CLINICAL TRIAL: IMMUNOPROPHYLAXIS IN THE PREVENTION OF ALLERGIC DISEASE

这个子项目是许多研究子项目中的一个 由NIH/NCRR资助的中心赠款提供的资源。子项目和 研究者（PI）可能从另一个NIH来源获得了主要资金， 因此可以在其他CRISP条目中表示。所列机构为 研究中心，而研究中心不一定是研究者所在的机构。 哮喘是一种高度流行的疾病，也是儿科人群发病率和死亡率的重要原因。 预防策略主要集中在避免过敏原，以防止致敏导致特应性和哮喘的发展。 致敏通常发生在学龄前;发生得越早，长期后果越严重。 最近的研究表明，在儿童早期减少过敏性致敏可能是预防哮喘的有效策略。 例如，预防性过敏治疗（PAT）研究表明，在6-14岁的儿童中，通过常规（皮下）免疫治疗可以减少过敏性鼻炎向哮喘的进展。 在另一项研究中，Passalacqua等人表明，舌下免疫疗法导致治疗组中新致敏反应的大幅减少。 此外，儿童哮喘和过敏症国际研究（ISAAC）已经确定了早期生活中花粉暴露水平与过敏症状之间的反比关系，这表明粘膜暴露于过敏原的程度增加可能会提供对致敏的保护。 舌下免疫治疗已被证明在儿童中是安全的，并且在超过15年的文献中没有报告严重的全身不良事件。 因此，本试验旨在通过舌下免疫疗法优化粘膜耐受过程，该疗法通过口腔粘膜提高过敏原暴露水平，这是一种已显示优先致耐受性的途径。 假设： 舌下免疫疗法与吸入过敏原混合物可以防止过敏致敏和哮喘的发展在高危儿童。

This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. Asthma is a highly prevalent disease and a significant cause of morbidity and mortality in the pediatric population. Preventive strategies have principally focused on allergen avoidance to prevent sensitization leading to the development of atopy and asthma. Sensitization commonly occurs during preschool years; the earlier it occurs, the more severe are the long-term consequences. Recent studies suggest that reduction of allergic sensitization during early childhood may be an effective strategy for asthma prevention. For example, the Preventive Allergy Treatment (PAT) study demonstrated that the progression of allergic rhinitis to asthma can be reduced by conventional (subcutaneous) immunotherapy in children 6-14 years of age. In another study, Passalacqua et al. showed that sublingual immunotherapy resulted in a major reduction in new sensitizations in the treatment group. Additionally,, the International Study of Asthma and Allergies in Childhood (ISAAC) has identified an inverse relationship between levels of pollen exposure in early life and allergy symptoms, suggesting that heightened mucosal exposure to the allergen may provide protection against sensitization. Sublingual immunotherapy has been shown to be safe in children, and no severe systemic adverse event has been reported in the literature in more than 15 years. Therefore, this trial aims to optimize the mucosal tolerance process by sublingual immunotherapy, which enhances the level of allergen exposure via the oral mucosa, a route that has been shown to be preferentially tolerogenic. HYPOTHESIS: Sublingual immunotherapy with an inhalant allergen mixture can prevent the development of allergic sensitization and asthma in high-risk children.