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Updated: Oct 20, 2025
Sublingual Immunotherapy as an Alternative to Induce Protection Against Acute Respiratory Infections
Published on: August 30, 2014
Efficacy of Sublingual Immunotherapy in Allergic Rhinitis Children during Coronavirus Disease 2019
Wenlong Liu1, Qingxiang Zeng1, Yiquan Tang1
1Department of Otolaryngology, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China.
Insights
Continuous exposure to house dust mites reduced sublingual immunotherapy effectiveness in children with allergic rhinitis. Frequent bedding cleaning improved treatment outcomes during COVID-19 restrictions.
Area of Science:
- Allergy and Immunology
- Pediatrics
- Environmental Health
Background:
- Sublingual immunotherapy (SLIT) is effective for pediatric allergic rhinitis (AR).
- The impact of persistent allergen exposure on SLIT efficacy, particularly during COVID-19, remains understudied.
- COVID-19 pandemic led to reduced outdoor activities, potentially increasing indoor allergen exposure.
Purpose of the Study:
- To evaluate the effectiveness of SLIT for children with AR during the COVID-19 pandemic.
- To assess the influence of persistent house dust mite (HDM) exposure on SLIT outcomes.
- To identify factors that may mitigate reduced SLIT effectiveness.
Main Methods:
- 335 children with HDM-sensitized AR undergoing SLIT were analyzed.
- Clinical effectiveness was measured using symptom and medication scores.
- Serum total IgE and specific IgE (sIgE) levels were monitored.
Main Results:
- Nasal symptom and medication scores increased during COVID-19 compared to the previous year, but remained below baseline.
- No significant changes in total IgE or sIgE levels were observed during SLIT.
- Frequent bedding cleaning correlated with better treatment response.
Conclusions:
- Continuous HDM exposure can diminish SLIT effectiveness in children with AR.
- Environmental control, such as frequent bedding cleaning, is crucial for optimizing SLIT outcomes.
- SLIT remains a viable treatment option, but allergen avoidance strategies are essential for sustained efficacy.
Background:
Sublingual immunotherapy (SLIT) had good effectiveness for children with allergic rhinitis (AR). However, no studies explored the effect of persistent allergen exposure on SLIT treatment. Coronavirus disease 2019 (COVID-19) restricts outdoor activities of children significantly. We aimed to evaluate the effectiveness of SLIT during this special period.
Methods:
A total of 335 AR children who sensitize to house dust mite (HDM) undergoing SLIT were recruited in this study. The clinical effectiveness and safety were evaluated at different time points using symptom and medication scores. The serum total IgE and specific IgE (sIgE) at different time points were detected by using the Unicap system.
Results:
The total nasal symptoms score (TNSS) and total medication score (TMS) during the epidemic of COVID-19 increased significantly compared with the same period last year (p < 0.05), despite that they were still significantly lower than baseline levels (p < 0.05). The occurrence of adverse reactions at different time points had no significant differences. We also found that the family of the good response group had more frequent bedding cleaning. Both the tIgE and sIgE levels had no significant changes during SLIT treatment.
Conclusion:
Our results suggest that continuous HDM exposure reduced the effectiveness of SLIT, whereas effective reduction of HDM levels by frequent bed cleaning will be helpful during the SLIT treatment.
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