ABSTRACT
BACKGROUND: : Despite the reported clinical effectiveness of house dust mite (HDM) sublingual immunotherapy (SLIT) in pediatric patients, the risk of treatment remains unclear in pediatric patients with allergic asthma. OBJECTIVE: To show a risk of adverse drug reactions (ADRs) in pediatric patient with allergic asthma during the initiation period of HDM SLIT. METHODS: We retrospectively analyzed the clinical data of pediatric patients aged ≤ 15 years who initiated allergen immunotherapy (AIT) with the SQ HDM SLIT-tablet for allergic rhinitis between February 2017 and September 2019. Asthma severity at baseline and ADRs during the first 4 weeks of the treatment were determined for each subject. RESULTS: In our study population (n = 217; median age, 8.4 years), 99 patients (45.6%) were classified as having asthma. One hundred and one patients (46.5%) in the whole cohort experienced ADRs during the first 4 weeks of therapy, but a major gap in the frequency of ADRs was not observed between an asthma group and a non-asthma group. CONCLUSIONS: The SQ HDM SLIT-tablet was well tolerated in pediatric patients with controlled HDM-driven allergic asthma. HDM-SLIT is an option to treat their allergic rhinitis without excessive concern for its ADRs.
Subject(s)
Allergens/adverse effects , Antigens, Plant/immunology , Food Hypersensitivity/blood , Gliadin/immunology , Immunoglobulin E/blood , Severity of Illness Index , Triticum/adverse effects , Allergens/immunology , Child, Preschool , Food Hypersensitivity/diagnosis , Humans , Probability , Triticum/immunologySubject(s)
Allergens/administration & dosage , Allergens/therapeutic use , Immunoglobulin E/blood , Milk Hypersensitivity/diagnosis , Allergens/immunology , Anaphylaxis/immunology , Animals , Humans , Immunoglobulin E/immunology , Infant , Infant, Newborn , Japan , Milk/immunology , Milk Hypersensitivity/immunology , Milk Proteins/immunology , Probability , Severity of Illness IndexABSTRACT
BACKGROUND: Respiratory syncytial virus (RSV) infection causes asthma-like symptoms in infants and young children. Although an increase in several mediators in the airway during RSV infection has been reported, the mechanisms involved in airway inflammation are not fully understood. The aim of this study was to investigate the immunological deviation associated with airway inflammation by measuring cytokine and chemokine levels in the airway during RSV infection. METHODS: One hundred and ten children under 3 years of age with respiratory symptoms were enrolled in this study from November 2004 through January 2005. Nasopharyngeal secretions (NPAs) were gently aspirated and analyzed with RSV antigen, thereafter the concentrations of IL-4, IL-10, IFN-gamma, and RANTES were measured using an ELISA kit. We also investigated the prognosis of each child after 1 year by reference to clinical records or by interviews and re-evaluated the cytokine and chemokine levels. RESULTS: Of the subjects, 70 children were RSV positive and 40 were negative. Only 4 children were given a diagnosis of asthma by the pediatrician when NPAs were collected. The levels of IL-4, IL-10, and RANTES were significantly higher in the RSV-positive patients than RSV-negative patients with P values at 0.0362, 0.0007, and 0.0047, respectively. In contrast, there was no significant difference in the levels of IFN-gamma. Furthermore, there was a significant positive correlation between IL-10 and RANTES. CONCLUSIONS: The increased production of IL-4, IL-10, and RANTES in the airway may play an important role in the pathophysiological mechanisms of RSV infection.