Division of Clinical Allergy, Department of Internal Medicine, Atami Hospital, International University of Health and Welfare, Atami, Shizuoka, Japan.
Department of Radiology, Atami Hospital, International University of Health and Welfare, Atami, Shizuoka, Japan.
J Allergy Clin Immunol Pract. 2019 Nov-Dec;7(8):2804-2811. doi: 10.1016/j.jaip.2019.06.003. Epub 2019 Jun 20.
The efficacy of the standardized quality (SQ) house dust mite (HDM) sublingual immunotherapy (SLIT) has been demonstrated for respiratory allergic disease. However, the effects of SLIT on inflammation and structural changes of the airways are still unknown.
The aim of this study was to assess the effects of the 6 SQ-HDM SLIT on airway inflammation and airway geometry in allergic asthma and rhinitis.
One hundred two asthmatic patients with rhinitis sensitized to HDM were randomized to receive either SLIT plus pharmacotherapy or standard pharmacotherapy alone, for 48 weeks. Fractional exhaled nitric oxide (FeNO), pulmonary function, quantitative computed tomography, and clinical symptoms were performed at baseline and end of the study.
Compared with pharmacotherapy, SLIT demonstrated a significant reduction of FeNO (P < .01), airway wall area/body surface area (WA/BSA, P < .001), wall thickness (T/√BSA, P < .001), percentage wall area (WA/Ao, P < .01), increase in luminal area (Ai/BSA, P < .05), improvement of airflow limitation (P < .001), and clinical symptom scores (P < .05). The change in forced expiratory volume in 1 second (FEV) was correlated with both changes in FeNO and airway dimensions. Multiple regression analysis showed that the change in FeNO was independently associated with an increase in FEV in the SLIT group (r = 0.623, P = .037).
Adding 6 SQ-HDM SLIT to standard asthma therapy provides a significant improvement in symptoms and pulmonary function compared with pharmacotherapy. Improvement of airflow limitation with SLIT was associated with the decrease in eosinophilic airway inflammation.
标准化质量（SQ）屋尘螨（HDM）舌下免疫疗法（SLIT）对呼吸道过敏性疾病的疗效已得到证实。然而，SLIT 对气道炎症和结构变化的影响仍不清楚。
本研究旨在评估 6 SQ-HDM SLIT 对过敏性哮喘和鼻炎患者气道炎症和气道几何结构的影响。
102 例对 HDM 敏感的哮喘合并鼻炎患者被随机分为 SLIT 加药物治疗组或标准药物治疗组，共 48 周。在基线和研究结束时进行呼出气一氧化氮分数（FeNO）、肺功能、定量计算机断层扫描和临床症状。
与药物治疗相比，SLIT 可显著降低 FeNO（P <.01）、气道壁面积/体表面积（WA/BSA，P <.001）、壁厚度（T/√BSA，P <.001）、壁面积百分比（WA/Ao，P <.01）、气道内腔面积增加（Ai/BSA，P <.05）、气流受限改善（P <.001）和临床症状评分改善（P <.05）。用力呼气量 1 秒（FEV）的变化与 FeNO 和气道尺寸的变化均相关。多元回归分析显示，在 SLIT 组中，FEV 的变化与 FeNO 的变化独立相关（r = 0.623，P =.037）。
与药物治疗相比，将 6 SQ-HDM SLIT 加入标准哮喘治疗可显著改善症状和肺功能。SLIT 改善气流受限与嗜酸性气道炎症的减少有关。
