Comparative clinical-immunological study of oral and subcutaneous immunotherapy in children with extrinsic bronchial asthma

Abstract

There is discrepancy of criteria regarding the clinical immunological efficacy of allergenic extracts, administered by oral way, for the control of allergic symptoms of the respiratory airways. The predominant mono-sensitization to D. pteronyssinus and the early development of allergic respiratory symptoms in our medium motivated us to evaluate the clinical-immunological efficacy of oral immunotherapy in children with bronchial asthma. Twenty-eight patients affected with extrinsic bronchial asthma to D. pteronyssinus were included in our study; their average age was 27.93 months (range between 18-42 months) and the SD (standard deviation), 5.46. For the reception of oral and subcutaneous vaccines, made-up of 100% D. pteronyssinus, the patients were divided into two groups of 14 children each. The clinical immunological evaluation was realized in basal conditions, 6 and 12 months after the initiation of both vaccines. IgE and seric IgG4 against D. pteronyssinus was quantified through RAST. The results obtained were as follows: 1. Subcutaneous immunotherapy (SI) was seen to be more effective than oral immunotherapy (OI), throughout the 12 months of the study. 2. In both vaccines, the IgE against D. pteronyssinus did not undergo any statistically significant changes (p less than 0.766 and p less than 0.246). 3. IgG4 against D. pteronyssinus increased more with subcutaneous than with oral therapy. There were statistically significant differences for both kinds of therapy at 6 and 12 months, the difference between basal and 12 months being p less than 0.001 and p less than 0.020, for subcutaneous and oral therapy respectively.(ABSTRACT TRUNCATED AT 250 WORDS)