scholarly journals Efficacy of Sublingual Immunotherapy in Allergic Rhinitis Children during Coronavirus Disease 2019

ORL ◽  
2021 ◽  
pp. 1-6
Author(s):  
Wenlong Liu ◽  
Qingxiang Zeng ◽  
Yiquan Tang ◽  
Shengbao Yan ◽  
Yan Li ◽  
...  
Keyword(s):  
Allergic Rhinitis ◽  
Sublingual Immunotherapy ◽  
Clinical Effectiveness ◽  
Specific Ige ◽  
Special Period ◽  
Time Points ◽  
Medication Score ◽  
The Family ◽  
Serum Total Ige ◽  
Response Group

<b><i>Background:</i></b> Sublingual immunotherapy (SLIT) had good effectiveness for children with allergic rhinitis (AR). However, no studies explored the effect of persistent allergen exposure on SLIT treatment. Coronavirus disease 2019 (COVID-19) restricts outdoor activities of children significantly. We aimed to evaluate the effectiveness of SLIT during this special period. <b><i>Methods:</i></b> A total of 335 AR children who sensitize to house dust mite (HDM) undergoing SLIT were recruited in this study. The clinical effectiveness and safety were evaluated at different time points using symptom and medication scores. The serum total IgE and specific IgE (sIgE) at different time points were detected by using the Unicap system. <b><i>Results:</i></b> The total nasal symptoms score (TNSS) and total medication score (TMS) during the epidemic of COVID-19 increased significantly compared with the same period last year (<i>p</i> &#x3c; 0.05), despite that they were still significantly lower than baseline levels (<i>p</i> &#x3c; 0.05). The occurrence of adverse reactions at different time points had no significant differences. We also found that the family of the good response group had more frequent bedding cleaning. Both the tIgE and sIgE levels had no significant changes during SLIT treatment. <b><i>Conclusion:</i></b> Our results suggest that continuous HDM exposure reduced the effectiveness of SLIT, whereas effective reduction of HDM levels by frequent bed cleaning will be helpful during the SLIT treatment.

scholarly journals Sublingual immunotherapy increases Treg/Th17 ratio in allergic rhinitis

Open Medicine ◽  
2021 ◽  
Vol 16 (1) ◽  
pp. 826-832
Author(s):  
Jiarong Wang ◽  
Liansheng Qiu ◽  
Yimin Chen ◽  
Minyun Chen
Keyword(s):  
T Cells ◽  
Allergic Rhinitis ◽  
Retrospective Study ◽  
Regulatory T Cells ◽  
Visual Analog Scale ◽  
Peripheral Blood ◽  
Sublingual Immunotherapy ◽  
Analog Scale ◽  
Vas Score ◽  
Medication Score

Abstract Background Few studies investigated the effects of sublingual immunotherapy (SLIT) on the peripheral regulatory T cells (Tregs)/Th17 ratio. Objective To investigate the effectiveness of SLIT in children with allergic rhinitis (AR) and the effects on the Tregs/Th17 ratio. Methods This was a retrospective study of children who were treated for AR between April 2017 and March 2018 at one hospital. The patients were grouped according to the treatments they received: SLIT + pharmacotherapy vs pharmacotherapy alone. Results Eighty children (51 boys and 29 girls; 40/group) were included. The visual analog scale (VAS) and medication scores at 1 year in the SLIT + pharmacotherapy group were 2.70 ± 1.08 and 1.1 ± 0.8, respectively, which were lower than at baseline (7.7 ± 1.2 and 3.6 ± 1.0, respectively) (both Ps < 0.05). For the pharmacotherapy group, the VAS score was decreased at 1 year vs baseline (3.3 ± 1.2 vs 7.4 ± 1.0; P < 0.05), but the medication score did not change (P > 0.05). In the SLIT + pharmacotherapy group, the Treg percentage increased, while the Th17 percentage decreased at 1 year (both Ps < 0.01). The percentages of Tregs and Th17s did not change in the pharmacotherapy group (both Ps > 0.05). Conclusions SLIT + pharmacotherapy can increase the Treg percentage and decrease the Th17 percentage in the peripheral blood of children with AR.

