Effects of dust mite immunotherapy on hormonal dosage, specific immunoglobulins G4 level and pulmonary function in children with asthma / 中国医师进修杂志

ABSTRACT

Objective To study the effects of dust mite immunotherapy on the hormonal dosage, specific immunoglobulins G4(sIgG4)level and pulmonary function in asthmatic children.Methods One hundred and twenty-four cases of asthmatic children were randomly divided into specific immunotherapy treatment(SIT) group (62 cases, treated with the dust mite immunotherapy) and inhaled corticosteroids (ICS) group (62 cases, treated with ICS). The changes of clinical symptoms, serum sIgG4 level, pulmonary function and ICS dosage before and after treatment were compared between two groups. Results After treatment for 12,18,and 24 months, the scores of childhood asthma control test(C-ACT) in SIT group were significantly higher than those in ICS group:(23.84 ± 1.15)scores vs.(22.75 ± 1.08) scores, (24.29 ± 1.27)scores vs.(23.17 ± 1.22)scores, (24.83 ± 1.40)scores vs.(23.88 ± 1.34)scores, there were significant differences (P<0.05). After treatment for 12, 24 months, the level of serum sIgG4 in SIT group were significantly higher than those in ICS group:(308.75 ± 102.96) μg/L vs. (239.64 ± 79.35) μg/L, (542.28 ± 113.37) μg/L vs. (243.65 ± 80.21) μg/L, there were significant differences (P<0.05). After treatment for 12, 24 months, the levels of percentage of forced expiratory volume in 1 second (FEV1%), percentage of maximal expiratory flow rate (PEF%) in SIT group were significantly higher than those in ICS group: FEV1%:(95.82 ± 7.64)% vs. (92.79 ± 8.52)%, (99.52 ± 8.17)% vs.(95.89 ± 7.53)%;PEF%:(95.78 ± 5.85)% vs.(93.54 ± 6.18)%,(99.77 ± 5.69)% vs. (97.61 ± 5.56)%, there were significant differences (P<0.05). After treatment for 12, 24 months, the scores of daytime asthma symptoms scale (DAS) and nocturnal asthma symptoms scale (NAS) in SIT group were significantly lower than those in ICS group:DAS:(1.75 ± 0.54)scores vs.(1.96 ± 0.60)scores, (0.84 ± 0.27) scores vs. (1.19 ± 0.38) scores;NAS: (0.75 ± 0.27) scores vs.(0.92 ± 0.30) scores, (0.55 ± 0.18)scores vs.(0.81 ± 0.24)scores, there were significant differences(P<0.05).After treatment for 12, 24 months, the dosage in SIT group was significantly lower than those in ICS group:(172.08±16.73)μg/d vs.(194.63 ± 14.17)μg/d,(138.09 ± 16.23)μg/d vs.(163.15 ± 15.38)μg/d, there were significant differences(P<0.05).Conclusions Dust mite immunotherapy can effectively improve the clinical symptoms and pulmonary function in children with dust mite allergy asthma and reduce the ICS dosage, it may be related to the increase of protective antibody sIgG4 in children.