title: Effect of one-year subcutaneous and sublingual immunotherapy on clinical and laboratory parameters in children with rhinitis and asthma: a randomized, placebo-controlled, double-blind, double-dummy study.
abstract: BACKGROUND
  It has been reported that both sublingual (SLIT) and subcutaneous (SCIT) allergen-specific immunotherapy have clinical efficacy, yet there are rather few comparative placebo studies of children. We aimed to investigate the clinical and immunological efficacy of mite-specific SLIT and SCIT versus a placebo in rhinitis and asthma in children.
  
  
  METHODS
  The outcomes of this 1-year, randomized, placebo-controlled, double-blind, double-dummy study were symptom and medication scores, visual analog scores (VAS), titrated skin prick tests, nasal and bronchial allergen provocation doses, serum house dust mite-specific immunglobulin E (HDM-sIgE), sIgG4, IL-10 and IFN-γ levels.
  
  
  RESULTS
  Clinical and laboratory parameters were evaluated in 30 patients. SCIT significantly diminished symptom and medication scores for rhinitis and asthma (p = 0.03 and p = 0.05 for rhinitis; p = 0.01 and p = 0.05 for asthma) and VAS. SLIT also reduced VAS, symptoms associated with rhinitis and asthma as well as medication usage for rhinitis, but this reduction was not significant when compared with the placebo. Skin reactivitiy to HDM and HDM-sIgE levels was reduced significantly in both immunotherapy groups. Serum IL-10 levels and nasal provocative doses increased significantly with both SCIT and SLIT. Nasal eosinophil increments after nasal challenge decreased with two treatment modes, but bronchial provocative doses and sputum eosinophil increments after bronchial challenge were reduced only with SCIT. In both treatment arms, there was no change in IFN-γ levels. Serum sIgG4 levels increased significantly only in the SCIT group.
  
  
  CONCLUSIONS
  Based on the limited number of patients at the end of the 1-year immunotherapy, the clinical efficacy of SCIT on rhinitis and asthma symptoms was more evident when compared with the placebo.
authors: Clinic of Pediatric Allergy and Immunology, Children's Hospital of Gaziantep, Gaziantep, Turkey. ayfyukselen@gmail.com
authors: Ayfer
authors: A
authors: Yukselen
authors: Seval Güneser
authors: SG
authors: Kendirli
authors: Mustafa
authors: M
authors: Yilmaz
authors: Derya Ufuk
authors: DU
authors: Altintas
authors: Gulbin Bingol
authors: GB
authors: Karakoc
mesh_terms: D000286:Administration, Sublingual; D000293:Adolescent; D000485:Allergens / Q000008:administration & dosage* / Q000276:immunology; D039741:Antigens, Dermatophagoides / Q000008:administration & dosage* / Q000276:immunology; D001249:Asthma / Q000276:immunology / Q000628:therapy*; D001985:Bronchial Provocation Tests; D002648:Child; D003888:Desensitization, Immunologic / Q000379:methods*; D004311:Double-Blind Method; D004334:Drug Administration Schedule; D004804:Eosinophils / Q000378:metabolism; D005260:Female; D006801:Humans; D007073:Immunoglobulin E / Q000097:blood; D007074:Immunoglobulin G / Q000097:blood; D007279:Injections, Subcutaneous; D016898:Interferon-alpha / Q000097:blood; D016753:Interleukin-10 / Q000097:blood; D008297:Male; D009299:Nasal Provocation Tests; D012220:Rhinitis / Q000276:immunology / Q000628:therapy*; D016896:Treatment Outcome
chemical_list: D000485:Allergens; D039741:Antigens, Dermatophagoides; D007074:Immunoglobulin G; D016898:Interferon-alpha; D016753:Interleukin-10; D007073:Immunoglobulin E