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Oral immunotherapy of children with rhinoconjunctivitis due to birch pollen allergy. A double blind study
Insights
Oral immunotherapy using birch pollen extract capsules effectively reduced symptoms and allergic reactions in children with birch pollinosis. This safe and economical treatment also prevented asthma development in the study group.
Area of Science:
- Allergy and Immunology
- Pediatrics
- Otolaryngology
Background:
- Birch pollinosis, a common allergic condition in children, causes rhinoconjunctivitis.
- Current treatments for birch pollinosis often manage symptoms but do not address the underlying allergy.
- Oral immunotherapy (OIT) presents a potential disease-modifying treatment strategy.
Purpose of the Study:
- To evaluate the efficacy and safety of oral immunotherapy with a birch pollen preparation in children suffering from birch pollinosis.
- To assess the impact of OIT on allergic symptoms, skin test reactivity, and specific antibody levels.
Main Methods:
- A 10-month, double-blind, placebo-controlled study involving 30 children with birch pollinosis.
- Participants received either enteric-coated birch pollen extract capsules (up to 1.4 x 10^6 biologic units/day) or placebo.
- Symptom severity, skin prick test results, conjunctival sensitivity, and specific IgE and IgG antibody levels were monitored.
Main Results:
- Actively treated children experienced significantly fewer symptoms during the birch pollen season after 3 months (P = 0.035).
- Skin prick reactions decreased more in the active group after 10 months (P = 0.01), and conjunctival sensitivity was lower after 3 months (P = 0.01).
- Increased IgG (P = 0.007) and pre-seasonal IgE (P = 0.001) against birch were observed in the active group, with no seasonal IgE increase.
Conclusions:
- Oral immunotherapy with high-dose, biologically potent birch pollen extract in enteric-coated capsules is effective for treating children with birch pollinosis.
- The treatment is safe, easy to administer, and cost-effective.
- Importantly, none of the treated children developed asthma, compared to five in the placebo group.
Abstract:
Thirty children with rhinoconjunctivitis due to birch pollinosis were treated in a double blind manner for 10 months with enteric-coated capsules containing either a birch pollen preparation (n = 14) with doses up to 1.4 X 10(6) biologic units per day or placebo (n = 16). Compared with the placebo group the actively treated children had less symptoms during the birch pollen season after 3 months of therapy (P = 0.035). Skin prick reactions decreased significantly more in the active group than in the placebo group after 10 months (P = 0.01). Conjunctival sensitivity was lower in the active group than in the placebo group after 3 months of treatment (P = 0.01) but not after 10 months. Compared with the placebo group the treated children more often increased their levels of IgG (P = 0.007) and pre-seasonal IgE (P = 0.001) against birch. There was a seasonal increase of IgE antibody level against birch in the placebo but not in the treatment group (P less than 0.001). None of the treated children developed asthma, compared with five of the untreated children. No general reactions occurred and few side effects were seen during the treatment period. We conclude that in children with birch pollinosis oral immunotherapy with high doses of a biologically potent preparation in enteric-coated capsules is effective, easy to perform, economic and safe.