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Local nasal immunotherapy with a powder extract for grass pollen induced rhinitis in pediatric ages: a controlled
M Bardare1, G Zani, E Novembre
11st Pediatric Clinic, University of Milan, Italy.
Insights
Grass pollen immunotherapy significantly reduced rhinoconjunctivitis symptoms in children within one year. Active treatment provided faster relief compared to placebo, with no adverse immunological effects observed.
Area of Science:
- Allergy and Immunology
- Pediatric Medicine
- Otolaryngology
Background:
- Grass pollen rhinoconjunctivitis is a common allergic condition in children.
- Current treatments often focus on symptom management rather than disease modification.
- Preseasonal immunotherapy offers a potential approach to alter the allergic response.
Purpose of the Study:
- To evaluate the efficacy and immunological effects of preseasonal grass pollen immunotherapy in pediatric patients with rhinoconjunctivitis.
- To compare the clinical outcomes of active immunotherapy versus placebo.
Main Methods:
- A randomized, double-blind, placebo-controlled study involving 40 pediatric patients (5-13 years) with grass pollen rhinoconjunctivitis.
- Patients received either grass pollen extract or placebo for 12 weeks preseasonally.
- Clinical symptoms, nasal provocation tests (NPT), rhinomanometry, prick tests, and serum IgA, IgE, and specific IgG/IgE levels were assessed before and after treatment.
Main Results:
- Actively treated patients showed a significant decrease in daily nasal and conjunctival signs and symptoms after one year compared to the placebo group.
- The placebo group achieved similar symptom reduction after three years of treatment.
- Nasal provocation tests demonstrated a significant increase in the dose threshold in actively treated patients, indicating improved tolerance.
- No significant immunological alterations were observed in either group.
Conclusions:
- Preseasonal grass pollen immunotherapy is effective in reducing symptoms of rhinoconjunctivitis in children.
- The treatment offers a faster onset of clinical improvement compared to placebo.
- Immunotherapy appears safe, with no significant adverse immunological changes detected.
Abstract:
Forty pediatric patients, ranging from 5-13 years of age and suffering from grass pollen rhinoconjunctivitis, were submitted to local nasal preseasonal (12 weeks) immunotherapy, either with a grass pollen extract or with placebo. After 1 year, 15 of these patients (5 previously treated with active product and 10 with placebo) were treated with the grass pollen extract preseasonally for 2 consecutive years. Before and after treatment, serum total IgA and IgE, and specific IgG and IgE were assayed as well as carrying out nasal provocation tests (NPT) with extracts at different concentrations, endpoint evaluations by rhinomanometry and prick tests with different concentrations of extract. After only 1 year, the actively treated patients showed a significant decrease of daily nasal and conjunctival signs and symptoms-as judged by a 1 to 3 score-in comparison with the control group. The placebo group showed the same results after the 3rd year. The improvement was confirmed by a significant increase of the dose threshold in NPT. No immunological alterations were evident.