DOI: https://doi.org/10.22141/2224-0551.14.7.2019.184625

Allergen-specific immunotherapy in the treatment of bronchial asthma in children

L.V. Besh, Z.L. Slyuzar

Abstract


The article presents a review of the literature that analyses the current possibilities and benefits of allergen-specific immunotherapy in children with bronchial asthma. Bronchial asthma has a leading place in the structure of allergic pathology. Accor­ding to the latest World Health Organization data, annually about 235–300 million people are diagnosed with it. It also belongs to those diseases that significantly reduce the quality of life of patients. Among children this pathology remains one of the most common diseases of the respiratory system, which is associated with the risk of disability and high mortality. Today, it has been proven that asthma pharmacotherapy can effectively control its symptoms, but it cannot affect the specific immune response and, if medication is discontinued, the symptoms of the disease may return. The only treatment that changes the natural course of allergy is allergen-specific immunotherapy, which reduces the sensitivity of the child’s body to the “guilty” allergen and reduces the activity of chronic inflammation. Allergen-specific immunotherapy is carried out with the use of purified water-salt extracts of allergens or allergenic components distracted from them. This method of treatment usually involves the hypodermic or sublingual administration of gradually increasing amounts of “guilty” allergens to a dose that is effective in inducing immunological allergen tolerance. The evidence base for the effectiveness of allergen-specific immunotherapy in the treatment of bronchial asthma has expanded significantly in recent years. Obtained data today proved that such treatment allows changing the composition of cytokine markers, reducing the sensitivity of the respiratory canal to allergen exposure and preventing the expansion of the spectrum of causally significant allergens, slowing the progression of the allergic process, reducing the need for drugs. Moreover, today it can be argued that after successful courses of allergen-specific immunotherapy, long-term remission of bronchial asthma persists. The unique therapeutic effect of allergen-specific immunotherapy dictates the need for its widespread use in the treatment of bronchial asthma in children. For literature review, the following databases were studied: Medline, Web of Science, the Cochrane Library, Scopus.

Keywords


children; bronchial asthma; allergen-specific immunotherapy; review

References


Maidannyk VG, Smiyan OI, Sichnenko PI, Popov SV, Romanjuk OK, Gorbas' VA, authors; Majdannyk VG, Smiyan OI, editors. Bronhial'na astma u ditej: navchal'nyj posibnyk [Bronchial asthma in children: a manual]. Sumy: SumDU; 2017. 243 p. (in Ukrainian).

Global Initiative for Asthma (GINA). Global Strategy for Asthma Management and Prevention 2014. Fontana, US; 2014. 133 p.

Masoli M, Fabian D, Holt S, Beasley R; Global Initiative for Asthma (GINA) Program. Program The global burden of asthma: executive summary of the GINA Dissemination Committee report. Allergy. 2004 May;59(5):469-78. doi:10.1111/j.1398-9995.2004.00526.x.

Agache I. EAACI Guidelines on allergen immunotherapy-Out with the old and in with the new. Allergy. 2018 Apr;73(4):737-738. doi: 10.1111/all.13393.

Maidannyk VG, Besh LV, Koloskova OK, Smiyan OI. Bronchial asthma in children: new clinical guidelines. International Journal of Pediatrics, Obstetrics and Gynecology. 2018;12(1):28-42. (in Ukrainian).

Ministry of Нealth of Ukraine. Order on October 8, 2013 № 868. On Adoption and Implementation of Medical and Technological Documents on the Standardization of Medical Care for Bronchial Asthma. Available from: https://zakon.rada.gov.ua/rada/show/v0868282-13. Accessed: October 8, 2013. (in Ukrainian).

Besh LV. Вronchial asthma in children. Zdorov’e rebenka 2012;(43):8-20. (in Ukrainian).

Besh LV, Lasycja TS, Besh OM. Bronhial'na astma v praktyci simejnogo likarja [Bronchial asthma in the practice of a family doctor]. Lviv: Prostir-M; 2018. 116 p. (in Ukrainian).

Besh LV. Features of the course and treatment of bronchial asthma in adolescents. Klinichna imunologija. Alergologija. Infektologija. 2013;(9-10):28-33. (in Ukrainian).

Gryshylo PV. Types of allergen-specific immunotherapy, indications for use, effectiveness in bronchial asthma and other allergic diseases. Asthma and allergy. 2016;(1):62-66. (in Ukrainian).

European Academy of Allergy and Clinical Immunology (EAACI). EAACI Guideline on Allergen Immunotherapy - allergic asthma. V 4.0/04 June 2017. 32 p.

Jutel M, Bartkowiak-Emeryk M, Bręborowicz A, et al. Sublingual immunotherapy (SLIT)--indications, mechanism, and efficacy: Position paper prepared by the Section of Immunotherapy, Polish Society of Allergy. Ann Agric Environ Med. 2016 Mar 23;23(1):44-53. doi: 10.5604/12321966.1196851.

Bagnasco D, Ferrando M, Testino E, Ricclo A, Canonica GW, Passalacqua G. Allergen Immunotherapy: Current State and Ways Forward. J Allergy Ther. 2018;(9):283. doi:10.4172/2155-6121.1000283.

