Comparison of SLIT and SCIT for house dust mite in children with allergic asthma and allergic rhinitis
Summary
The Turkish investigators conducting this study intended to compare mite-specific sublingual immunotherapy (SLIT) and subcutaneous immunotherapy (SCIT) versus a placebo in children with allergic rhinitis and asthma. To do this, they performed a one year, randomized, placebo-controlled, double-blind, double-dummy study.
They evaluated symptom and medication scores, visual analog scores (VAS), titrated skin prick tests, nasal and bronchial allergen provocation tests, serum house dust mite-specific IgE (HDM-sIgE), sIgG4, IL-10, and IFN-gamma levels. Thirty patients were studied.
SCIT significantly diminished symptom and medication scores for both rhinitis and asthma, and also improved VAS. SLIT also reduced VAS and symptoms of asthma and rhinitis as well as medication use for rhinitis, but these reductions were not significant compared with placebo (whereas SCIT reductions were). Skin prick tests and sIgE to mite were reduced by both treatments. Serum IL-10 and nasal provocation doses increased significantly with both treatments. Nasal eosinophils after nasal challenge decreased with both treatments, but bronchial provocation doses and sputum eosinophils after bronchial challenge were reduced only with SCIT. sIgG4 levels increased significantly only in the SCIT group. There were no changes in IFN-gamma levels in either group.
The authors concluded that based on the limited number of patients evaluated the efficacy of SCIT was "more evident" when compared with placebo than that of SLIT.
Reference
Yukselen A, et al. Effect of one year subcutaneous and sublingual immunotherapy on clinical and laboratory parameters in children with rhinitis and asthma: a randomized, placebo-controlled, double-blind, double-dummy study. In: International Archives of Allergy and Immunology 2012; 157:288-298.