[Clinical efficacy of a standardized specific immunotherapy against house dust mite in 85 asthmatic children].
OBJECTIVE
The scientific basis and the clinical effectiveness of allergen specific immunotherapy (SIT) administered by subcutaneous injection are well established. This study aimed to observe the changes in amount of inhaled corticosteroids, total IgE, specific IgE, peak expiratory flow rate (PEF), etc. during a standardized SIT against house dust mite in allergic asthmatic children.


METHODS
Children (5 - 13 years old) with mild to moderate allergic asthma seen from February 2005 to June 2008 were enrolled into this study. A non- randomized retrospective study was performed. All children were diagnosed sensitive to dust mites, the treatment group accepted standardized dust mite allergen specific immunotherapy. Each fourth injections were defined as observation points, the study took 3.4 years. The investigators recorded the treatment, the cumulative allergen extract, changes of daily doses of inhaled corticosteroid, peak expiratory flow (PEF), total IgE (TIgE), specific IgE (SIgE). The control group only received inhaled corticosteroids. The daily doses of inhaled corticosteroid and the number of asthma attacks, and the control rate were compared between the 2 groups.


RESULTS
Totally 85 children were treated with SIT [(7.6 ± 1.4) years], 45 males and 40 females; 50 children received only drug treatment [(7.7 ± 1.5) years], 28 males and 22 females. The cumulative dose of allergen was up to (69.7 ± 4.8) µg after the 20 times injection, the dose of inhaled corticosteroids was significantly less than that in the control group (t = 2.359, P < 0.05). PEF was significantly higher than that of pre-treatment level (F = 7.874, P < 0.05). TIgE and SIgE had no significant change (t = 0.313, P > 0.05, t(Derp) = 0.517, t(Derf) = 0.717, P > 0.05). After the treatment, the control rate of the SIT group was 85.5%, that of the control group was 62.0% (χ(2) = 10.150, P < 0.01).


CONCLUSIONS
The standardized SIT against house dust mite could reduce steroid use in mild to moderate allergic asthmatic children. After (38.7 ± 2.3) weeks, the cumulative dose of allergen was up to (69.7 ± 4.8) µg, inhaled corticosteroid was significantly reduced. At the end of SIT, 85% of patients obtained complete control of asthma. Total IgE and mite-specific IgE had no significant changes.
Pediatric Pneumology Department, Yuying Children's Hospital Affiliated to Wenzhou Medical College, Wenzhou 325003, China.
Xuan
X
Zhang
Meng-rong
MR
Li
Chao
C
Wang
Xiao-ning
XN
Wang
Hai-lin
HL
Zhang
Jian
J
Lin
Ke
K
Jin
Ying-chun
YC
Li
D000293:Adolescent; D000818:Animals; D039741:Antigens, Dermatophagoides / Q000627:therapeutic use*; D001249:Asthma / Q000276:immunology / Q000628:therapy*; D002648:Child; D002675:Child, Preschool; D003888:Desensitization, Immunologic / Q000379:methods*; D005260:Female; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D007073:Immunoglobulin E / Q000276:immunology; D008297:Male; D039981:Pyroglyphidae / Q000276:immunology; D012189:Retrospective Studies; D016896:Treatment Outcome
D039741:Antigens, Dermatophagoides; D005938:Glucocorticoids; D007073:Immunoglobulin E