Acupoint Herbal Patching for Long-Term Immune Function in Children with Recurrent Respiratory-Tract Infections: A Systematic Review of Real-World Data.

Abstract

Objective: Acupoint herbal patching (AHP) has been used for the prevention and treatment of recurrent respiratory-tract infections (RRTIs) in children. some studies have suggested relevance to immune function as AHP's mechanism. This study was conducted to evaluate the long-term effects of AHP on immune function in pediatric patients with RRTIs based on real-world data from more than 1-year of follow-up. Materials and Methods: Eleven English-, Korean-, and Chinese-language databases were searched comprehensively up to January 2020. Real-world clinical data assessing AHP for children with RRTI and reporting long-term immune function-related biomarkers as outcomes were included. Descriptive analyses of the details of the participants, interventions, and outcomes were conducted. The risk of bias was assessed, using the ROBINS-I [Risk of Bias in Non-randomized Studies-of Interventions] tool. Results: Four observational studies with 399 pediatric participants were included. Two studies reported salivary secretory immunoglobulin (Ig) A (sIgA) as an immune function-related biomarker and 2 reported serum levels of IgA, IgG, and IgM. sIgA levels showed inconsistent results at 1 year after AHP. However, IgA, IgG, and IgM levels were increased significantly at both 1 and 2 years after AHP. The frequency and duration of respiratory infections were also reduced significantly after AHP. Most studies had high risks of bias, especially lack of consideration of confounding factors. Conclusions: Current evidence suggested that AHP might be connected to immune function-related biomarker levels and symptoms in pediatric patients with RRTIs in the long-term. Further well-designed, large-size, long-term registries are needed to investigate the effects of AHP on immune function in pediatric patients with RRTIs.