scholarly journals Comparison of Sublingual Immunotherapy in Patients With Allergic Rhinitis Sensitive to House Dust Mites in Korea

2019 ◽  
pp. 014556131988259
Author(s):  
Joo Hyun Jung ◽  
Tae Kyu Kang ◽  
Il Gyu Kang ◽  
Seon Tae Kim
Keyword(s):  
Allergic Rhinitis ◽  
Symptom Score ◽  
Sublingual Immunotherapy ◽  
House Dust Mites ◽  
Dust Mites ◽  
Immunoglobulin G4 ◽  
Treatment Groups ◽  
Satisfaction Rate ◽  
Medication Score ◽  
Igg4 Level

The aim of this study was to investigate the clinical outcomes of sublingual immunotherapy (SLIT) using 2 kinds of SLIT medications (LAIS and Staloral) in patients with allergic rhinitis for Dermatophagoides pteronyssinus and Dermatophagoides farinae. We have evaluated the patient’s characteristics, safety, and compliance in 293 patients and also analyzed the symptom score, medication score, satisfaction rate, and immunologic measurement in 84 patients who have continued the treatment over 1 year. The symptom scores were significantly improved in both treatment groups, 51% versus 44% (LAIS vs Starloral) at 1 year ( P < .05). The medication score was also significantly decreased in both treatment groups ( P < .05), 50.8% versus 60%. The subjective improvement score was 44.4% versus 46.1%, and satisfaction rate was 29% versus 40% ( P < .05). The serum immunoglobulin G4 (IgG4) level was significantly increased in Staloral group ( P < .05). The adverse events were 6.2% versus 33.3% and the compliance was 37.7% versus 25.1%. In conclusion, the improvements in symptom score and medication scores were not significant different between 2 SLIT medications at 1 year. LAIS was more compliant, less side effects and Staloral has shown increased satisfaction rate and IgG4 level.

scholarly journals Predictors for Short-Term Efficacy of Allergen-Specific Sublingual Immunotherapy in Children with Allergic Rhinitis

2020 ◽  
Vol 2020 ◽  
pp. 1-7 ◽  
Author(s):  
Wenlong Liu ◽  
Qingxiang Zeng ◽  
Renzhong Luo
Keyword(s):  
Allergic Rhinitis ◽  
Clinical Efficacy ◽  
Sublingual Immunotherapy ◽  
Roc Curves ◽  
Specific Ige ◽  
Multivariate Logistic Regression Model ◽  
Air Conditioner ◽  
Short Term ◽  
Total Ige ◽  
Term Efficacy

Background.A good compliance in allergen-specific sublingual immunotherapy (SLIT) often comes from good short-term efficacy. We aimed to evaluate the pretreatment parameters which can predict the short-term clinical efficacy in children that underwent SLIT. Methods. 517 children with allergic rhinitis (AR) that underwent SLIT were recruited in this study. Baseline clinical characteristics and laboratory parameters were collected, and the clinical efficacy was evaluated using symptom and medication scores. A multivariate logistic regression model and receiver operating characteristic (ROC) curves were established. Results. A total of 303 (65%) in 466 children that underwent SLIT achieved short-term clinical efficacy. The time of using the air conditioner was negatively correlated with clinical efficacy, whereas the serum-specific IgE (s-IgE) levels, the serum IL-10 and IL-35 levels, and the s-IgE/total-IgE ratio were positively correlated with clinical efficacy. Conclusion. The time of using the air conditioner, serum-specific IgE (s-IgE) levels, serum IL-10 and IL-35 levels, and s-IgE/total-IgE ratio may be helpful for child selection before SLIT.

scholarly journals Correlated dynamics of serum IGE and IGE+ clonotype count with allergen air level in seasonal allergic rhinitis

