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[Accelerated desensitization with Dermatophagoides pteronyssinus in severe asthmatic children. Evaluation after one
Insights
Rush immunotherapy with Dermatophagoides pteronyssinus extracts improved asthma symptoms and medication scores in children. While some allergic markers decreased, efficacy is best measured by clinical outcomes, not lab results.
Area of Science:
- Allergy and Immunology
- Pediatric Pulmonology
- Clinical Therapeutics
Context:
- Severe chronic asthma in children presents significant management challenges.
- Standard immunotherapy protocols may not be suitable for all pediatric patients.
- Investigating alternative immunotherapy approaches is crucial for improving patient outcomes.
Purpose:
- To evaluate the safety and efficacy of rush immunotherapy using Dermatophagoides pteronyssinus extracts in children with severe chronic asthma.
- To assess changes in clinical symptoms, medication use, and allergic parameters following immunotherapy.
- To determine the correlation between clinical improvement and immunological/allergic markers.
Summary:
- A cohort of 17 children with severe chronic asthma underwent rush immunotherapy with Dermatophagoides pteronyssinus extracts over one year.
- Assessments included symptom/medication scores, lung function, nasal challenges, skin tests, and serum IgE/IgG4 levels.
- Improvements in symptoms and medication scores were observed in 10 children, with decreased nasal and skin sensitivity in some.
- No direct correlation was found between quality of life improvements and laboratory results.
Impact:
- Rush immunotherapy is a feasible treatment option for children suffering from severe asthma.
- Clinical symptom and medication scores are reliable indicators for assessing immunotherapy efficacy in pediatric asthma.
- Further research is warranted to optimize immunotherapy strategies and understand the underlying mechanisms in severe pediatric asthma.
Abstract:
An homogeneous group of 17 children with severe chronic asthma were given a rush immunotherapy with standardized Dermatophagoides pteronyssinus extracts. Maintenance dose was injected monthly for one year. Symptom and medication scores as well as functional (lung function tests, specific nasal challenges), immunologic and allergic parameters (skin tests, total serum IgE, specific IgE and IgG4) were recorded before and at the end of the study. Rush immunotherapy was well tolerated in spite of some moderate systemic adverse reactions. Symptom and medication scores improved in 10 children. Nasal and skin sensitivity decreased in respectively 3 and 7 children. However there was no correlation between the improvement of quality of life and laboratory results. This study shows that specific immunotherapy is possible in children with severe asthma. Its efficacy should be assessed by symptom and medication scores.