Chinese Guideline on allergen immunotherapy for allergic rhinitis

Yixiao Bao¹, Jianjun Chen², Lei Cheng^{3

4}, Yinshi Guo⁵, Suling Hong⁶, Weijia Kong², He Lai⁷, Houyong Li⁸, Huabin Li⁸, Jing Li⁹, Tianying Li¹⁰, Xiaoping Lin¹¹, Shixi Liu¹², Zheng Liu¹³, Hongfei Lou^{14

15}, Juan Meng¹², Qianhui Qiu¹⁶, Kunling Shen¹⁷, Wei Tang¹⁸, Zezhang Tao¹⁹, Chengshuo Wang^{14

15}, Xiangdong Wang^{14

15}, Qingyu Wei²⁰, Li Xiang²¹, Hua Xie²², Yu Xu¹⁹, Gehua Zhang²³, Yuan Zhang^{14

15}, Yiwu Zheng²⁴, Yuxiang Zhi²⁵, Dehua Chen¹⁰, Haiyu Hong¹⁰, Quansheng Li²⁰, Lin Liu³, Yifan Meng^{14

15}, Nan Wang¹³, Yihui Wang¹, Yue Zhou², Luo Zhang^{14

15

26}; Chinese Society of Allergy (CSA) and Chinese Allergic Rhinitis Collaborative Research Group (C2AR2G)

Affiliations

¹ Department of Pediatric Respiratory Medicine, Pubin Children Hospital, Shanghai Children Medical Center Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200092, China.
² Department of Otorhinolaryngology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China.
³ Department of Otorhinolaryngology, the First Affiliated Hospital, Nanjing Medical University, Nanjing 210029, China.
⁴ International Centre for Allergy Research, Nanjing Medical University, Nanjing 210029, China.
⁵ Department of Allergy & Immunology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200127, China.
⁶ Department of Otorhinolaryngology, the First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China.
⁷ Department of Allergy, the Second Affiliated Hospital of Guangzhou Medical University, Guangzhou 510260, China.
⁸ Department of Otolaryngology, Head and Neck Surgery, Affiliated Eye, Ear, Nose and Throat Hospital, Fudan University, Shanghai 200031, China.
⁹ State Key Laboratory of Respiratory Disease, Allergy and Clinical Immunology, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou 510120, China.
¹⁰ Department of otolaryngology, the First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080, China.
¹¹ The PLA Center of respiratory and allergic disease diagnosing and management, Shenyang 110016, China.
¹² Department of Otolaryngology, West China Hospital, Sichuan University, Chengdu 610041, China.
¹³ Department of Otolaryngology Head and Neck Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China.
¹⁴ Department of Otolaryngology Head and Neck Surgery, Beijing TongRen Hospital, Capital Medical University, Beijing 100730, China.
¹⁵ Beijing Key Laboratory of Nasal Diseases, Beijing Institute of Otolaryngology, Beijing 100005, China.
¹⁶ Department of Otorhinolaryngology, Zhujiang Hospital, Southern Medical University, Guangzhou 510282, China.
¹⁷ Department of Pediatric Respiratory Medicine, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing 100045, China.
¹⁸ Department of Pulmonary and Critical Care Medicine, Shanghai Ruijin Hospital affiliated to Shanghai Jiaotong University, School of Medicine, Shanghai 200025, China.
¹⁹ Department of Otolaryngology, Renmin Hospital of Wuhan University, Wuhan 430060, China.
²⁰ Department of Allergy, NO.202 Hospital of PLA, Shenyang 110003, China.
²¹ Department of Allergy, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing 100045, China.
²² Department of Respiratory Medicine, the General Hospital of Shenyang Military Region, Shenyang 110016, China.
²³ Department of Otolaryngology Head and Neck Surgery, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou 510630, China.
²⁴ Scientific Affairs, ALK, Guangzhou 510300, China.
²⁵ Department of Allergy, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100720, China.
²⁶ Department of Allergy, Beijing TongRen Hospital, Capital Medical University, Beijing 100730, China.

PMID: 29268533
PMCID: PMC5721020
DOI: 10.21037/jtd.2017.10.112

Review

Chinese Guideline on allergen immunotherapy for allergic rhinitis

Yixiao Bao et al. J Thorac Dis. 2017 Nov.

. 2017 Nov;9(11):4607-4650.

doi: 10.21037/jtd.2017.10.112.