2019 ◽  
pp. 13-22
Author(s):  
AI Mikelov ◽  
DB Staroverov ◽  
EA Komech ◽  
YuB Lebedev ◽  
DM Chudakov ◽  
...  
Keyword(s):  
Allergic Rhinitis ◽  
Seasonal Allergic Rhinitis ◽  
Birch Pollen ◽  
Specific Ige ◽  
Chain Gene ◽  
Initial Increase ◽  
Total Ige ◽  
Serum Ige ◽  
Time Points ◽  
Pollination Season

Mechanisms of maintenance of immunological memory in the chronic course of seasonal allergic rhinitis remain poorly understood. The detailed understanding of these mechanisms is required for design of new approaches for allergy treatment. It is known that the level of allergen-specific IgE antibodies (sIgE), which play a key role in the development of the disease, is increased in patients with seasonal allergic rhinitis during pollination season. This study aimed to investigate the dynamics of serum IgE levels and characteristics of the clonal repertoire of IgE-secreting lymphocytes depending on the intensity of the patient's contact with the allergen. For three patients, allergic to birch pollen (22, 22, and 28 y.o.), we measured total IgE and birch pollen specific IgE levels at 6 time points with 2 week interval during the birch pollination season. Immunoglobulin heavy chain gene (IGH) clonal repertoire data for several B-cell subpopulations at different time points were obtained for one patient. We observe growth of the sIgE level (91%, 37%, and 64% compared to the baseline) at the peak of pollination season in all three donors. Initial increase in sIgE and IgE levels coincides with the birch pollination initiation; sIgE and total IgE levels correlate with the birch pollen air level (sIgE: R2 = 0.98 at p < 0.05; total IgE: R2 = 0.95 at p < 0.05). We detected IgE clonotypes only in samples obtained during the birch pollination, which indicates an increase of IGE-expressing cells concentration during this period. The frequency of IgE clonotypes was extremely low compared to that of the clonotypes of other isotypes (IgE — 0.01%, IgM — 48.4%, IgD — 14%, IgG — 17.4%, IgA — 19.8%). Hypermutation and phylogenetic analysis of the sequences from the 13 detected IgE-containing clonal groups showed that these IgE clonotypes could originate from IgG as a result of sequential isotype-switching.

scholarly journals Sublingual immunotherapy for pollen allergic rhinitis: a systematic review and meta-analysis

2020 ◽  
Author(s):  
Lufang Feng ◽  
Liujiao Cao ◽  
Peijing Yan ◽  
Xiajing Chu ◽  
Na Zhang ◽  
...  
Keyword(s):  
Systematic Review ◽  
Allergic Rhinitis ◽  
Adverse Events ◽  
Sublingual Immunotherapy ◽  
Meta Analysis ◽  
Gastrointestinal Symptoms ◽  
Specific Ige ◽  
Cochrane Library ◽  
Serious Adverse Events

Intro Allergic rhinitis（AR） is a common condition which can significantly impair quality of life. This study aimed to illustrate the efficacy and safety of sublingual immunotherapy (SLIT) on pollen AR patients. Methods Four electronic databases (PubMed, EMBASE, Cochrane Library, and Web of Science) were searched from their inception until September 2019. Two reviewers （FLF and CLJ） independently extracted the data. The Cochrane’s Risk of Bias tool was used to assess the quality of included studies. The outcomes of study were calculated by MD or SMD with 95%CI. A meta-analysis was performed using RevMan 5.3 software. Results In this systematic review, a total of 8 articles were included, involving 785 participants. The quality of the included studies ranged from low to moderate. The results of the meta-analysis showed that compared with placebo, a significant reduction of nasal symptoms were observed on SLIT (MD = −0.84, 95% CI = −1.47 to −0.22, P < 0.05), IgE (SMD =0.46, 95% CI = 0.16 to 0.76, P < 0.05); No significant effect on medication scores (MD = −0.41, 95% CI = −0.89 to 0.07, P =0.10). No serious adverse events were reported, and symptoms of adverse events were reported more frequently in the gastrointestinal symptoms. Conclusion SLIT can effectively relieve rhinitis symptoms and decrease the level of specific-IgE for pollen allergic rhinitis patients and the safety was verified. But due to the low quality of studies, more high-quality randomized trials are needed to provide stronger evidence of the conclusion.

