Pediatrics & Neonatology
Volume 51, Issue 1 , Pages 14-18, February 2010

Clinical Efficacy of House Dust Mite-specific Immunotherapy in Asthmatic Children

Department of Pediatrics, Taipei Veterans General Hospital and School of Medicine, National Yang-Ming University, Taipei, Taiwan

Received 3 March 2009; received in revised form 23 April 2009; accepted 22 May 2009.

Article Outline

Background

Immunotherapy has been widely used in the treatment of allergic diseases. We evaluated the clinical efficacy of specific immunotherapy with extracts of Dermatophagoides pteronyssinus (Dp) and Dermatophagoides farinae (Df) in children with asthma.

Methods

All 40 children had moderate-to-severe asthma and positive allergen tests for Dp and Df. All required daily medication. They were randomly assigned to two groups: Half of them received immunotherapy with subcutaneous injections of Dp and Df extracts, while the other half were not given immunotherapy. Participants were followed up for more than 6 months.

Results

Children in both groups had apparent improvements in medication use and symptoms after 6 months. The mean medication scores declined from 3.6 ± 1.14 to 1.7 ± 0.66 in the immunotherapy group (p < 0.01) and from 3.35 ± 0.87 to 2.4 ± 1.09 in the control group (p < 0.01). There was a significant difference between the two groups (mean difference 0.95; p < 0.01). The symptom score improved in the immunotherapy group from 2.65 ± 0.98 to 1.20 ± 1.00 (p < 0.01) and in the control group from 2.55 ± 0.99 to 1.40 ± 0.88 (p < 0.01), with a significant difference between the two groups (mean difference 0.3; p < 0.01). The number of office visits in the immunotherapy group was greater than that of the controls, but the frequencies of emergency room visits and hospitalization decreased.

Conclusion

Our study showed that specific immunotherapy with Dp and Df was beneficial for asthmatic children.

Key Words:  asthma , children , house dust mite , immunotherapy

No full text is available. To read the body of this article, please view the PDF online.

 

