Possibilities of sublingual allergen-specific immunotherapy in preschool children with sensitization to mold fungus allergens

Authors

  • O. V. Sharikadze P. L. Shupyk National Medical Academy of Postgraduate Education, Kyiv, Ukraine,
  • O. M. Okhotnikova P. L. Shupyk National Medical Academy of Postgraduate Education, Kyiv, Ukraine,

DOI:

https://doi.org/10.14739/2310-1237.2020.1.203744

Keywords:

sublingual immunotherapy, immunologic desensitization, children, allergic asthma, mold Alternaria alternata

Abstract

 

Purpose. Determination of the efficacy of sublingual allergen-specific immunotherapy (SLIT) in preschool children with sensitization to allergens of mold Alternaria alternata.

Materials and methods. The study involved 447 children aged 4.1 ± 0.9 years (from 3 to 7 years old), with verified diagnoses of allergic bronchial asthma and/or allergic rhinitis. In 58 patients with proven sensitization to Alternaria alternata major allergens, the efficacy of sublingual allergen-specific immunotherapy (SLIT) was assessed, which was carried out for 3 years and evaluated using a visual analogue scale (VAS) and the sIgE level to the major component of Alternaria Alt a1. 27 children (group II) who received exclusively basic therapy were included in the comparison group.

Results. During three years, SLIT in patients of the first group showed a significant decrease in the frequency of nasal symptoms: sneezing from 29 (26; 31) mm to 8 (6; 11) mm (P = 0.008), rhinorrhea from 29 (26; 34 ) mm to 5 (4; 6) mm (P = 0.012) mm, itching from 20 (17; 23) mm to 5 (4; 6) (P = 0.002) mm and nasal congestion from 29 (25; 35) mm to 7 (5; 9) mm (P = 0.016) compared with the initial level. Similar dynamics were observed with the nasal symptoms itching of the eyes, redness of the eyes and discharge from the eyes, which significantly decreased from 26 (23; 31) mm to 5 (3; 7) mm (P = 0.007), from 29 (26; 36) mm to 4 (3; 6) mm (P = 0.014) and from 29.5 mm to 5.0 (4; 7) mm (P = 0.003) in comparison with the initial values. Dynamics were also observed in relation to asthma symptoms, namely, the cough and shortness of breath indices reliably decreased from 54 (46; 61) mm to 7 (6; 9) mm (P = 0.013) and from 50 (39; 57) mm to 7 (5; 9) mm (P = 0.011) compared to baseline values. It should be noted that the indicators of VAS in children after the end of the SLIT course were significantly lower than those in children who received basic therapy.

Conclusions. The study showed that the use of sublingual immunotherapy in children with sensitization to mold Alternaria alternata and the presence of clinical manifestations of allergic rhinitis and / or allergic bronchial asthma, is an effective and safe treatment method and allows to gain control over symptoms of the disease quickly (within the first 6 months).

References

Rekalova, E. M., & Petrenko, L. V. (2017). Funhalna alerhіia u khvorykh na lehku ta serednoi vazhkostі bronkhіalnu astmu: klіnіchnі, funkcіonalnі, alerholohіchnі, laboratornі osoblyvostі [Fungal allergy in patients with mild and moderate asthma: clinical, functional, allergic, laboratory features]. Ukrainskyi pulmonolohichnyi zhurnal, (2), 19-22. [in Ukrainian].

Bongomin, F., Gago, S., Oladele, R. O., & Denning, D. W. (2017). Global and Multi-National Prevalence of Fungal Diseases-Estimate Precision. Journal of Fungi, 3(4), Article Unsp 57. https://doi.org/10.3390/jof3040057

Castanhinha, S., Sherburn, R., Walker, S., Gupta, A., Bossley, C. J., Buckley, J., Ullmann, N., Grychtol, R., Campbell, G., Maglione, M., Koo, S., Fleming, L., Gregory, L., Snelgrove, R. J., Bush, A., Lloyd, C. M., & Saglani, S. (2015). Pediatric severe asthma with fungal sensitization is mediated by steroid-resistant IL-33. Journal of Allergy and Clinical Immunology, 136(2), 312-322. https://doi.org/10.1016/j.jaci.2015.01.016

Coop, C. A. (2014). Immunotherapy for Mold Allergy. Clinical Reviews in Allergy & Immunology, 47(3), 289-298. https://doi.org/10.1007/s12016-013-8389-4

Denning, D. W., Pashley, C., Hartl, D., Wardlaw, A., Godet, C., Del Giacco, S., Delhaes, L., & Sergejeva, S. (2014). Fungal allergy in asthma-state of the art and research needs. Clinical and Translational Allergy, 4, Article 14. https://doi.org/10.1186/2045-7022-4-14

Crameri, R., Garbani, M., Rhyner, C., & Huitema, C. (2014). Fungi: the neglected allergenic sources. Allergy, 69(2), 176-185. https://doi.org/10.1111/all.12325

Fukutomi, Y., & Taniguchi, M. (2015). Sensitization to fungal allergens: Resolved and unresolved issues. Allergology International, 64(4), 321-331. https://doi.org/10.1016/j.alit.2015.05.007

del Rio, P. R., Vidal, C., Just, J., Tabar, A. I., Sanchez-Machin, I., Eberle, P., Borja, J., Bubel, P., Pfaar, O., Demoly, P., & Calderon, M. A. (2017). The European Survey on Adverse Systemic Reactions in Allergen Immunotherapy (EASSI): A paediatric assessment. Pediatric Allergy and Immunology, 28(1), 60-70. https://doi.org/10.1111/pai.12660

Seguel, J. M., Merrill, R., Seguel, D., & Campagna, A. C. (2017). Indoor Air Quality. American Journal of Lifestyle Medicine, 11(4), 284-295. https://doi.org/10.1177/1559827616653343

Twaroch, T. E., Curin, M., Valenta, R., & Swoboda, I. (2015). Mold allergens in respiratory allergy: From structure to therapy. Allergy, Asthma and Immunology Research, 7(3), 205-220. doi:10.4168/aair.2015.7.3.205

Del Giacco, S. R., Bakirtas, A., Bel, E., Custovic, A., Diamant, Z., Hamelmann, E., Heffler, E., Kalayci, O., Saglani, S., Sergejeva, S., Seys, S., Simpson, A., & Bjermer, L. (2017). Allergy in severe asthma. Allergy, 72(2), 207-220. https://doi.org/10.1111/all.13072

Downloads

How to Cite

1.
Sharikadze OV, Okhotnikova OM. Possibilities of sublingual allergen-specific immunotherapy in preschool children with sensitization to mold fungus allergens. Pathologia [Internet]. 2020May25 [cited 2024Apr.19];(1). Available from: http://pat.zsmu.edu.ua/article/view/203744

Issue

No. 1 (2020)

Section

Original research

License

Authors who publish with this journal agree to the following terms:

    1. Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
Лицензия Creative Commons
    1. Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.

  1. Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (SeeThe Effect of Open Access).