scholarly journals Sublingual Immunotherapy Induces Regulatory Function of IL-10-Expressing CD4+CD25+Foxp3+ T Cells of Cervical Lymph Nodes in Murine Allergic Rhinitis Model

2012 ◽  
Vol 2012 ◽  
pp. 1-11 ◽  
Author(s):  
Takaya Yamada ◽  
Miki Tongu ◽  
Kaoru Goda ◽  
Noriaki Aoi ◽  
Ichiro Morikura ◽  
...  
Keyword(s):  
T Cells ◽  
Allergic Rhinitis ◽  
Lymph Nodes ◽  
Sublingual Immunotherapy ◽  
Specific Ige ◽  
Regulatory Function ◽  
Sublingual Administration ◽  
Type I ◽  
Cervical Lymph Nodes

Sublingual immunotherapy (SLIT) has been considered to be a painless and efficacious therapeutic treatment of allergic rhinitis which is known as type I allergy of nasal mucosa. Nevertheless, its mechanisms need to be further investigated. In this study, we constructed an effective murine model of sublingual immunotherapy in allergic rhinitis, in which mice were sublingually administered with ovalbumin (OVA) followed by intraperitoneal sensitization and nasal challenge of OVA. Sublingually treated mice showed significantly decreased specific IgE responses as well as suppressed Th2 immune responses. Sublingual administration of OVA did not alter the frequency of CD4+CD25+ regulatory T cells (Tregs), but led to upregulation of Foxp3- and IL-10-specific mRNAs in the Tregs of cervical lymph nodes (CLN), which strongly suppressed Th2 cytokine production from CD4+CD25− effector T cells in vitro. Furthermore, sublingual administration of plasmids encoding the lymphoid chemokines CCL19 and CCL21-Ser DNA together with OVA suppressed allergic responses. These results suggest that IL-10-expressing CD4+CD25+Foxp3+ Tregs in CLN are involved in the suppression of allergic responses and that CCL19/CCL21 may contribute to it in mice that received SLIT.

The Role of Nasal Endoscopy in Allergic Rhinitis and House Dust Mite Sublingual Immunotherapy

2021 ◽  
pp. 1-7
Author(s):  
Beina Liu ◽  
Jiapeng Feng ◽  
Sunhong Hu
Keyword(s):  
Allergic Rhinitis ◽  
House Dust ◽  
Color Change ◽  
Sublingual Immunotherapy ◽  
Endoscopic Examination ◽  
House Dust Mites ◽  
Therapeutic Modality ◽  
Nasal Endoscopy ◽  
Medication Score ◽  
Vas Scores

<b><i>Introduction:</i></b> While there exists considerable evidence for efficacy of sublingual immunotherapy (SLIT), its impact on the improvement of nasal signs in allergic rhinitis (AR) patients remains quite unclear. In this study, the endoscopic examination and the modified Lund-Kennedy (MLK) scoring system were performed to describe and evaluate the therapeutic effect of SLIT. <b><i>Methods:</i></b> A total of 105 patients with AR induced by house dust mites were enrolled and treated with standardized <i>Dermatophagoides farinae</i> (<i>D. farinae</i>) drops for 1 year. The total nasal symptoms score (TNSS), total medication score (TMS), visual analog scale (VAS), and MLK scores were assessed at baseline and 6 and 12 months. The MLK score was also compared for its correlation with TNSS, TMS, and VAS. <b><i>Results:</i></b> The TNSS, TMS, and VAS scores statistically decreased after SLIT compared to baseline (all <i>p</i> &#x3c; 0.05). After 12 months of treatment, the rates of well-controlled, partial controlled, and uncontrolled AR patients were 42, 49.5, and 8.5%, respectively. The nasal endoscopy findings showed significant improvement in nasal signs, which mainly included color change of turbinate mucosa, reduction of nasal secretions, and improvement of nasal edema. A significant decrease was observed in MLK scores, and there was a positive correlation between MLK and VAS scores. <b><i>Conclusions:</i></b> In addition to commonly utilized subjective assessments (TMS, TNSS, and VAS), our results of endoscopic examination and the MLK scores consistently confirmed that SLIT is an effective therapeutic modality for AR patients. The MLK scores might be considered as an auxiliary tool to evaluate efficacy of SLIT in clinical practice and outcomes research.

