Immunotherapy with a standardized Dermatophagoides pteronyssinus extract. VI. Specific immunotherapy prevents the onset of new sensitizations in children

doi:10.1016/S0091-6749(97)70069-1

Journal of Allergy and Clinical Immunology

Volume 99, Issue 4, April 1997, Pages 450-453

https://doi.org/10.1016/S0091-6749(97)70069-1 Get rights and content

Abstract

Background: The natural history of allergic sensitization is complex and poorly understood. A prospective nonrandomized study was carried out in a population of asthmatic children younger than 6 years of age whose only allergic sensitivity was to house dust mites (HDMs). Objectives: The study was designed to determine whether specific immunotherapy (SIT) with standardized allergen extracts could prevent the development of new sensitizations over a 3-year follow-up survey. Methods: We studied 22 children monosensitized to HDM who were receiving SIT with standardized allergen extracts and 22 other age-matched control subjects who were monosensitized to HDM. The initial investigation included a full clinical history, skin tests with a panel of standardized allergens, and the measurement of allergen-specific IgE, depending on the results of skin tests. Children were followed up on an annual basis for 3 years, and the development of new sensitizations in each group was recorded. Results: Ten of 22 children monosensitized to HDM who were receiving SIT did not have new sensitivities compared with zero of 22 children in the control group (p = 0.001, chi square test). Conclusions: This study suggests that SIT in children monosensitized to HDM alters the natural course of allergy in preventing the development of new sensitizations. (J Allergy Clin Immunol 1997;99:450-3.)

Section snippets

Patients

Forty-four patients ranging in age from 2 to 6 years and attending the asthma clinic of the hospital were included in the study on the basis of the following criteria.

1. A clinical history of asthma was clearly established.⁵ Asthma was defined according to the criteria of the National Asthma Education Program Expert Panel Report.⁶

2. A positive skin prick test response to D. pteronyssinus (Stallergènes Laboratories, Fresnes, France) was demonstrated.

3. A positive Phadebas RAST or CAP system score

Characteristics of the patients

Forty-four children younger than 6 years of age who were monosensitized to HDM were enrolled in the study. Twenty-two patients received SIT, and a second group of 22 patients who did not receive SIT served as a control group. Both groups were comparable in terms of age and sex. The median age at the beginning of the study was 5 years (range, 4 to 6 years) in the SIT group and 4 years (range, 3 to 5 years) in the control group. Sixty-eight percent of members of the SIT group were boys as

Discussion

In this study 22 children with asthma monosensitized to HDM and younger than 6 years of age who received SIT were evaluated prospectively and compared with 22 children monosensitized to HDM who were not treated with SIT. Children who received SIT had fewer new sensitivities to inhalant allergens than those who did not received SIT. Forty-five percent of monosensitized children who received SIT did not have new sensitization as compared with 0% in the control group.

SIT has been widely used for

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^☆: From ^aService des Maladies Respiratoires, Hôpital Arnaud de Villeneuve, Montpellier; and ^bDépartement d'Information Médicale et Biostatistiques, CHU Gaston, Doumergue, Nîmes.

^☆☆: Reprint requests: Jean Bousquet, MD, Hôpital Arnaud de Villeneuve, 34295-Montpellier-Cedex 5, France.

^★: 1/1/77910

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Immunotherapy with a standardized Dermatophagoides pteronyssinus extract. VI. Specific immunotherapy prevents the onset of new sensitizations in children☆,☆☆,★

Abstract

Section snippets

Patients

Characteristics of the patients

Discussion

Lancet

J Allergy Clin Immunol

J Allergy Clin Immunol

J Allergy Clin Immunol

J Allergy Clin Immunol

J Allergy Clin Immunol

J Allergy Clin Immunol

J Allergy Clin Immunol

Immunotherapy. Position Paper of the European Academy of Allergy and Clinical Immunology

Allergy

Sensitization to inhalant allergens in wheezing infants is predictive of the development of infantile asthma

Allergy

Expert panel report to provide clinical guidelines for diagnosis and treatment of asthma

J Sch Health

Comparison between rush immunotherapy with a standardized allergen and an alum adjuved pyridine extracted material in grass pollen allergy

Clin Allergy

Natural history of bronchial asthma in childhood. A prospective study from birth up to 12-14 years of age

Allergy