Abstract

This review presents up-to-date understanding of immunotherapy in the treatment of children with allergic asthma. The principal types of allergen immunotherapy (AIT) are subcutaneous immunotherapy (SCIT) and sublingual immunotherapy (SLIT). Both of them are indicated for patients with allergic rhinitis and/or asthma, who have evidence of clinically relevant allergen-specific IgE, and significant symptoms despite reasonable avoidance measures and/or maximal medical therapy. Studies have shown a significant decrease in asthma symptom scores and in the use of rescue medication, and a preventive effect on asthma onset. Although the safety profile of SLIT appears to be better than SCIT, the results of some studies and meta-analyses suggest that the efficacy of SCIT is better and that SCIT has an earlier onset than SLIT in children with allergic asthma. Severe, not controlled asthma, and medical error were the most frequent causes of SCIT-induced adverse events.

Highlights

  • Asthma is one of the most common chronic inflammatory disorders in children, and airway remodeling can cause it to persist into adulthood

  • The objective of the current review is to summarize the evidence for the efficacy, safety, potential barriers to, and facilitators of the use of allergen immunotherapy (AIT) in pediatric asthma

  • sublingual immunotherapy (SLIT) appear to be effective in allergic asthma, literature is more supportive of an subcutaneous immunotherapy (SCIT) predominance in clinical efficacy [91]

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Summary

Subcutaneous and Sublingual immunotherapy in Allergic Asthma in Children

Sophia Tsabouri1*, Antigoni Mavroudi, Gavriela Feketea and George V. The principal types of allergen immunotherapy (AIT) are subcutaneous immunotherapy (SCIT) and sublingual immunotherapy (SLIT). Both of them are indicated for patients with allergic rhinitis and/or asthma, who have evidence of clinically relevant allergen-specific IgE, and significant symptoms despite reasonable avoidance measures and/or maximal medical therapy. Studies have shown a significant decrease in asthma symptom scores and in the use of rescue medication, and a preventive effect on asthma onset. The safety profile of SLIT appears to be better than SCIT, the results of some studies and meta-analyses suggest that the efficacy of SCIT is better and that SCIT has an earlier onset than SLIT in children with allergic asthma.

INTRODUCTION
History of SCIT
History of SLIT
MECHANISMS OF IMMUNOTHERAPY TO AEROALLERGENS
DURATION OF TREATMENT
Efficacy of SCIT
Efficacy of SLIT
PREVENTIVE EFFECT OF AIT
SPECIAL CONSIDERATIONS
Polysensitized Patients
Omalizumab and AIT
SCIT vs SLIT
OTHER ISSUES
CONCLUSION
Findings
AUTHOR CONTRIBUTIONS
Full Text
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