Agache I, Lau S, Akdis CA, et al. EAACI Guidelines on Allergen Immunotherapy: House dust mite-driven allergic asthma. Allergy. 2019 May;74(5):855-873. doi: 10.1111/all.13749.

Asamoah F, Kakourou A, Dhami S, et al. Allergen immunotherapy for allergic asthma: a systematic overview of systematic reviews. Clin Transl Allergy. 2017 Aug 2;7:25. doi: 10.1186/s13601-017-0160-0.

Chelladurai Y, Suarez-Cuervo C, Erekosima N, et al. Effectiveness of subcutaneous versus sublingual immunotherapy for the treatment of allergic rhinoconjunctivitis and asthma: a systematic review. J Allergy Clin Immunol Pract. 2013 Jul-Aug;1(4):361-9. doi: 10.1016/j.jaip.2013.04.005.

Seidenberg J, Pajno GB, Bauer CP, La Grutta S, Sieber J. Safety and tolerability of seasonal ultra-rush, high-dose sublingual-swallow immunotherapy in allergic rhinitis to grass and tree pollens: an observational study in 193 children and adolescents. J Investig Allergol Clin Immunol. 2009;19(2):125-31.

Sastre J. Molecular diagnosis in allergy. Clin Exp Allergy. 2010 Oct;40(10):1442-60. doi: 10.1111/j.1365-2222.2010.03585.x.

Bachert C, Larche M, Bonini S, et al. Allergen immunotherapy on the way to product-based evaluation WAO statement. World Allergy Organ J. 2015 Sep 16;8(1):29. doi: 10.1186/s40413-015-0078-8.

Canonica GW, Ansotegui IJ, Pawankar R, et al. A WAO - ARIA - GA²LEN consensus document on molecular-based allergy diagnostics. World Allergy Organ J. 2013 Oct 3;6(1):17. doi: 10.1186/1939-4551-6-17.

Korovkina ES, Mokronosova MA. House dust mite allergy in view of molecular allergology. Meditsinskaya Immunologiya. 2012;14(4-5):279-288. doi: 10.15789/1563-0625-2012-4-5-279-288. (in Russian).

Weghofer M, Grote M, ReschY, et al. Identification of Der p 23, a peritrophin-like protein, as a new major Dermatophagoides pteronyssinus allergen associated with the peritrophic matrix of mite fecal pellets. J Immunol. 2013 Apr 1;190(7):3059-67. doi: 10.4049/jimmunol.1202288.

Zubchenko SO, Yuryev SD. Assessment diagnostic criteria in patients with different clinical and laboratory manifestations of sensitization to hous dust mites efficiency and forecasting allergen specific immunotherapy based on allergies component diagnostic. Imunologija ta alergologija: nauka i praktyka. 2015;(2):98-107. (in Ukrainian).

Nelson HS. Multiallergen immunotherapy for allergic rhinitis and asthma. J Allergy Clin Immunol. 2009 Apr;123(4):763-9. doi: 10.1016/j.jaci.2008.12.013.

Scadding GW, Calderon MA, Bellido V, et al. Optimisation of grass pollen nasal allergen challenge for assessment of clinical and immunological outcomes. J Immunol Methods. 2012 Oct 31;384(1-2):25-32. doi: 10.1016/j.jim.2012.06.013.

Besh OM, Radchenko OM, Bandrivska AZ. Analysis of the use of specific immunotherapy in treatment of bronchial asthma in adults. In: Proceeding of a Scientific and Practical Conference of Allergists of Ukraine. 2010, May 12-13; Vinnitsya, Ukraine. Vinnitsya; 2010. 102-103 pp. (in Ukrainian).

Besh OM, Radchenko OM. Allergen-specific immunotherapy and its place in the treatment of bronchial asthma: current state of the problem. Experimental and clinical physiology and biochemistry. 2014;(3):77-85. (in Ukrainian).

Abramson MJ, Puy RM, Weiner JM. Allergen immunotherapy for asthma. Cochrane Database Syst Rev. 2000;(2):CD001186. doi:10.1002/14651858.CD001186.

Pfaar O, Bachert C, Bufe A, et al. Guideline on allergen-specific immunotherapy in IgE-mediated allergic diseases: S2k Guideline of the German Society for Allergology and Clinical Immunology (DGAKI), the Society for Pediatric Allergy and Environmental Medicine (GPA), the Medical Association of German Allergologists (AeDA), the Austrian Society for Allergy and Immunology (ÖGAI), the Swiss Society for Allergy and Immunology (SGAI), the German Society of Dermatology (DDG), the German Society of Oto- Rhino-Laryngology, Head and Neck Surgery (DGHNO-KHC), the German Society of Pediatrics and Adolescent Medicine (DGKJ), the Society for Pediatric Pneumology (GPP), the German Respiratory Society (DGP), the German Association of ENT Surgeons (BV-HNO), the Professional Federation of Paediatricians and Youth Doctors (BVKJ), the Federal Association of Pulmonologists (BDP) and the German Dermatologists Association (BVDD). Allergo J Int. 2014;23(8):282-319. doi:10.1007/s40629-014-0032-2.

