Effects on inflammation parameters of a double-blind, placebo controlled one-year course of SLIT in children monosensitized to mites.
BACKGROUND
Clinical documentation about effects on local markers of inflammation of sublingual immunotherapy (SLIT) in children is still poor.


METHODS
Twenty-four children (age range 4-16 years, average 8.5 years) monosensitized to house dust mites (HDMs) were randomized to receive active or placebo SLIT for this allergen according to a double-blind, placebo-controlled design. Before treatment and 10-12 months later the following parameters were checked: ECP and tryptase in sputum and nasal secretion, serum and nasal mite-specific IgE (sIgE), allergen-specific nasal challenge test (sNCT), nasal symptoms and tryptase after sNCT.


RESULTS
Nasal tryptase and nasal IgE in basal conditions were unchanged in treated children but significantly increased in untreated children (P = 0.0156 and P = 0.0313, respectively). The threshold for sNCT was unchanged in both groups of children, but the symptom score after sNCT was unchanged in the placebo group and significantly decreased in the active group (P = 0.0084). The nasal tryptase after sNCT was unchanged in the active group and significantly increased in the placebo group (P = 0.0218). Intergroup comparison showed a significant difference in oral tryptase and nasal tryptase after sNCT in favour of the active group.


CONCLUSIONS
These interim results after only 1 year of treatment show that SLIT in children monosensitized to HDMs is able to avoid the spontaneous increase in both nasal sIgE antibodies and in local allergic inflammation in basal conditions. These outcomes are confirmed and supported by the decrease of symptoms in the active group combined with the increase of nasal tryptase only in the control group in both cases after sNCT.
Marcucci
F
F
Clinica Pediatrica, University of Perugia, Perugia, Italy.
Sensi
L
L
Frati
F
F
Bernardini
R
R
Novembre
E
E
Barbato
A
A
Pecora
S
S
D000286:Administration, Sublingual; D000328:Adult; D000818:Animals; D000918:Antibody Specificity / Q000276:immunology; D001798:Blood Proteins / Q000276:immunology / Q000378:metabolism; D002648:Child; D002669:Child Welfare; D002675:Child, Preschool; D004311:Double-Blind Method; D047091:Eosinophil Granule Proteins; D005260:Female; D006801:Humans; D007073:Immunoglobulin E / Q000276:immunology; D007167:Immunotherapy; D018836:Inflammation Mediators / Q000276:immunology* / Q000378:metabolism; D008297:Male; D008925:Mites / Q000276:immunology*; D009297:Nasal Mucosa / Q000276:immunology / Q000378:metabolism; D009299:Nasal Provocation Tests; D012130:Respiratory Hypersensitivity / Q000276:immunology / Q000628:therapy; D012260:Ribonucleases / Q000276:immunology / Q000378:metabolism; D012697:Serine Endopeptidases / Q000276:immunology / Q000378:metabolism; D013183:Sputum / Q000276:immunology / Q000378:metabolism; D016896:Treatment Outcome; D053802:Tryptases
D001798:Blood Proteins; D047091:Eosinophil Granule Proteins; D018836:Inflammation Mediators; D007073:Immunoglobulin E; D012260:Ribonucleases; D012697:Serine Endopeptidases; D053802:Tryptases