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Effects of dust mite allergen-specific immunotherapy on prevention and cure in children with asthma and allergic rhinitis and the reasons of symptom exacerbation during specific immunotherapy

TAN Yong-qiang,BAO Yi-xiao,SHEN Jin,YE Gui-yun,CHEN Liu.Department of Pediatrics,Chongming Branch Hospital of Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine,Shanghai 202150,China  
Objective To evaluate the effects of dust mite allergen-specific immunotherapy combined with standardized management on prevention and cure in children with asthma and allergic rhinitis and analyze the reasons of the asthma and allergic rhinitis symptom exacerbation during specific immunotherapy.Methods One hundred and two children with established diagnosis of allergic asthma and allergic rhinitis to dust mite were enrolled in this study from january 2006 to december 2010,of whom 78 children received the treatment with specific immunotherapy(SIT)combined with standardized management for 2 to 4 year(as the test group)and the other 24 served as the control group with inhaled corticosteroids according to Global Initiative for Asthma(GINA)and Allergic Rhinitis and its Impact on Asthma(ARIA)in the same time.At the beginning,6 months,1 year,2 years of the treament and 1 year after the treament,the clinical symptom and acute episode,pulmonery function(Peak Expiratory Flow,PEF)and Chinese children asthma control test(Ch-CACT)of the asthmatic children,symptem scores and Visual Analogue Scale(VAS)of allergic rhinitis were analyzed,while respiratory tract infection of all the patients were recorded at the second year and after 1 year of the treatment.The reasons of the asthma and allergic rhinitis symptom exacerbation during dust mite allergen-specific immunotherapy were analyzed.The data were analyzed by SPSS15.0.Results Compared with control group,the frequency of acute episode,the frequency of respiratory tract infection in test group were significantly decreased at the 2 years of the treament and 1 year after the treament.The PEFof asthmasic children were obviously improved in the test group at the 2 years of the treament and 1 year after the treament and the Ch-CACT were more higher in the test group than the control group at 1 year after the treament.Compared with control group,the symptem scores and VAS of allergic rhinitis were significantly increased in test group at the 6 months,1 year,2 years of the treament and 1 year after the treament.The common reasons of the asthma and allergic rhinitis symptom exacerbation during specific immunotherapy were climatic factor,respiratory tract infection,nasosinusitis and improper room cleared,etc.Conclusion The dust mite allergen-specific immunotherapy can enhance the PEF and Ch-CACT of the asthmasic children,can obviously improve the symptem scores and VAS of allergic rhinitis and it is a persistent and effective means on prevention and cure in children with allergic rhinitis and asthma.The climatic factor,respiratory tract infection,nasosinusitis are common reasons of the asthma and allergic rhinitis symptom exacerbation during specific immunotherapy.
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