Yang Wenwen, Wang Weijie, Ji Yishu, Pan Huisong
Department of Pediatric, XianJu People's Hospital, Zhejiang Southeast Campus of Zhejiang Provincial People's Hospital, Affiliated Xianju's Hospital, Hangzhou Medical College, Taizhou, China.
J Asthma. 2025 Jan;62(1):124-133. doi: 10.1080/02770903.2024.2391441. Epub 2024 Aug 28.
Asthma is a common chronic condition in children globally. Allergen-specific immunotherapy, such as subcutaneous (SCIT) and sublingual (SLIT) therapies, are promising by increasing allergen tolerance. This meta-analysis compares the efficacy and safety of SLIT and SCIT in pediatric asthma.
We searched PubMed, Cochrane Library, and Embase for randomized controlled trials and case-control studies comparing SLIT and SCIT in asthmatic children. Meta-analysis was conducted using random-effects models with calculations R software version 4.3.2 and RevMan version 5.4. Study quality and bias risk were assessed using the Newcastle-Ottawa Scale and Cochrane Risk of Bias Tool.
The literature search yielded a total of 1787 records, with 7 studies meeting the inclusion criteria after screening and assessments. There was no significant difference in the Total Asthma Symptoms Score between SLIT and SCIT (mean difference -0.05 [95% CI: -0.21; 0.10]). However, asthma improvement rates were higher in the SLIT group (risk ratio 0.77 [95% CI: 0.64; 0.93]). FEV1 improvement showed no significant difference (mean difference -1.60 [95% CI: -6.27; 3.08]). Adverse events were similar between the treatments (risk ratio 0.56 [95% CI: 0.11; 2.82]).
SLIT and SCIT were generally similarly effective and safe for treating pediatric asthma. SLIT may be preferred due to its noninvasive administration. More research is needed on long-term effects and tailored treatment approaches.
哮喘是全球儿童常见的慢性疾病。特异性变应原免疫疗法，如皮下免疫疗法（SCIT）和舌下免疫疗法（SLIT），有望通过提高变应原耐受性来治疗哮喘。本荟萃分析比较了SLIT和SCIT在儿童哮喘治疗中的疗效和安全性。
我们检索了PubMed、Cochrane图书馆和Embase数据库，查找比较SLIT和SCIT治疗哮喘儿童的随机对照试验和病例对照研究。使用随机效应模型进行荟萃分析，计算软件为R软件4.3.2版和RevMan 5.4版。采用纽卡斯尔-渥太华量表和Cochrane偏倚风险工具评估研究质量和偏倚风险。
文献检索共获得1787条记录，经筛选和评估后，有7项研究符合纳入标准。SLIT和SCIT在总哮喘症状评分上无显著差异（平均差值-0.05 [95%置信区间：-0.21；0.10]）。然而，SLIT组的哮喘改善率更高（风险比0.77 [95%置信区间：0.64；0.93]）。第一秒用力呼气容积（FEV1）的改善无显著差异（平均差值-1.60 [95%置信区间：-6.27；3.08]）。两种治疗方法的不良事件相似（风险比0.56 [95%置信区间：0.11；2.82]）。
SLIT和SCIT在治疗儿童哮喘方面总体上疗效和安全性相似。由于SLIT为非侵入性给药方式，可能更受青睐。关于其长期影响和个性化治疗方法，还需要更多研究。
