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 al- lergic diseases. Sublingual immunotherapy (SLIT) offers the possibility of home administration, which improves patient com- fort 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 rhi- nitis (AR), sensitized to grass pollen. At the first visit (V0, September 2016), one group received the first dose of oral immunother- apy 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 spirome- try. 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 spe- cific 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.

Nasal reactivity evaluation in children with allergic rhinitis receiving grass pollen sublingual immunotherapy / Schiavi, Laura; Brindisi, Giulia; DE CASTRO, Giovanna; DE VITTORI, Valentina; Loffredo, Lorenzo; Spalice, Alberto; Duse, Marzia; Zicari, Anna Maria. - In: ALLERGY AND ASTHMA PROCEEDINGS. - ISSN 1088-5412. - 41:5(2020), pp. 357-362. [10.2500/aap.2020.41.200063]

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

Laura Schiavi
Conceptualization
;
Giulia Brindisi
Conceptualization
;
Giovanna De Castro;Valentina De Vittori
;
Lorenzo Loffredo;Alberto Spalice;Marzia Duse;Anna Maria Zicari
Ultimo
Supervision
2020

Abstract

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 al- lergic diseases. Sublingual immunotherapy (SLIT) offers the possibility of home administration, which improves patient com- fort 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 rhi- nitis (AR), sensitized to grass pollen. At the first visit (V0, September 2016), one group received the first dose of oral immunother- apy 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 spirome- try. 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 spe- cific 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.
2020
immunotherapy; rhinomanometry; nasal obstruction; children
01 Pubblicazione su rivista::01a Articolo in rivista
Nasal reactivity evaluation in children with allergic rhinitis receiving grass pollen sublingual immunotherapy / Schiavi, Laura; Brindisi, Giulia; DE CASTRO, Giovanna; DE VITTORI, Valentina; Loffredo, Lorenzo; Spalice, Alberto; Duse, Marzia; Zicari, Anna Maria. - In: ALLERGY AND ASTHMA PROCEEDINGS. - ISSN 1088-5412. - 41:5(2020), pp. 357-362. [10.2500/aap.2020.41.200063]
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11573/1457056
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