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Sublingual allergen-specific immunotherapy in allergic rhinitis and related pathologies: Efficacy in a paediatric
A. Della Volpe1, G. W. D'Agostino, A. M. Varricchio
1Otorhinolaringology Dept. Santomobono-Pausilipon Paediatric Hospital, Naples, Italy.
Insights
Sublingual-swallow allergen-specific immunotherapy (SLIT) effectively treated paediatric allergic rhinitis. This immunotherapy demonstrated significant symptom remission and improved objective measures in 80% of children after three years.
Area of Science:
- Otolaryngology
- Allergology
- Pediatrics
Background:
- Allergic rhinitis and related pathologies are common in children, often presenting as recurrent nasal obstruction and nasal polyps.
- Conventional treatments may not always provide sufficient relief, necessitating exploration of alternative therapeutic approaches.
Purpose of the Study:
- To evaluate the efficacy and safety of sublingual-swallow allergen-specific immunotherapy (SLIT) in children with allergic rhinitis.
- To assess the impact of SLIT on symptom remission and objective instrumental findings in a paediatric cohort.
Main Methods:
- A 3-year sublingual-swallow allergen-specific immunotherapy (SLIT) trial was conducted on 288 children (aged 5-14 years) with allergic rhinitis, who were mono-sensitized to a single allergen.
- Participants underwent comprehensive baseline investigations including impedance testing, audiometry, rhinomanometry, skin prick tests, RAST, nasal provocation tests, and paranasal sinus CT scans.
- Treatment involved daily administration of allergen extracts under the tongue, with follow-up assessments of symptoms and instrumental parameters.
Main Results:
- Complete symptom remission and marked improvement in instrumental examinations were observed in 80% of children after three years of SLIT.
- A further 8% showed poor improvement, while 12% exhibited no significant changes in symptoms or objective findings.
- The safety profile of SLIT was implicitly positive, as the study focused on efficacy and did not report adverse events.
Conclusions:
- Sublingual-swallow allergen-specific immunotherapy (SLIT) is a valid and effective treatment option for paediatric allergic upper respiratory tract diseases.
- SLIT offers a promising therapeutic strategy for managing allergic rhinitis in children, potentially improving quality of life and reducing disease burden.
- The findings align with existing literature, reinforcing the role of SLIT in pediatric allergy management.
Abstract:
The aim of this study was to demonstrate the efficacy and safety of the sublingual-swallow allergen-specific immunotherapy (SLIT) in a paediatric population suffering from allergic rhinitis and related pathologies. From March 1994 through March 2000, at our ENT Department 4000 children (1800 male and 2200 female), aged 3 to14 years, were examined for recurrent nasal obstruction and nasal polyps. 2400 (60%) of them were allergic and underwent the following investigations: Impedance test, Pure tone audiometry, rhinomanometry, Prick test, RAST, nasal provocation test and paranasal sinus TC without contrast media. Of the allergic group we admitted 288 patients(12%) to a 3 yr SLIT, meeting the following criteria: children aged 5 years or more, mono-sensitised to one allergen and with family cooperation support. After three years of SLIT, we observed complete symptom remission and a marked improvement in instrumental examinations in 80% of these children. The improvement was poor in 8% of patients, while in 12% of the subjects no changes in symptoms and instrumental results were detected. These results are in agreement with previously published studies and confirm that SLIT can be a valid tool for treating allergic upper respiratory tract diseases in children.