scholarly journals Comparison of Outcomes Between Mometasone Furoate Intranasal Spray and Oral Montelukast in Patients with Allergic Rhinitis

2020 ◽  
Vol 18 (2) ◽  
pp. 268-270
Author(s):  
Sushma Bhattachan ◽  
Yogesh Neupane ◽  
Bibhu Pradhan ◽  
Naramaya Thapa
Keyword(s):  
Allergic Rhinitis ◽  
Symptom Score ◽  
Nasal Symptom ◽  
Mometasone Furoate ◽  
Total Ige ◽  
Total Nasal Symptom Score ◽  
Medication Score ◽  
The Mean ◽  
Serum Total Ige ◽  
Intranasal Spray

Background: Allergic rhinitis is a common ailment with rising trend and worldwide prevalence of some 400 million. Methods: This prospective randomized crosssectional study was done at the Department of Otorhinolaryngology and Head and Neck Surgery, Tribhuvan University, Teaching Hospital, Kathmandu, Nepal from June 2016 to August 2017. They were randomly assigned to two groups by lottery method. Group A received mometasone furoate intranasal spray and Group B received oral montelukast for a total duration of one month. Prior to starting medication and one month after medications, total nasal symptom score was documented. Statistical analysis was done using SPSS version 18.Results: Total of 126 patients between 16 to 52 years were enrolled in the study. The mean duration of symptoms was 3.93 years. The mean value of serum total IgE was 833.49 IU/ml. The mean pre and post medication score for mometasone furoate intranasal spray group was 16.32 and 5.44 respectively, which was significant. Similarly, the mean pre and post medication score for oral montelukast group was 15.24 and 7.87 respectively which was also found to be significant. Comparing the means of scores for both the groups, mometasone furoate was found to be more effective than oral montelukast.Conclusions: Both mometasone furoate intranasal spray and oral montelukast were effective in the treatment of patient with allergic rhinitis. Oral montelukast can therefore be used as a first line treatment for patients with allergic rhinitis. Keywords: Allergic rhinitis; mometasone furoate intranasal spray; montelukast; serum total IgE; total nasal symptom score.

scholarly journals Circulating MIF Associated With Disease Severity and Clinical Response of Sublingual Immunotherapy in House Dust Mite–Induced Allergic Rhinitis

2021 ◽  
Vol 12 ◽  
Author(s):  
Shaobing Xie ◽  
Hua Zhang ◽  
Fengjun Wang ◽  
Zhihai Xie ◽  
Weihong Jiang ◽  
...  
Keyword(s):  
Allergic Rhinitis ◽  
Clinical Response ◽  
Disease Severity ◽  
Multivariate Regression ◽  
Sublingual Immunotherapy ◽  
Poor Response ◽  
Multivariate Regression Analysis ◽  
Blood Eosinophil ◽  
Dust Mite ◽  
Response Group

