患者被随机分配接受 SLIT (n = 16)、SCIT (n = 16) 或单独药物治疗 (n = 16)。收集症状、药物治疗和视觉模拟评分 (VAS)，并在基线和治疗后 12 个月进行支气管鼻高反应性、皮肤点刺试验、总特异性 IgE。此外，用重组 Der p 1 和 Bet v 1 提取物培养外周血单核细胞，并测量过敏原特异性 IL-4、IL-5、IL-13、IFN-gamma、IL-10 和 TGF-β 分泌物。结果 SLIT 和 SCIT 证明鼻炎和哮喘症状总评分、药物总评分、VAS 和皮肤对 HDM 的反应性显着降低 (P
Background In children, the clinical efficacy and immunological mechanisms of sublingual immunotherapy (SLIT) compared with subcutaneous immunotherapy (SCIT) is still to be elucidated.Objectives To compare SLIT, SCIT and pharmacotherapy in relation to clinical efficacy and immunological mechanisms that govern its effect in asthmatic/rhinitis children who were sensitized to house dust mite (HDM).Methods In this single centre, prospective, randomized, controlled, open labelled, three parallel group trial, 48 patients mono-sensitized to HDM were randomized to receive either SLIT (n = 16), SCIT (n = 16) or pharmacotherapy alone (n = 16). Symptom, medication and visual analogue score (VAS) were collected and bronchial-nasal hyper-reactivity, skin prick tests, total-specific IgE were performed at baseline and 12 months after treatment. In addition, peripheral blood mononuclear cells were cultured with recombinant Der p 1 and Bet v 1 extracts and allergen-specific IL-4, IL-5, IL-13, IFN-gamma, IL-10, and TGF-beta secretions were measured.Results SLIT and SCIT demonstrated a significant reduction of total rhinitis and asthma symptom score, total medication score, VAS and skin reactivity to HDM (P