Abstract
Background: Many studies have demonstrated the efficacy of single-allergen sublingual immunotherapy (SLIT) in polysensitized patients with allergic rhinitis (AR), but less is reported in polysensitized patients with allergic asthma (AS).Method: Data of 133 adult patients with house dust mite (HDM)-induced AS who had been treated for 3 years were collected. These patients were divided into the control group (treated with low to moderate dose of inhaled glucocorticoids and long-acting β2 agonists, n = 37) and the SLIT group (further treated with Dermatophagoides farinae drops, n = 96). The SLIT group contained three subgroups: the single-allergen group (only sensitized to HDM, n = 35), the 1- to 2-allergen group (HDM combined with one to two other allergens, n = 32), and the 3-or-more-allergen group (HDM combined with three or more other allergens, n = 29). The total asthma symptom score (TASS), total asthma medicine score (TAMS), and asthma control test (ACT) were assessed before treatment and at yearly visits. Forced expiratory volume in 1 s/forced vital capacity (FEV1/FVC) was assessed before treatment and at the end of SLIT.Results: TASS and ACT scores in the control group were significantly higher than that in the single-allergen group and the 1- to 2-allergen group after 1, 2, and 3 years of SLIT and significantly higher than that in the 3-or-more-allergen group after 3-year SLIT (all p < 0.05). TAMS of the control group was significantly higher than that of the other three groups after 0.5, 1, 2, and 3 years of SLIT (all p < 0.05). FEV1/FVC in the control group was significantly higher than baseline after 3 years of immunotherapy (p < 0.05).Conclusion: Patients sensitized to HDM with/without other allergens showed similar efficacy after 3 years of SLIT. However, the initial response of patients with three or more allergens was slower during immunotherapy process.
Highlights
Asthma is a common chronic airway disease worldwide, affecting 18% of the populations in different countries [1]
house dust mite (HDM) served as the main allergen in southern places while pollen might be the main allergen in the northern area in China
Recruitment criteria included patients sensitized to aeroallergens aged 18–60 years, all of whom have been diagnosed with mild-to-moderate bronchial asthma; pulmonary function test FEV1 >70% of the predicted value; patients without previous Allergen immunotherapy (AIT) and with single allergen of HDM or HDM combined with other one to three or more allergens were recruited; other allergens are limited to inhaled allergens, but there is no limit to the types of allergens
Summary
Asthma is a common chronic airway disease worldwide, affecting 18% of the populations in different countries [1]. It has been recently proposed that asthma is a heterogeneous disease with different clinical phenotypes, and allergic asthma (AS) is one of the most important phenotypes, accounting for more than three-fifths of adult asthma [2]. The World Allergy Organization Position Paper estimated that the global prevalence of allergic diseases was 10–40%, including 300 million patients with AS [3]. In China, house dust mite (HDM) is the main allergen for patients with allergic diseases and the prevalence of sensitization was ∼48% [4]. Kewu Huang and his colleagues reported in the Lancet that the prevalence of asthma in people aged over 20 was 4.2% in China, and the total number of patients had reached 45.7 million in 2019. Many studies have demonstrated the efficacy of single-allergen sublingual immunotherapy (SLIT) in polysensitized patients with allergic rhinitis (AR), but less is reported in polysensitized patients with allergic asthma (AS)
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