Background: Macrophage migration inhibitory factor (MIF) is described as a pro-inflammatory cytokine involved in many inflammatory and allergic disorders, but the role of MIF in allergic rhinitis (AR) remains poorly clarified. The aim of this study was to investigate the association between circulating MIF levels and house dust mite (HDM)-induced AR, and evaluate MIF as a potential biomarker in reflecting disease severity and predicting the clinical response of sublingual immunotherapy (SLIT) in HDM-induced AR patients.Methods: In this study, we enrolled 160 persistent HDM-induced AR patients (AR group), including 48 mild AR patients (MAR group) and 112 moderate–severe AR patients (MSAR group), and 77 healthy controls (HC group). Circulating levels of MIF were measured by ELISA, and the relationship between MIF concentrations and disease severity was assessed. In the MSAR group, 106 patients were assigned to receive SLIT for 3 years. At the end of the study, patients were categorized into good response group and poor response group, and associations between clinical variables or biomarkers and clinical response were analyzed by the multivariate regression analysis.Results: The concentrations of serum MIF were significantly higher in AR patients than in HCs, especially in those with MSAR. Moreover, circulating MIF levels were positively correlated with TNSS, VAS, serum HDM–specific IgE, total IgE, blood eosinophil count, and blood eosinophil percentage (all p &lt; 0.05). Eighty MSAR patients finally completed SLIT, 45 patients obtained good response, and 35 patients resulted in poor response. The serum levels of MIF were significantly lower in the good-response group than in the poor-response group (p &lt; 0.001). The receiver operating characteristic analysis for MIF showed good accuracy for predicting clinical response of SLIT (area under the curve = 0.877, p &lt; 0.001). The multivariate regression analysis demonstrated that serum MIF was an independent factor for SLIT responsiveness.Conclusion: Serum MIF appeared to be an important biological indicator in reflecting disease severity and an independent predictor for clinical responsiveness of SLIT in HDM-induced AR patients.

Nasal reactivity evaluation in children with allergic rhinitis receiving grass pollen sublingual immunotherapy

2020 ◽  
Vol 41 (5) ◽  
pp. 357-362
Author(s):  
Laura Schiavi ◽  
Giulia Brindisi ◽  
Giovanna De Castro ◽  
Valentina De Vittori ◽  
Lorenzo Loffredo ◽  
...  
Keyword(s):  
Allergic Rhinitis ◽  
Grass Pollen ◽  
Sublingual Immunotherapy ◽  
Provocation Test ◽  
Allergic Diseases ◽  
Treated Group ◽  
Specific Ige ◽  
Patient Comfort ◽  
Control Group ◽  
Nasal Function

Background: The European Academy of Allergy and Clinical Immunology guidelines, strongly recommended allergen immunotherapy (AIT) as an effective treatment to achieve long-term clinical benefits and to modify the natural history of allergic diseases. Sublingual immunotherapy (SLIT) offers the possibility of home administration, which improves patient comfort and compliance. Objective: The primary outcome of this study was to assess the change in nasal reactivity after grass-pollen AIT treatment. Methods: This was a monocentric, prospective, observational study conducted in Rome from September 2016 to June 2018, in the Pediatric Department of Policlinico Umberto I. We enrolled children, ages between 6 and 12 years, with persistent allergic rhinitis (AR), sensitized to grass pollen. At the first visit (V0, September 2016), one group received the first dose of oral immunotherapy for grass-pollen spray buccal and the other group continued only standard therapy. All the patients had nasal specific immunoglobulin I (IgE) assay (Phl p1, Phl p5), active anterior rhinomanometry with a nasal provocation test (NPT), and spirometry. The patients attended two follow-up visits, in May 2017 (V1) and May 2018 (V2), with the same examinations as at V0. Results: During the treatment, we observed, in the treated group, a significant increase in the mean nasal flow compared with untreated children (p < 0.001). In the AIT group, we found an improvement of nasal function and only 21.05% of all the children in the active group with a positive NPT result at V2. In the control group, we found, at V2, a worsening of nasal function, with 89.47% of the children with a positive NPT result. Furthermore, we found a significant reduction of nasal specific IgE levels at the end of the observation period in the treated group. Conclusion: Analysis of our data provided evidence for a clinical effect of SLIT in inducing clinical changes and allergen tolerance in children with AR.

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