Kim Chang Keun, Callaway Zak, Park Jin-Sung, Kwon Eunmi
Asthma & Allergy Center, Department of Pediatrics, Inje University Sanggye Paik Hospital, Seoul, Korea.
School of Biological Sciences, University of Ulsan, Ulsan, Korea.
Asia Pac Allergy. 2021 Oct 25;11(4):e43. doi: 10.5415/apallergy.2021.11.e43. eCollection 2021 Oct.
Atopic asthma (AA) and allergic rhinitis (AR) are often seen as comorbidities and specific immunotherapy (SIT) is considered evidence-based treatment for them both.
The purpose of this study was to evaluate the efficacy of multiallergen subcutaneous SIT (SCIT) in reducing nasal and sputum eosinophilia, symptom scores, and impaired lung function in Korean pediatric patients with AR and AA.
Children aged 6-15 years with a documented history of bronchial asthma and seasonal/perennial AR were recruited then randomly selected to 1 of 2 groups: "immunotherapy group" (inhaled corticosteroids [ICS] and short-acting beta-agonist [SABA] + subcutaneous injection of standardized extracts of up to 4 allergens [n = 53]) or "drug only group" (ICS and SABA only [n = 19]). All data were collected retrospectively.
Comparing the 2 treatment groups, the immunotherapy group showed a significantly ( = 0.006) greater reduction in nasal eosinophilia over the 3-year treatment period. Only the immunotherapy group exhibited a significant reduction in sputum eosinophilia over the 3-year treatment period ( = 0.003). Fifty-one point one percent of patients in the immunotherapy group showed significant improvement in the methacholine challenge test negative conversion rate compared to only 17.65% in the drug only group ( = 0.0168). There were significantly greater improvements in symptom scores in the immunotherapy group compared to the drug only group. For all allergens tested, only house dust mite reactivity changed significantly over the treatment period and only in the immunotherapy group ( [ < 0.0001] and [ = 0.035]).
SCIT was associated with greater improvements in lung function and bronchial hyperresponsiveness and reductions in nasal and sputum eosinophilia and allergen reactivity. Changes in symptom scores were also much greater in patients receiving SCIT when compared to those who did not receive it. Korean children with AA and AR respond well to long-term multiallergen SCIT.
特应性哮喘（AA）和过敏性鼻炎（AR）常被视为合并症，特异性免疫疗法（SIT）被认为是针对这两种疾病的循证治疗方法。
本研究旨在评估多过敏原皮下特异性免疫疗法（SCIT）对降低韩国AR和AA儿科患者的鼻和痰液嗜酸性粒细胞增多、症状评分及肺功能损害的疗效。
招募6至15岁有支气管哮喘和季节性/常年性AR病史记录的儿童，然后随机分为2组中的1组：“免疫疗法组”（吸入性糖皮质激素[ICS]和短效β受体激动剂[SABA]+皮下注射多达4种过敏原的标准化提取物[n = 53]）或“仅药物组”（仅ICS和SABA[n = 19]）。所有数据均为回顾性收集。
比较两个治疗组，免疫疗法组在3年治疗期内鼻嗜酸性粒细胞减少显著更多（P = 0.006）。仅免疫疗法组在3年治疗期内痰液嗜酸性粒细胞有显著减少（P = 0.003）。免疫疗法组51.1%的患者在乙酰甲胆碱激发试验阴性转化率方面有显著改善，而仅药物组为17.65%（P = 0.0168）。与仅药物组相比，免疫疗法组的症状评分改善显著更大。对于所有测试的过敏原，仅屋尘螨反应性在治疗期内有显著变化，且仅在免疫疗法组（P < 0.0001和P = 0.035）。
SCIT与肺功能和支气管高反应性的更大改善以及鼻和痰液嗜酸性粒细胞增多及过敏原反应性的降低相关。与未接受SCIT的患者相比，接受SCIT的患者症状评分变化也更大。患有AA和AR的韩国儿童对长期多过敏原SCIT反应良好。
