Pollen immunotherapy reduces the development of asthma in children with seasonal rhinoconjunctivitis (the PAT-study).
BACKGROUND
Children with allergic rhinitis are likely to develop asthma.


OBJECTIVE
The purpose of this investigation was to determine whether specific immunotherapy can prevent the development of asthma and reduce bronchial hyperresponsiveness in children with seasonal allergic rhinoconjunctivitis.


METHODS
From 6 pediatric allergy centers, 205 children aged 6 to 14 years (mean age, 10.7 years) with grass and/or birch pollen allergy but without any other clinically important allergy were randomized either to receive specific immunotherapy for 3 years or to an open control group. All subjects had moderate to severe hay fever symptoms, but at inclusion none reported asthma with need of daily treatment. Symptomatic treatment was limited to loratadine, levocabastine, sodium cromoglycate, and nasal budesonide. Asthma was evaluated clinically and by peak flow. Methacholine bronchial provocation tests were carried out during the season(s) and during the winter.


RESULTS
Before the start of immunotherapy, 20% of the children had mild asthma symptoms during the pollen season(s). Among those without asthma, the actively treated children had significantly fewer asthma symptoms after 3 years as evaluated by clinical diagnosis (odds ratio, 2.52; P <.05). Methacholine bronchial provocation test results improved significant in the active group (P <.05).


CONCLUSIONS
Immunotherapy can reduce the development of asthma in children with seasonal rhinoconjunctivitis.
Möller
Christian
C
Department of Paediatrics, Umeå University, Sweden.
Dreborg
Sten
S
Ferdousi
Hosne A
HA
Halken
Susanne
S
Høst
Arne
A
Jacobsen
Lars
L
Koivikko
Antti
A
Koller
Dieter Y
DY
Niggemann
Bodo
B
Norberg
Lene A
LA
Urbanek
Radvan
R
Valovirta
Erkka
E
Wahn
Ulrich
U
D000293:Adolescent; D001249:Asthma / Q000175:diagnosis / Q000517:prevention & control*; D029662:Betula / Q000009:adverse effects / Q000276:immunology; D001985:Bronchial Provocation Tests; D002648:Child; D003233:Conjunctivitis, Allergic / Q000209:etiology / Q000628:therapy*; D003888:Desensitization, Immunologic; D006801:Humans; D016210:Methacholine Chloride / Q000494:pharmacology; D006109:Poaceae / Q000009:adverse effects / Q000276:immunology; D011058:Pollen / Q000009:adverse effects / Q000276:immunology*; D006255:Rhinitis, Allergic, Seasonal / Q000209:etiology / Q000628:therapy*; D012621:Seasons
D016210:Methacholine Chloride