Low-dose local nasal immunotherapy in children with perennial allergic rhinitis due to Dermatophagoides

• Published in: Allergy (Copenhagen) Vol. 57; no. 1; pp. 23 - 28
• Main Authors: MARCUCCI, F, SENSI, L. G, CAFFARELLI, C, CAVAGNI, G, BERNARDINI, R, TIRI, A, RIVA, G, NOVEMBRE, E
• Format: Journal Article
• Language: English
• Published: Oxford Blackwell 2002
• Subjects: Administration, Intranasal; Antigens, Dermatophagoides; Biological and medical sciences; Child; Child, Preschool; Desensitization, Immunologic - methods; Dose-Response Relationship, Immunologic; Double-Blind Method; Female; Glycoproteins - administration & dosage; Glycoproteins - adverse effects; Glycoproteins - immunology; Humans; Immunoglobulin E - blood; Immunoglobulin G - blood; Immunopathology; Immunotherapy (general aspects); Male; Medical sciences; Rhinitis, Allergic, Perennial - etiology; Rhinitis, Allergic, Perennial - therapy; Treatment Outcome; Allergy; Nose disease; Rhinitis; Multicenter study; Local administration; Randomization; Acari; Immunotherapy; ENT disease; Child; Human; Immunopathology; Desensitization; Dermatophagoides farinae; Low dose; Treatment efficiency; Acaridida; Intranasal administration; Acariformes; Arachnida; Treatment; Arthropoda; Double blind study; Pyroglyphidae; Invertebrata; Allergen
• ISSN: 0105-4538; 1398-9995
• DOI: 10.1034/j.1398-9995.2002.13149.x

Allergen specific immunotherapy was known to be useful in the treatment of respiratory allergic disease. Local nasal immunotherapy (LNIT) offers advantages such as a good efficacy/safety ratio and a more convenient allergen delivery. The aim of this study was to assess the safety and clinical efficacy of a modified scheduling of LNIT in 32 children with allergic rhinitis due to Dermatophagoides. A multicentre, randomized, double-blind placebo controlled study carried out for two years, with a modified schedule of LNIT treatment: a build-up phase at increasing dosages from 2.5 AU to 80 AU and a maintenance period at low dosage (80 AU) once a week. Symptom and medication scores. threshold dose with specific nasal provocation test (NPT) and immunological parameters (IgE and IgG4) were evaluated. No important local or systemic side-effects were observed in children who completed the study. Compared to placebo, the active treatment group showed significant improvement in rhinitis symptoms and a reduction of drug consumption after 18 months of LNIT. These results were confirmed by a significant reduction of allergen specific nasal reactivity. Serum and nasal specific IgE and IgG4 did not show any difference in the two groups. The safety and clinical efficacy of low-dose LNIT suggests that this therapy may be useful in the treatment of allergic rhinitis disease in children.