title: Assessing the efficacy of immunotherapy with a glutaraldehyde-modified house dust mite extract in children by monitoring changes in clinical parameters and inflammatory markers in exhaled breath.
abstract: BACKGROUND
  The aim of this study was to evaluate the effectiveness of specific immunotherapy (SIT) management with allergoids in children with allergic asthma by monitoring changes in clinical parameters and inflammatory markers in exhaled breath.
  
  
  METHODS
  The study population included 43 patients (24 males) of 6-14 years of age, who had allergic asthma and were sensitized to mites. Twenty-three individuals were treated with subcutaneous SIT (PURETHAL® Mites, HAL Allergy) for 8 months, i.e. the SIT group, and 20 were given medication to treat symptoms only, i.e. the control group. Before treatment and after 4 and 8 months, several clinical parameters, the levels of exhaled nitric oxide and the pH of exhaled breath condensate (EBC) were determined.
  
  
  RESULTS
  The SIT group presented with an improvement in asthma classification, a reduction in maintenance drug therapy and improved scores on the quality-of-life questionnaire. These changes were not observed in the control group. Both groups presented significant decreases in EBC pH values at 4 and 8 months after treatment compared to at baseline. However, analysis of the variable 'ratio' showed an increase in the EBC pH values after 8 months of treatment in the SIT group compared with the values at 4 months.
  
  
  CONCLUSIONS
  SIT with standardized mite extract reduces asthma symptoms in children. A decrease in EBC pH values was observed in both groups, although the SIT group presented a tendency of recovered values after 8 months. Future studies of EBC pH monitoring in the longer term are needed to determine the effectiveness of this marker.
authors.affiliation: Sección de Alergia e Inmunologia Clínica, Hospital Sant Joan de Déu, Universidad de Barcelona, Barcelona, Spain.
authors.forename: Jaime
authors.initials: J
authors.lastname: Lozano
authors.forename: María-Jesús
authors.initials: MJ
authors.lastname: Cruz
authors.forename: Mónica
authors.initials: M
authors.lastname: Piquer
authors.forename: Maria-Teresa
authors.initials: MT
authors.lastname: Giner
authors.forename: Ana María
authors.initials: AM
authors.lastname: Plaza
mesh_terms: D000293:Adolescent; D000485:Allergens / Q000008:administration & dosage / Q000276:immunology; D000818:Animals; D001249:Asthma / Q000175:diagnosis* / Q000276:immunology / Q000628:therapy; D015415:Biomarkers / Q000378:metabolism; D016022:Case-Control Studies; D002648:Child; D003888:Desensitization, Immunologic; D045853:Exhalation; D005260:Female; D006801:Humans; D018836:Inflammation Mediators / Q000378:metabolism*; D008297:Male; D009569:Nitric Oxide / Q000032:analysis; D011446:Prospective Studies; D039981:Pyroglyphidae / Q000276:immunology; D011788:Quality of Life; D012129:Respiratory Function Tests; D016896:Treatment Outcome
chemical_list: D000485:Allergens; D015415:Biomarkers; D018836:Inflammation Mediators; D009569:Nitric Oxide