title: Long-Term Effect of Sublingual and Subcutaneous Immunotherapy in Dust Mite-Allergic Children With Asthma/Rhinitis: A 3-Year Prospective Randomized Controlled Trial.
abstract: OBJECTIVE
  Specific allergen immunotherapy is the only treatment modality that might change the natural course of allergic diseases in childhood. We sought to prospectively compare the long-term clinical and immunological effects of sublingual (SLIT) and subcutaneous (SCIT) immunotherapy compared with pharmacotherapy alone.
  
  
  METHODS
  In this single-center, prospective randomized controlled trial, 48 children with mild persistent asthma with/without rhinitis, monosensitized to house dust mites (HDMs) were followed for 3 years. At baseline and years 1 and 3 of follow-up, patients were evaluated and compared for total rhinitis (TRSS) and asthma (TASS) symptom scores, total symptom scores (TSS), total medication scores (TMS), safety profiles, skin-nasal-bronchial reactivity, and immunological parameters.
  
  
  RESULTS
  A significant reduction was observed in TASS for both HDM-SCIT and HDM-SLIT at year 3 of treatment compared with baseline and controls (P<.05 for both), with significant improvement in rhinitis symptoms for both groups compared with controls (P=.01 for both). TSS decreased significantly in both HDM-SCIT and HDM-SLIT at year 3 compared with baseline (P=.007 and P=.04, respectively) and controls (P<.01 for both). A significant reduction in TMS was observed in HDM-SCIT and HDM-SLIT compared with baseline and controls (P=.01 in all cases), with a reduction in skin reactivity to HDM (P<.05). Finally, a significant increase in allergen specific IgG4 was observed in the SCIT group at year 3 compared with baseline, the SLIT group, and controls (P<.001 in all cases).
  
  
  CONCLUSIONS
  HDM-sensitized asthmatic children treated for at least 3 years with either SCIT or SLIT showed sustained clinical improvement.
authors.forename: E
authors.initials: E
authors.lastname: Karakoc-Aydiner
authors.forename: A O
authors.initials: AO
authors.lastname: Eifan
authors.forename: S
authors.initials: S
authors.lastname: Baris
authors.forename: E
authors.initials: E
authors.lastname: Gunay
authors.forename: E
authors.initials: E
authors.lastname: Akturk
authors.forename: T
authors.initials: T
authors.lastname: Akkoc
authors.forename: N N
authors.initials: NN
authors.lastname: Bahceciler
authors.forename: I B
authors.initials: IB
authors.lastname: Barlan
mesh_terms: D000818:Animals; D018927:Anti-Asthmatic Agents / Q000627:therapeutic use*; D039741:Antigens, Dermatophagoides / Q000276:immunology; D060829:Arthropod Proteins / Q000276:immunology; D001249:Asthma / Q000150:complications / Q000276:immunology / Q000628:therapy*; D002648:Child; D003546:Cysteine Endopeptidases / Q000276:immunology; D003888:Desensitization, Immunologic / Q000379:methods; D005260:Female; D005541:Forced Expiratory Volume; D006801:Humans; D006967:Hypersensitivity / Q000150:complications / Q000276:immunology / Q000628:therapy; D007073:Immunoglobulin E / Q000276:immunology; D007074:Immunoglobulin G / Q000276:immunology; D007279:Injections, Subcutaneous; D007371:Interferon-gamma / Q000276:immunology; D016753:Interleukin-10 / Q000276:immunology; D015848:Interleukin-5 / Q000276:immunology; D007963:Leukocytes, Mononuclear / Q000276:immunology; D008137:Longitudinal Studies; D008297:Male; D039981:Pyroglyphidae / Q000276:immunology*; D065631:Rhinitis, Allergic / Q000150:complications / Q000276:immunology / Q000628:therapy*; D063729:Sublingual Immunotherapy / Q000379:methods*; D016896:Treatment Outcome
chemical_list: D018927:Anti-Asthmatic Agents; D039741:Antigens, Dermatophagoides; D060829:Arthropod Proteins; C451163:Dermatophagoides pteronyssinus antigen p 2; C508609:IL10 protein, human; C508599:IL5 protein, human; D007074:Immunoglobulin G; D015848:Interleukin-5; D016753:Interleukin-10; D007073:Immunoglobulin E; D007371:Interferon-gamma; D003546:Cysteine Endopeptidases; C451162:Dermatophagoides pteronyssinus antigen p 1