Department of Otorhinolaryngology, Nanjing Children's Hospital Affiliated to Nanjing Medical University, Jiangsu, P.R. China.
Int Forum Allergy Rhinol. 2014 Oct;4(10):796-801. doi: 10.1002/alr.21397. Epub 2014 Aug 21.
The efficacy of single-allergen-specific immunotherapy in polysensitized subjects is a matter of debate. This study aimed to investigate the efficacy of house dust mite (HDM) sublingual immunotherapy (SLIT) in monosensitized and polysensitized children.
A total of 112 children, aged 4 to 13 years old, with HDM-induced respiratory allergic diseases were allocated to a monosensitized group (n = 56) or a polysensitized group (n = 56). Both groups were treated by standard pharmacotherapy and SLIT with Dermatophagoides farinae (American HDM) extracts for 52 weeks. Symptoms, medications, visual analogue scale (VAS), and presence of adverse events (AEs) were assessed once a month. Skin-prick test (SPT) was done before and after treatment. After treatment, subjects in the polysensitized group who completed the study were further analyzed as subgroup 1 (n = 20) and subgroup 2 (n = 15) according to the number of coexisting allergens.
Forty-one subjects in the monosensitized group and 35 subjects in the polysensitized group completed the study. The global clinical parameters had significantly improved after treatment, with no significant difference between the monosensitized and polysensitized group throughout this period (all p > 0.05). The comparison among the monosensitized group, subgroup 1, and subgroup 2 indicated that there was no significant difference in symptoms scores and VAS at each scheduled follow-up visit. There was also no significant difference in total medications score (TMS) in the monosensitized group, subgroup 1, and subgroup 2 after week 24 (all p > 0.05). No severe systemic AEs were reported.
No significant difference was observed in the clinical effects of HDM SLIT between polysensitized and monosensitized children with respiratory allergic diseases.
单一过敏原特异性免疫治疗在多敏患者中的疗效存在争议。本研究旨在探讨屋尘螨（HDM）舌下免疫治疗（SLIT）在单敏和多敏儿童中的疗效。
共有 112 名年龄在 4 至 13 岁之间、由 HDM 引起的呼吸道过敏性疾病患儿被分为单敏组（n=56）或多敏组（n=56）。两组均接受标准药物治疗和用屋尘螨（美国 HDM）提取物进行 SLIT，治疗 52 周。每月评估一次症状、药物使用、视觉模拟评分（VAS）和不良反应（AE）的发生情况。治疗前后进行皮肤点刺试验（SPT）。治疗后，完成研究的多敏组受试者根据共存过敏原的数量进一步分为亚组 1（n=20）和亚组 2（n=15）。
单敏组有 41 名受试者和多敏组有 35 名受试者完成了研究。治疗后所有临床参数均有显著改善，整个治疗期间两组间无显著差异（均 P＞0.05）。单敏组、亚组 1 和亚组 2 之间的比较表明，在每个预定随访时间点，症状评分和 VAS 均无显著差异。在第 24 周后，单敏组、亚组 1 和亚组 2 的总药物评分（TMS）也无显著差异（均 P＞0.05）。未报告严重全身 AE。
在呼吸道过敏性疾病的多敏和单敏儿童中，HDM SLIT 的临床疗效无显著差异。