Authors

Affiliations

¹ Department of Pediatric Respiratory Medicine, Pubin Children Hospital, Shanghai Children Medical Center Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200092, China.
² Department of Otorhinolaryngology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China.
³ Department of Otorhinolaryngology, the First Affiliated Hospital, Nanjing Medical University, Nanjing 210029, China.
⁴ International Centre for Allergy Research, Nanjing Medical University, Nanjing 210029, China.
⁵ Department of Allergy & Immunology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200127, China.
⁶ Department of Otorhinolaryngology, the First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China.
⁷ Department of Allergy, the Second Affiliated Hospital of Guangzhou Medical University, Guangzhou 510260, China.
⁸ Department of Otolaryngology, Head and Neck Surgery, Affiliated Eye, Ear, Nose and Throat Hospital, Fudan University, Shanghai 200031, China.
⁹ State Key Laboratory of Respiratory Disease, Allergy and Clinical Immunology, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou 510120, China.
¹⁰ Department of otolaryngology, the First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080, China.
¹¹ The PLA Center of respiratory and allergic disease diagnosing and management, Shenyang 110016, China.
¹² Department of Otolaryngology, West China Hospital, Sichuan University, Chengdu 610041, China.
¹³ Department of Otolaryngology Head and Neck Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China.
¹⁴ Department of Otolaryngology Head and Neck Surgery, Beijing TongRen Hospital, Capital Medical University, Beijing 100730, China.
¹⁵ Beijing Key Laboratory of Nasal Diseases, Beijing Institute of Otolaryngology, Beijing 100005, China.
¹⁶ Department of Otorhinolaryngology, Zhujiang Hospital, Southern Medical University, Guangzhou 510282, China.
¹⁷ Department of Pediatric Respiratory Medicine, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing 100045, China.
¹⁸ Department of Pulmonary and Critical Care Medicine, Shanghai Ruijin Hospital affiliated to Shanghai Jiaotong University, School of Medicine, Shanghai 200025, China.
¹⁹ Department of Otolaryngology, Renmin Hospital of Wuhan University, Wuhan 430060, China.
²⁰ Department of Allergy, NO.202 Hospital of PLA, Shenyang 110003, China.
²¹ Department of Allergy, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing 100045, China.
²² Department of Respiratory Medicine, the General Hospital of Shenyang Military Region, Shenyang 110016, China.
²³ Department of Otolaryngology Head and Neck Surgery, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou 510630, China.
²⁴ Scientific Affairs, ALK, Guangzhou 510300, China.
²⁵ Department of Allergy, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100720, China.
²⁶ Department of Allergy, Beijing TongRen Hospital, Capital Medical University, Beijing 100730, China.

PMID: 29268533
PMCID: PMC5721020
DOI: 10.21037/jtd.2017.10.112

Abstract

The present document is based on a consensus reached by a panel of experts from Chinese Society of Allergy (CSA) and Chinese Allergic Rhinitis Collaborative Research Group (C2AR2G). Allergen immunotherapy (AIT), has increasingly been used as a treatment for allergic rhinitis (AR) globally, as it has been shown to provide a long-term effect in improving nasal and ocular symptoms, reducing medication need, and improving quality of life. AIT is currently the only curative intervention that can potentially modify the immune system in individuals suffering from AR and prevent the development of new sensitization and the progression of disease from AR to asthma. Although the use of AIT is becoming more acceptable in China, to date no AR immunotherapy guideline from China is available for use by the international community. This document has thus been produced and covers the main aspects of AIT undertaken in China; including selection of patients for AIT, the allergen extracts available on the Chinese market, schedules and doses of allergen employed in different routes of AIT, assessment of effect and safety, patients' administration and follow-up, and management of adverse reactions. The Chinese guideline for AR immunotherapy will thus serve as a reference point by doctors, healthcare professionals and organizations involved in the AIT of AR in China. Moreover, this guideline will serve as a source of information for the international community on AIT treatment strategies employed in China.

Keywords: Allergen immunotherapy (AIT); China; allergic rhinitis (AR); guideline.

PubMed Disclaimer

Conflict of interest statement

Conflicts of Interest: The authors have no conflicts of interest to declare.

Figures

**Figure 1**
Algorithm and annotations for immunotherapy. AR, allergic rhinitis; AIT, allergen immunotherapy; FEV1, forced expiratory volume in one second.

**Figure 2**
Drugs in the crash cart for emergency use.

**Figure 3**
Essential emergency equipment in immunotherapy centre. (A) The emergency room bed; (B) the mucus suction pump; (C) the oxygen tank; (D) bag valve mask, blood pressure meter and stethoscope; (E) the endotracheal tube.

**Figure 4**
Flow chart for administration of specific immunotherapy. The scope surrounded by red dot lines is the scope for the institute. AR, allergic rhinitis; SPT, skin prick test; sIgE, specific immunoglobulin E.

See this image and copyright information in PMC

References

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Chinese Guideline on allergen immunotherapy for allergic rhinitis

Affiliations

Chinese Guideline on allergen immunotherapy for allergic rhinitis

Authors

Affiliations

Abstract

Conflict of interest statement

Figures

References

Publication types

LinkOut - more resources

Full Text Sources

Other Literature Sources

Research Materials