The efficacy of sublingual immunotherapy for allergic rhinitis and the predictive role of cytokines in its therapeutic effect

Abstract

Objective:The study aimed to investigate the efficacy of sublingual immunotherapy(SLIT) in treatment of adult allergic rhinitis, and to explore the predictive role of baseline serum cytokine levels in its therapeutic effect.Method:Sixty patients with moderatesevere perennial AR sensitized with house dust mites were treated for 2 years. The SLIT group(n=30) were treated with standardized dust mite vaccine SLIT and conventional drugs, and the control group(n=30) were treated with placebo and conventional drugs. The combined symptom and medication score(CSMS) were compared between the two groups to evaluate the efficacy at baseline and 2 year endpoint. According to therapeutic effect, the SLIT group and the control group were divided into subgroups respectively, and the baseline IFN-γ and IL4, IL10, IL17 levels were compared between the effective group and the ineffective group in each group. The ROC curve was drawn to find the best predictive index and the best cut-off value was calculated. Result:①There was no significant difference between the SLIT group and the control group at baseline CSMS(P>0.05). There was significant difference between the two groups at 2year endpoint CSMS(P<0.05). ②In the SLIT group, there was no significant difference between the effective group and the ineffective group with the IFN-γ and IL17(P>0.05). The IL4 level in the effective group was significantly higher than the ineffective group while the IL10 level was significantly lower(P<0.05). In the control group, there were no significant differences in the levels of IFN-γ, IL4, IL10 and IL17 between the two subgroups(P>0.05). ③Baseline IL4/IL10 has higher predictive value than IL4 and IL10 alone. The best cut-off value is 2.04, and the sensitivity and specificity of predictive value were 72.7% and 73.7% respectively. Conclusion: SLIT combined with conventional drug therapy is more effective than conventional drug therapy alone. IL4/IL10 has a better predictive role in SLIT effect than IL4 or IL10 alone. The higher the ratio, the better therapeutic effect is.