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. 2021 Oct 25;11(4):e43.
doi: 10.5415/apallergy.2021.11.e43. eCollection 2021 Oct.

Efficacy of subcutaneous immunotherapy for patients with asthma and allergic rhinitis in Korea: effect on eosinophilic inflammation

Chang Keun Kim  1 , Zak Callaway  2 , Jin-Sung Park  1   3 , Eunmi Kwon  1
Affiliations

Efficacy of subcutaneous immunotherapy for patients with asthma and allergic rhinitis in Korea: effect on eosinophilic inflammation

Chang Keun Kim et al. Asia Pac Allergy. .

Abstract

Background: Atopic asthma (AA) and allergic rhinitis (AR) are often seen as comorbidities and specific immunotherapy (SIT) is considered evidence-based treatment for them both.

Objective: The purpose of this study was to evaluate the efficacy of multiallergen subcutaneous SIT (SCIT) in reducing nasal and sputum eosinophilia, symptom scores, and impaired lung function in Korean pediatric patients with AR and AA.

Methods: Children aged 6-15 years with a documented history of bronchial asthma and seasonal/perennial AR were recruited then randomly selected to 1 of 2 groups: "immunotherapy group" (inhaled corticosteroids [ICS] and short-acting beta2-agonist [SABA] + subcutaneous injection of standardized extracts of up to 4 allergens [n = 53]) or "drug only group" (ICS and SABA only [n = 19]). All data were collected retrospectively.

Results: Comparing the 2 treatment groups, the immunotherapy group showed a significantly (p = 0.006) greater reduction in nasal eosinophilia over the 3-year treatment period. Only the immunotherapy group exhibited a significant reduction in sputum eosinophilia over the 3-year treatment period (p = 0.003). Fifty-one point one percent of patients in the immunotherapy group showed significant improvement in the methacholine challenge test negative conversion rate compared to only 17.65% in the drug only group (p = 0.0168). There were significantly greater improvements in symptom scores in the immunotherapy group compared to the drug only group. For all allergens tested, only house dust mite reactivity changed significantly over the treatment period and only in the immunotherapy group (Dermatophagoides pteronyssinus [p < 0.0001] and Dermatophagoides farina [p = 0.035]).

Conclusion: SCIT was associated with greater improvements in lung function and bronchial hyperresponsiveness and reductions in nasal and sputum eosinophilia and allergen reactivity. Changes in symptom scores were also much greater in patients receiving SCIT when compared to those who did not receive it. Korean children with AA and AR respond well to long-term multiallergen SCIT.

Keywords: Allergen immunotherapy; Child; Desensitization; Eosinophilia.

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Conflict of interest statement

Conflict of Interest: The authors have no financial conflicts of interest.

Figures

Fig. 1
Fig. 1. Nasal eosinophil count in the immunotherapy group (left) and drug only group (right). Bars on graph show mean±standard deviation.
Fig. 2
Fig. 2. Sputum eosinophil count in immunotherapy group (left) and drug only group (right). Bars on graph show mean±standard deviation.
Fig. 3
Fig. 3. Bronchial hypersensitivity negative conversion. Dotted bars on left in each group are proportion of patients with negative conversion after treatment. Cross-hatched bars on right in each group are proportion of patients with no significant improvement after treatment.
Fig. 4
Fig. 4. Changes in wheal size (Dermatophagoides pteronyssinus) in immunotherapy group and drug only group.
Fig. 5
Fig. 5. Changes in wheal size (Dermatophagoides farinae) in immunotherapy group and drug only group.
See this image and copyright information in PMC

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