title: Effect of high-dose sublingual immunotherapy on respiratory infections in children allergic to house dust mite.
abstract: BACKGROUND
  Allergic rhinitis is characterized by eosinophil inflammation. Allergic inflammation may induce susceptibility to respiratory infections (RI). House dust mite (HDM) sensitization is very frequent in childhood. Allergen immunotherapy may cure allergy as it restores a physiologic immune and clinical tolerance to allergen and exerts anti-inflammatory activity.
  
  
  OBJECTIVE
  This study investigated whether six-month high-dose, such as 300 IR (index of reactivity), HDM-sublingual immunotherapy (SLIT) could affect RI in allergic children.
  
  
  METHODS
  Globally, 40 HDM allergic children (18 males; mean age, 9.3 years) were subdivided in 2 groups: 20 treated by symptomatic drugs (group 1) and 20 by high-dose HDM-SLIT (group 2), since September 2012 to April 2013. The daily maintenance dose of HDM-SLIT was 4 pressures corresponding to 24, 4.8, and 60 µg, respectively of the major allergens Dermatophagoides pteronyssinus (Der p) 1, Der p 2, and Dermatophagoides farinae (Der f) 1. RI was diagnosed when at least 2 symptoms or signs, and fever were present for at least 48 hours. A family pediatrician provided diagnosis on a clinical ground.
  
  
  RESULTS
  SLIT-treated children had significantly (p = 0.01) less RI episodes (3.5) than control group (5.45). About secondary outcomes, SLIT-treated children had less episodes of pharyngo-tonsillitis (p < 0.05) and bronchitis (p < 0.005), and snoring (p < 0.05) than control group. In addition, SLIT-treated children had less fever (p < 0.01) and took fewer medications, such as antibiotics (p < 0.05) and fever-reducers (p < 0.01), than control group.
  
  
  CONCLUSIONS
  This preliminary study might suggest that also a short course (6 months) of high-dose SLIT, titrated in µg of major allergens, could reduce RI in allergic children.
authors.affiliation: Department of Pediatrics, San Paolo Hospital, 20142 Milan, Italy.
authors.forename: Salvatore
authors.initials: S
authors.lastname: Barberi
authors.affiliation: Department of Medicine, IRCCS-Azienda Ospedaliera Universitaria San Martino, 16132 Genoa, Italy.
authors.forename: Giorgio
authors.initials: G
authors.lastname: Ciprandi
authors.affiliation: Department of Pediatrics, San Paolo Hospital, 20142 Milan, Italy.
authors.forename: Elvira
authors.initials: E
authors.lastname: Verduci
authors.affiliation: Department of Pediatrics, San Paolo Hospital, 20142 Milan, Italy.
authors.forename: Enza
authors.initials: E
authors.lastname: D'Auria
authors.affiliation: Department of Pediatrics, San Paolo Hospital, 20142 Milan, Italy.
authors.forename: Piercarlo
authors.initials: P
authors.lastname: Poli
authors.affiliation: Department of Pediatrics, San Paolo Hospital, 20142 Milan, Italy.
authors.forename: Benedetta
authors.initials: B
authors.lastname: Pietra
authors.affiliation: Allergy/Pulmonary Rehabilitation, ICP Hospital, 20100 Milan, Italy.
authors.forename: Cristoforo
authors.initials: C
authors.lastname: Incorvaia
authors.affiliation: Medical and Scientific Department, Stallergenes Italy, 20155 Milan, Italy.
authors.forename: Serena
authors.initials: S
authors.lastname: Buttafava
authors.affiliation: Medical and Scientific Department, Stallergenes Italy, 20155 Milan, Italy.
authors.forename: Franco
authors.initials: F
authors.lastname: Frati
authors.affiliation: Department of Pediatrics, San Paolo Hospital, 20142 Milan, Italy.
authors.forename: Enrica
authors.initials: E
authors.lastname: Riva
keywords: Allergens; Child; Mites; Respiratory Tract Infections; Sublingual Immunotherapy