Purpose of the Study. Prevalence of atopic diseases has increased in westernized countries despite current prevention strategies. The objective of this study was to determine whether specific immunotherapy (IT) can stop progression of sensitization to additional environmental allergens in children monosensitized to house dust mites.
Study Population. One hundred thirty-four children ages 5 to 8 years, with intermittent asthma, with or without rhinitis, sensitized to house dust mites.
Methods. Children were evaluated by prick skin testing and measurement of serum allergen-specific immunoglobulin E (IgE). Parents of 75 children accepted IT and these children were received IT with dust mite extract for 3 years. The remaining 63 children were treated with medication and were considered a control group. All children were skin tested and had serum allergen-IgE measured every year for 6 years.
Results. Both groups were comparable in regard to age, sex, and presence of rhinitis. At the end of the 6-year study period, 25% of patients in the IT group showed new sensitization(s), compared with 66% in the control group (P < .0002). The most frequent new sensitizations were pollens, animal danders, and Alternaria mold. The IT was well-tolerated.
Conclusion. Specific IT may prevent the development of new sensitizations in children with asthma, with or without rhinitis, monosensitized to house dust mites.
Reviewer’s Comments. This nonrandomized clinical trial highlights the renewed interest in immunotherapy because of its potential to modify the natural history of atopic sensitization. If subsequent studies confirm the results of this trial, our standard of care may change to include early introduction of IT in atopic children, as opposed to current symptomatic management with medication with the use of immunotherapy as a second- or third-line treatment.
- Copyright © 2002 by the American Academy of Pediatrics