Sublingual immunotherapy abrogates seasonal bronchial hyperresponsiveness in children with Parietaria-induced respiratory allergy: a randomized controlled trial.
BACKGROUND
The use of immunotherapy in asthmatic children is still controversial. Sublingual immunotherapy (SLIT) may represent an advance, due to the good safety profile, but little is known about its effects on lung function and nonspecific bronchial responsiveness.


OBJECTIVE
The aim of this study was to assess the effects of SLIT on these parameters, in children with Parietaria pollen-induced asthma.


METHODS
Thirty children with asthma solely due to Parietaria who participated in a previous randomized, placebo-controlled trial with SLIT were studied: pulmonary function test and methacholine challenge were carried out at baseline in winter 1999 (out season), during the 1999 season (before randomization), and during the 2001 season.


RESULTS
Before randomization, there was a significant fall in methacholine provocation concentration during the pollen season vs baseline in both groups (SLIT group 9.78 +/- 5.95 mg/ml vs 3.37 +/- 2.99 mg/ml; placebo 8.70 +/- 6.25 mg/ml vs 2.44 +/- 2.25 mg/ml; P =.005). In the second pollen season, the response to methacholine returned to baseline values in the active group (9.10 +/- 7.7 mg/ml; P = NS vs baseline), whereas in the placebo group a significant increase in reactivity was still present (2.46 +/- 2.26; P = 0.008 vs baseline). No significant difference in FEV(1) and FEF(25-75) between the two groups was observed at all times.


CONCLUSIONS
Our data show that SLIT abrogates the seasonal bronchial hyperreactivity in children with asthma due to Parietaria. This may be regarded as an indirect evidence of the effect on bronchial inflammation.
Pajno
G B
GB
Paediatric Clinic, Messina Polyclinic Hospital, University of Messina, Messina, Italy.
Passalacqua
G
G
Vita
D
D
Caminiti
L
L
Parmiani
S
S
Barberio
G
G
D000293:Adolescent; D001249:Asthma / Q000503:physiopathology / Q000628:therapy*; D016535:Bronchial Hyperreactivity / Q000628:therapy*; D002648:Child; D003888:Desensitization, Immunologic; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D008168:Lung / Q000503:physiopathology; D008297:Male; D032403:Parietaria / Q000276:immunology*; D011058:Pollen / Q000276:immunology*