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Abstract
Sharikadze O.V.
Background. This study determined the efficacy of sublingual allergen–specific immunotherapy (SLIT) in Ukrainian children younger than 5 years of age with allergic rhinitis and bronchial asthma sensitized to house dust mite allergens. Methods. A cohort prospective study was conducted over a two years period with assessment of the sensitization towards inhalant allergens, measured in-vivo by wheal size and number of positive reactions on the standard skin prick test (SPT). SPSS was used to analyse any statistical correlation. Results. A total of 125 atopic asthma or/and allergic rhinitis with the mean age of 4.11 ±0.83 who were sensitized to house dust mites Dermatophagoides pteronyssinus and/or Dermatophagoides farina were included. 47 children received two-years SLIT to treat house dust mite allergies using standardized extract of sublingual allergens containing a mixture of house dust mites (Der. pteronyssinus and Der. farinae) in the correlation of 1(0,175 НЕР):1(0,175 НЕР) (Diater, Spain). These patients were mono-sensitized with Der. pteronyssinus and Der. farinae or were SPT poly-sensitized, but these patients only had house dust mite allergy symptoms. In this group the assessment of clinical efficacy of SLIT showed the significant differences in VAS before treatment and 6 months after its receiving. The symptom “nasal obstruction” was assessed as 2.3±-1.6 points at the beginning of the therapy, and the data reduced almost twice (1.3±-1.1); Р <0,05 after 6 months of SLIT; then (12 and 24 months) it decreased to 0.91±0.9 and 0.34±0.5; Р <0,01, correspondingly. Conclusion. This study has shown that using of SLIT in atopic asthma or/and allergic rhinitis children under 5 year sensitized to house dust mites is an effective and safe treatment method and allows to quickly (over the first 6 months of SLIT) control the symptoms. The data of comparative analysis in the group of patients who didn’t receive SLIT has pointed to high frequency of disease symptom occurrence after the end of baseline therapy.
KeyWords: sublingual allergen-specific immunotherapy, children, bronchial asthma, allergic rhinitis, sensitization, allergens, Diater
ОСОБЛИВОСТІ ЛІКУВАННЯ ДІТЕЙ ДОШКІЛЬНОГО ВІКУ, СЕНСІБІЛІЗОВАНИХ ДО АЛЕРГЕНІВ ДОМАШНЬОГО ПИЛУ
Шарикадзе О.В.
Це дослідження визначило ефективність сублингвально алерген-специфічної імунотерапії (SLIT) українських дітей молодше 5 років з алергічним ринітом та бронхіальною астмою, сенсибілізованих до алергенів пилових кліщів. Методи. Проспективне дослідження когорти проводилося протягом двох років з оцінкою сенсибілізації до інгаляційних алергенів, виміряної in-vivo за розміром пухирів і кількості позитивних реакцій на стандартному тесті на шкірі (SPT). Для аналізу статистики використовувався пакет SPSS. Результати. Обстежено 125 дітей (середній вік 4,11 ± 0,83 років) з атопічною астмою та/або алергічним ринітом, які були сенсибілізовані до домашніх пилових кліщів Dermatophagoides pteronyssinus та/або Dermatophagoides farina. 47 дітей отримали дворічний курс SLIT з використанням стандартизованого екстракту сублінгвальних алергенів, що містять суміш кліщів домашнього пилу (Der. Pteronyssinus і Der. Farinae) в співвідношенні 1 (0,175 НЕР): 1 (0,175 НЕР) (Діатер, Іспанія). Пацієнти були моносенсібіровани Dermatophagoides pteronyssinus і / або Dermatophagoides farina або були полісенсібілізовані (за SPT), однак симптоми розвивалися тільки на домашній пил. У цій групі оцінка клінічної ефективності SLIT показала значні відмінності до лікування і через 6 місяців після його отримання. Симптом «носової обструкції» оцінювався як 2,3 ± 1,6 бала на початку терапії і зменшувалися майже в два рази (1,3 ± 1,1); Р <0,05 після 6 місяців SLIT. Потім (12 і 24 місяці) він знизився до 0,91 ± 0,9 і 0,34 ± 0,5; Р <0,01, відповідно. Висновок. Дослідження показало, що використання SLIT при атопічній астмі та/або алергічному риніті у дітей до 5 років, сенсибілізованих до домашніх пилових кліщів, є ефективним і безпечним методом лікування і дозволяє швидко (протягом перших 6 місяців SLIT) контролювати симптоми. Дані порівняльного аналізу в групі пацієнтів, які не отримували SLIT, вказують на високу частоту виникнення симптомів хвороби після закінчення базової терапії.
Ключові слова: сублінгвальна алерген-специфічна імунотерапія, діти, бронхіальна астма, алергічний риніт, сенсибілізація, алергени, Діатер.
ОСОБЕННОСТИ ЛЕЧЕНИЯ ДЕТЕЙ ДОШКОЛЬНОГО ВОЗРАСТА, СЕНСИБИЛИЗИРОВАННЫХ АЛЛЕРГЕНАМИ ДОМАШНЕЙ ПЫЛИ
Шарикадзе Е.В.
Это исследование определило эффективность сублингвальной аллерген-специфической иммунотерапии (SLIT) украинских детей моложе 5 лет с аллергическим ринитом и бронхиальной астмой, сенсибилизированных к аллергенам пылевых клещей. Методы. Проспективное исследование когорты проводилось в течение двух лет с оценкой сенсибилизации к ингаляционным аллергенам, измеренной in-vivo по размеру волдырей и количеству положительных реакций на стандартном тесте на коже (SPT). Для анализа статистики использовался пакет SPSS. Результаты. Обследованы 125 детей (средний возраст 4,11 ± 0,83 лет) с атопической астмой и/или аллергическим ринитом, которые были сенсибилизированы к домашним пылевым клещам Dermatophagoides pteronyssinus и/или Dermatophagoides farina. 47 детей получили двухлетний курс SLIT с использованием стандартизованного экстракта сублингвальных аллергенов, содержащих смесь клещей домашней пыли (Der. Pteronyssinus и Der. Farinae) в соотношении 1 (0,175 НЕР): 1 (0,175 НЕР) (Диатер, Испания). Пациенты были моносенсибированы Dermatophagoides pteronyssinus и/или Dermatophagoides farina или были полисенсибилизированы (по SPT), однако симптомы развивались только на домашнюю пыль. В этой группе оценка клинической эффективности SLIT показала значительные различия до лечения и через 6 месяцев после его получения. Симптом «носовой обструкции» оценивался как 2,3 ± -1,6 балла в начале терапии и уменьшались почти в два раза (1,3 ± -1,1); Р <0,05 после 6 месяцев SLIT. Затем (12 и 24 месяца) он снизился до 0,91 ± 0,9 и 0,34 ± 0,5; Р <0,01, соответственно. Вывод. Исследование показало, что использование SLIT при атопической астме или/или аллергическом рините детей до 5 лет, сенсибилизированных к домашним пылевым клещам, является эффективным и безопасным методом лечения и позволяет быстро (в течение первых 6 месяцев SLIT) контролировать симптомы. Данные сравнительного анализа в группе пациентов, которые не получали SLIT, указывают на высокую частоту появления симптомов болезни после окончания базовой терапии.
Ключевые слова: сублингвальная аллерген-специфическая иммунотерапия, дети, бронхиальная астма, аллергический ринит, сенсибилизация, аллергены, Диатер.
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