CLINICAL TRIAL: IMMUNOPROPHYLAXIS IN THE PREVENTION OF ALLERGIC DISEASE

这个子项目是许多研究子项目中利用 资源由NIH/NCRR资助的中心拨款提供。子项目和 调查员(PI)可能从NIH的另一个来源获得了主要资金， 并因此可以在其他清晰的条目中表示。列出的机构是 该中心不一定是调查人员的机构。 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。预防策略主要侧重于避免过敏原，以防止导致特应性和哮喘的致敏反应。敏感化通常发生在学龄前几年；越早发生，长期后果就越严重。最近的研究表明，减少儿童早期的过敏反应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)免疫疗法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。结果显示，舌下免疫治疗导致治疗组中新的致敏反应显著减少。此外，儿童哮喘和过敏症国际研究(ISAC)发现，早期接触花粉的水平与过敏症状之间存在负相关关系，这表明增加粘膜接触过敏原可能会提供保护，防止过敏。舌下免疫治疗在儿童中已被证明是安全的，在超过15年的文献中没有报道过严重的全身不良事件。因此，这项试验的目的是通过舌下免疫治疗来优化粘膜耐受过程，通过口腔粘膜提高过敏原暴露水平，这是一种已被证明具有优先耐受性的途径。 假设： 使用吸入性过敏原混合物进行舌下免疫治疗可以防止高危儿童发生过敏性过敏和哮喘。

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.