title: Serum-specific IgE and allergen immunotherapy in allergic children.
abstract: OBJECTIVE
  Allergen immunotherapy (AIT) is indicated in IgE-mediated respiratory allergy. Recently, it has been reported that serum-specific IgE (sIgE) levels >10 kU/l may predict AIT efficacy in adults with allergic rhinitis. The aim of the present preliminary study was to investigate whether this cut-off could also be associated with perception of effective AIT in children with allergic asthma and/or rhinitis due to house dust mites (HDM).
  
  
  METHODS
  A total of 31 allergic children (17 males; mean age of 12.5 years) with levels of serum sIgE to HDM >10 kU/l were evaluated. Eight allergic children (five males; mean age of 13.4 years) with levels of serum sIgE to HDM <10 kU/l were considered as control. All patients were treated with sublingual immunotherapy for 3 years with HDM allergen extract. Children's perception of AIT efficacy was assessed by visual analog scale (VAS), considering both symptom severity and drug use. Responder patients were defined with >6 VAS. Severity of nasal symptoms was assessed by nasal VAS, and asthma control was evaluated by asthma control test; both were considered before and after AIT.
  
  
  RESULTS
  All children (but one) with sIgE >10 kU/l perceived AIT efficacy, whereas only one child with sIgE <10 kU/l perceived AIT benefit (p < 0.001). There was a strong relationship between perception of AIT efficacy by VAS and serum sIgE levels (r = 0.615; p < 0.001). Also, nasal VAS and asthma control tests significantly improved only in children with sIgE >10 kU/l (p < 0.001 for both).
  
  
  CONCLUSIONS
  Allergen-sIgE assessment before AIT prescription might represent a useful tool to individuate potential responders.
authors.affiliation: Pediatric Pulmonology & Allergy Unit, Istituto Giannina Gaslini, Genoa, Italy.
authors.forename: Mariangela
authors.initials: M
authors.lastname: Tosca
authors.forename: Michela
authors.initials: M
authors.lastname: Silvestri
authors.forename: Michela
authors.initials: M
authors.lastname: Sivestri
authors.forename: Andrea
authors.initials: A
authors.lastname: Accogli
authors.forename: Giovanni Arturo
authors.initials: GA
authors.lastname: Rossi
authors.forename: Giorgio
authors.initials: G
authors.lastname: Ciprandi
mesh_terms: D000286:Administration, Sublingual; D000818:Animals; D039741:Antigens, Dermatophagoides / Q000276:immunology; D001249:Asthma / Q000209:etiology / Q000517:prevention & control*; D002648:Child; D003888:Desensitization, Immunologic / Q000379:methods*; D005260:Female; D006801:Humans; D006967:Hypersensitivity / Q000150:complications / Q000276:immunology / Q000628:therapy*; D007073:Immunoglobulin E / Q000097:blood; D008297:Male; D039981:Pyroglyphidae / Q000276:immunology; D016032:Randomized Controlled Trials as Topic; D016896:Treatment Outcome; D064232:Visual Analog Scale
chemical_list: D039741:Antigens, Dermatophagoides; D007073:Immunoglobulin E