Published Online: June 13, 2015
There has been a rise in asthma and allergic diseases, reaching epidemic proportions, in recent decades causing significant health and social impact. In the absence of a cure, prevention is the most effective strategy. Asthma and allergies run in families, and house dust mite allergen is a major cause in most developed and many developing countries. One potential strategy to prevent the development of allergy is to immunize high risk infants, ie, those with a strong family history, using extract of a common allergen such as house dust mite.
In a recent article in The Journal of Allergy and Clinical Immunology (JACI), Zolkipli et al carried out a trial in 104 infants at high risk of allergy based on a family history of allergic disease in both parents or one parent and one sibling. The infants were divided into two groups. Fifty-three infants were given house-dust mite extract as drops of oral solution twice daily for one year starting at six months of age (active), while 51 infants were given similar solution without the vaccine (placebo). They were assessed every three months for the development of allergic symptoms such as cough, wheeze, eczema, runny nose, and food allergy, and allergy skin prick tests were carried out. They were also monitored closely for any adverse effects.
After a year of treatment, allergy was reduced by more than 50% in infants given active treatment. Only five (9.4%) in the active group developed allergy on skin prick test compared to 13 (25.5%) in the placebo group. A major reduction in allergic symptoms such as wheeze and eczema was not observed at this stage but further assessment of these children at six years is planned. Importantly, the treatment was found to be safe, opening avenues for similar and larger studies to develop a safe and effective way of reducing the epidemic of asthma and allergy.
The Journal of Allergy and Clinical Immunology (JACI) is an official scientific journal of the AAAAI, and is the most-cited journal in the field of allergy and clinical immunology.