Back to Article Outline

References 

  1. Noon L . Prophylactic inoculation against hay fever . Lancet . 1911;1:1572–1573
  2. Cooke RA . Hay fever and asthma: the uses and limitation of desensitization . N Y Med J . 1918;107:577–583
  3. Inal A , Altintas DU , Yilmaz M , Karakoc GB , Kendirli SG , Sertdemir Y . Prevention of new sensitizations by specific immunotherapy in children with rhinitis and/or asthma monosensitized to house dust mite . J Investig Allergol Clin Immunol . 2007;17:85–91
  4. Malling HJ , Weeke B . Position paper: immunotherapy . Allergy . 1993;48:S7–35
  5. Bousquet J , Michel FB . Specific immunotherapy in asthma: is it effective? . J Allergy Clin Immunol . 1994;94:1–11
  6. Abramson MJ , Puy RM , Weiner JM . Is allergen immunotherapy effective in asthma? A meta-analysis of randomized controlled trials . Am J Respir Crit Care Med . 1995;151:969–974
  7. Adkinson NF , Eggleston PA , Eney D , et al.   A controlled trial of immunotherapy for asthma in allergic children . N Engl J Med . 1997;336:324–331
  8. Berg T , Nordvall L , Lanner A . Clinical studies of a purified timothy pollen extract. Desensitization therapy with a purified timothy pollen preparation compared to a crude timothy pollen extract. I. Results of tests in vivo . Int Arch Allergy Appl Immunol . 1980;63:266–274
  9. Bosquet J , Becker WM , Hejjaoni A , et al.   Differences in clinical and immunologic reactivities of patients allergic to grass pollen and multiple pollen species. II. Efficacy of a double-blind placebo controlled specific immunotherapy with standardized extracts . J Allergy Clin Immunol . 1991;88:43–53
  10. Negrini AC . Immunotherapy for respiratory allergic diseases: indications, efficacy and monitoring . Allergy Immunol . 1993;25:431–435
  11. Global Initiative for Asthma(GINA)  . GINA report, global strategy for asthma management and prevention . Bethesda, MD: National Institutes of Health; 2004; NIH publication 02–3659.
  12. Voorhost R , Spieksma-Boezeman MJE , Spieksma FTM . Is a mite (Dermatophagoides sp) the producer of the house dust allergen? . Allerg Asthma (Leipz) . 1964;6:329–334 [In German]
  13. Tang RB , Tsai LC , Hwang HM , et al.   The prevalence of allergic disease and IgE antibodies to house dust mite in school children in Taiwan . Clin Exp Allergy . 1990;20:33–38
  14. Tang RB , Wu KK . Total serum IgE, allergy skin testing, and the radioallergosorbent test for the diagnosis of allergy in asthmatic children . Ann Allergy . 1989;64:432–435
  15. Hejjaoui A , Dhivert H , Michel FB , Bousquet J . Immunotherapy with a standardized Dermatophagoides pteronyssinus extract. IV. Systemic reactions according to the immunotherapy schedule . J Allergy Clin Immunol . 1990;85:473–479
  16. Alvarez-Cuesta E , Bousquet J , Canonica GW , Durham SR , Malling HJ , Valovirta E . Standards for practical allergen-specific immunotherapy . Allergy . 2006;61(Suppl 82):1–20
  17. Steen N , Hutchinson A , McColl E , et al.   Development of a symptom based outcome measure for asthma . BMJ . 1994;309:1065–1068
  18. Di Bernardino C , Di Bernardino F , Colombo R , Angrisano A . A case control study of Dermatophagoides immunotherapy in children below 5 years of age . Allerg Immunol (Paris) . 2002;34:56–59
  19. British Society for Allergy and Clinical Immunology (BSACI) Working Party  . Position paper on allergen immunotherapy. Report of a BSACI working party . Clin Exp Allergy . 1993;23(Suppl 3):1–44
  20. Bousquet J , Lockey R , Malling HJ . Allergen immunotherapy: therapeutic vaccines for allergic diseases. A WHO position paper . J Allergy Clin Immunol . 1998;102:558–562
  21. Tsai LC , Tang RB , Hung MW , Chen HM , Tsai SJ . Expression of serum IL-2, IL2R, and CD8 levels during hyposensitization in house-dust-sensitive asthmatics . J Asthma . 1990;27:307–314
  22. Tsai LC , Tang RB , Hung MW , Chang ZN . Changes in the levels of house dust mite specific IgG4 during immuno-therapy in asthmatic children . Clin Exp Allergy . 1991;21:367–372
  23. Tsai LC , Hung MW , Tang RB . Changes of serum-specific IgE antibody titer during hyposensitization in mite-sensitive asthmatic children . J Asthma . 1990;27:95–100
  24. Creticos PS . The consideration of immunotherapy in the treatment of allergic asthma . J Allergy Clin Immunol . 2000;105:S559–S574
  25. Peat JK , Woolcock AJ , Cullen K . Rate of decline of lung function in subjects with asthma . Eur J Respir Dis . 1987;70:171–179
  26. Ulrik CS , Backer V , Dirksen A . A 10-year follow-up of 180 adults with bronchial asthma: factors important for the decline in lung function . Thorax . 1992;47:14–18
  27. Pifferi M , Baldini G , Marrazzini G , et al.   Benefits of immunotherapy with a standardized Dermatophagoides pteronyssinus extract in asthmatic children: a three-year prospective study . Allergy . 2002;57:785–790
  28. Wahn U . Immunotherapy in children . Curr Opin Allergy Clin Immunol . 2002;2:557–560
  29. Nelson HS . Efficacy and safety of allergen immunotherapy in children . Ann Allergy Asthma Immunol . 2006;96:S2–S5
  30. Jacobsen L , Niggemann B , Dreborg S , et al.   (The PAT investigator group). Specific immunotherapy has long-term preventive effect of seasonal and perennial asthma: 10-year follow-up on the PAT study . Allergy . 2007;62:943–948
  31. Passalacqua G , Durham SR . Global Allergy and Asthma European Network. Allergic rhinitis and its impact on asthma update: allergen immunotherapy . J Allergy Clin Immunol . 2007;119:881–891
  32. Winther L , Malling HJ , Mosbech H . Allergen-specific immunotherapy in birch-and grass-pollen-allergic rhinitis. II. Side-effects . Allergy . 2000;55:827–835

PII: S1875-9572(10)60004-6

doi:10.1016/S1875-9572(10)60004-6

Pediatrics & Neonatology
Volume 51, Issue 1 , Pages 14-18, February 2010

Article Tools