Marogna M, Bruno M E, Massolo A, Falagiani P
Pneumology Unit, Cuasso al Monte, Macchi Hospital Foundation, Varese, Italy.
Eur Ann Allergy Clin Immunol. 2008 May;40(1):22-9.
Very few studies have evaluated the effects of sublingual immunotherapy (SLIT) in elderly adults with either rhinitis or bronchial asthma. The aim of this study was to ascertain whether SLIT is effective in these patients.
One hundred and sixty seven patients (aged 18-65 years) with persistent rhinitis and mild asthma, selected from 573 subjects allergic to house-dust mites, were treated with either standard chronic pharmacotherapy or SLIT plus drugs on demand. Monthly symptom/drug scores, respiratory function, methacholine (MCh) challenge and eosinophil count were scheduled at the beginning and end of the study.
We analysed two age groups (18-28 years, 49 patients) and 55-65 years, 40 patients). There were no differences between the groups at baseline but MCh sensitivity was lower in the older patients. At the end of treatment, SLIT achieved improvement in all variables (p< 0.001) in both age groups, but the global symptoms were lower in the younger patients (p=0.0002). There were also fewer new sensitizations in the SLIT groups (p=0.03) than in the "control"patients given standard pharmacotherapy, but with no relation to age. Asthma became worse only in the control groups, regardless of age.
SLIT reduces symptoms, drug consumption and the progression of the disease in both young and elderly subjects allergic to house-dust mites, with persistent rhinitis and mild bronchial asthma.
很少有研究评估舌下免疫疗法（SLIT）对患有鼻炎或支气管哮喘的老年人的效果。本研究的目的是确定SLIT对这些患者是否有效。
从573名对屋尘螨过敏的受试者中选出167名患有持续性鼻炎和轻度哮喘的患者（年龄在18 - 65岁之间），分别接受标准慢性药物治疗或SLIT加按需用药治疗。在研究开始和结束时安排每月的症状/药物评分、呼吸功能、乙酰甲胆碱（MCh）激发试验和嗜酸性粒细胞计数。
我们分析了两个年龄组（18 - 28岁，49名患者）和55 - 65岁，40名患者）。两组在基线时无差异，但老年患者的MCh敏感性较低。治疗结束时，SLIT使两个年龄组的所有变量均有改善（p < 0.001），但年轻患者的总体症状较轻（p = 0.0002）。SLIT组的新致敏情况也比接受标准药物治疗的“对照”患者少（p = 0.03），但与年龄无关。无论年龄大小，仅对照组的哮喘病情加重。
SLIT可减轻患有持续性鼻炎和轻度支气管哮喘且对屋尘螨过敏的年轻和老年患者的症状、药物消耗及疾病进展。
