Controlled study of preseasonal immunotherapy with grass pollen extract in tablets: effect on bronchial hyperreactivity.
BACKGROUND
Based on experimental results, the sublingual route for immunotherapy (IT) has been accepted as a viable alternative to the injection route, but few data on the effects on asthma are so far available.


OBJECTIVE
In the present open controlled trial we evaluated whether a preseasonal IT with grass polllen in orosoluble tablets added to pharmacotherapy, can improve non-specific bronchial hyperreactivity. The clinical efficacy was evaluated as well.


METHODS
Fifty-one patients (mean age 27.4 years) suffering from rhinoconjunctivitis and/or mild-intermittent/mild-persistent asthma due to grass pollen were allocated to two groups receiving pharmacotherapy alone (n = 25) or pharmacotherapy plus IT in tablets (n = 26). A methacholine test was performed in asthmatic subjects out of the pollen seasons at baseline and after 3 years of treatment. Symptom scores and drug intake were evaluated during pollen seasons by a diary card.


RESULTS
A significant increase p = .01) in the PD20 at the methacholine test was observed in the IT group compared to the control group. A significant clinical improvement both for rhinitis (p = .001) and asthma (p = .001) was observed in the IT group, and this improvement was paralleled by a clear-cut reduction of drug intake (p = .001). An improvement of rhinitis symptoms without modification of drug intake was seen in the control group (p = .01) The treatment was well tolerated and no relevant side effect was reported during the 3 years.


CONCLUSIONS
The investigated local IT reduced the nonspecific bronchial hyperreactivity. Furthermore, it was clinically effective and safe.
Lombardi
C
C
Section of Respiratory Allergology, Sant'Orsola Hospital, Brescia, Italy,
Gargioni
S
S
Venturi
S
S
Zoccali
P
P
Canonica
G W
GW
Passalacqua
G
G
D000328:Adult; D001249:Asthma / Q000188:drug therapy / Q000276:immunology / Q000503:physiopathology; D016535:Bronchial Hyperreactivity / Q000188:drug therapy / Q000276:immunology; D003233:Conjunctivitis, Allergic / Q000188:drug therapy / Q000276:immunology; D003888:Desensitization, Immunologic; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010936:Plant Extracts / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D006109:Poaceae / Q000009:adverse effects; D011058:Pollen / Q000009:adverse effects; D011537:Pruritus / Q000139:chemically induced; D006255:Rhinitis, Allergic, Seasonal / Q000188:drug therapy / Q000276:immunology; D012621:Seasons; D013607:Tablets; D016896:Treatment Outcome
D010936:Plant Extracts; D013607:Tablets