Passalacqua G, Nowak-Wegrzyn A, Canonica GW. Local side effects of sublingual and oral immunotherapy. J Allergy Clin Immunol Pract. 2017 Jan - Feb;5(1):13-21. doi: 10.1016/j.jaip.2016.06.020.

Tosca MA., Licari A, Olcese R, Marseglia G, Sacco O, Ciprandi G. Immunotherapy and asthma in children. Front Pediatr. 2018 Aug 21;6:231. doi: 10.3389/fped.2018.00231.

Pukhlik BM. Elementarnaia allergologiia: monografiia [Elementary allergology: monograph]. Vinnytsya: Veles; 2002. 148 p. (in Russian).

Smirnova OV, Vykhristenko LR. The role of cells of immunity system in pathogenesis of bronchial asthma. Meditsinskie novosti. 2011;(5):14-19. (in Russian).

Brehler R, Klimek L, Kopp MV, Virchow CJ. Specific immunotherapy-indications and mode of action. Dtsch Arztebl Int. 2013 Mar;110(9):148-58. doi: 10.3238/arztebl.2013.0148.

Kazmirchuk VJe, Kovalchuk LV. Klinichna imunologija i alergologija [Clinical immunology and allergology]. Vinnytsya: Nova knyga; 2006. 504 p. (in Ukrainian).

Bousquet PJ, Calderon MA, Demoly P, et al. The Consolidated Standards of Reporting Trials (CONSORT) Statement applied to allergen-specific immunotherapy with inhalant allergens: a Global Allergy and Asthma European Network (GA(2)LEN) article. J Allergy Clin Immunol. 2011 Jan;127(1):49-56, 56.e1-11. doi: 10.1016/j.jaci.2010.09.017.

Rosewich M, Lee D, Zielen S. Pollinex Quattro: an innovative four injections immunotherapy in allergic rhinitis. Hum Vaccin Immunother. 2013 Jul;9(7):1523-31. doi: 10.4161/hv.24631.

Shamji MH, Kappen JH, Akdis M, et al. Biomarkers for monitoring clinical efficacy of allergen immunotherapy for allergic rhinoconjunctivitis and allergic asthma: an EAACI Position Paper. Allergy. 2017 Aug;72(8):1156-1173. doi: 10.1111/all.13138.

Shamji MH, Durham SR. Mechanisms of allergen immunotherapy for inhaled allergens and predictive biomarkers. J Allergy Clin Immunol. 2017 Dec;140(6):1485-1498. doi: 10.1016/j.jaci.2017.10.010.

Vorobyeva OV, Gushchin IS. Controlled trials of efficacy and safety of allergen-specific immunotherapy: historical aspects. Russian Allergological Journal. 2013;(4):3-15. (in Russian).

Gogunska IV. The study of the effectiveness of specific immunotherapy for allergic diseases of the upper respiratory tract according to the results of a 5-year retrospective study. Novosti Meditsiny i Farmatsii. Allergologiia I immunologiia. 2010;(322):46-53. (in Ukrainian).

Zabolotny DI, Melnikov OF, Gogunska IV, Holodenko TJu, Pukhlik BM.. Experimentally acknowledged effectiveness of allergen-specific immunotherapy. Klinichna imunologija. Alergologija. Infektologija. 2012;(2):59-62. (in Ukrainian).

Feshchenko UI, Iashyna LA, Polianska MA. Basics of spirometry and it’s particularities in chronic obstructive pulmonary disease. Asthma and allergy. 2012;(2):22-27. (in Ukrainian).

Matvienko YA. The features of immunogramma in patients with bronchial asthma and their practical implication. Asthma and allergy. 2012;(1):51-56. (in Ukrainian).

Lupinek C, Marth K, Niederberger V, Valenta R. Analysis of serum IgE reactivity profiles with microarrayed allergens indicates absence of de novo IgE sensitizations in adults. J Allergy Clin Immunol. 2012 Dec;130(6):1418-20.e4. doi: 10.1016/j.jaci.2012.06.028.

Flicker S, Linhart B, Wild C, Wiedermann U, Valenta R. Passive immunization with allergen-specific IgG antibodies for treatment and prevention of allergy. Immunobiology. 2013 Jun;218(6):884-91. doi: 10.1016/j.imbio.2012.10.008.

Joint Task Force on Practice Parameters; American Academy of Allergy, Asthma and Immunology; American College of Allergy, Asthma and Immunology; Joint Council of Allergy, Asthma and Immunology. Allergen immunotherapy: a practice parameter second update. J Allergy Clin Immunol. 2007 Sep;120(3 Suppl):S25-85. doi: 10.1016/j.jaci.2007.06.019.

Tsabouri S, Mavroudi A, Feketea G, Guibas GV. Subcutaneous and Sublingual Immunotherapy in Allergic Asthma in Children. Front Pediatr. 2017 Apr 21;5:82. doi: 10.3389/fped.2017.00082.






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