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Current Allergy and Asthma Reports

Erschienen in:

25.04.2022 | Immunotherapy and Immunomodulators (B Vickery, Section Editor)

Allergen Immunotherapy in Young Children

verfasst von: Venusa Phomakay, Mike Tankersley

Erschienen in: Current Allergy and Asthma Reports | Ausgabe 8/2022

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Abstract

Purpose of Review

Allergen immunotherapy (AIT) has been shown to be safe and effective in children and is a unique treatment strategy that has disease-modifying and preventative effects that are not shared with other treatment options for allergic diseases. This article reviews the present knowledge and relevant updates on AIT in children.

Recent Findings

Although there is no definite lower age limit for starting AIT, clear indications for AIT are established and each case should be considered individually by weighing risks and benefits. Documented short- and long-term benefits of AIT in children with allergic disease include significant improvement of symptoms and quality of life, and decreased use of medications as well as preventing the development of new allergen sensitizations and the progression of allergic rhinitis to asthma.

Summary

This review provides a comprehensive overview of the present knowledge and key updates on AIT in the pediatric population.

Christiansen ES, Kjaer HF, Eller E, Bindslev-Jensen C, Host A, Mortz CG, et al. The prevalence of atopic diseases and the patterns of sensitization in adolescence. Pediatr Allergy Immunol. 2016;27(8):847–53. https://doi.org/10.1111/pai.12650.CrossRefPubMed

Jutel M, Agache I, Bonini S, Burks AW, Calderon M, Canonica W, et al. International consensus on allergy immunotherapy. J Allergy Clin Immunol. 2015;136(3):556–68. https://doi.org/10.1016/j.jaci.2015.04.047.CrossRefPubMed

Finegold I. Immunotherapy: when to initiate treatment in children. Allergy Asthma Proc. 2007;28(6):698–705. https://doi.org/10.2500/aap.2007.28.3053.CrossRefPubMed

Cox L, Nelson H, Lockey R, Calabria C, Chacko T, Finegold I, et al. Allergen immunotherapy: a practice parameter third update. J Allergy Clin Immunol. 2011;127(1 Suppl):S1-55. https://doi.org/10.1016/j.jaci.2010.09.034.CrossRefPubMed

Cox L, Larenas-Linnemann D, Lockey RF, Passalacqua G. Speaking the same language: The World Allergy Organization Subcutaneous Immunotherapy Systemic Reaction Grading System. J Allergy Clin Immunol. 2010;125(3):569–74, 74 e1–74 e7. https://doi.org/10.1016/j.jaci.2009.10.060.

Tinkelman DG, Cole WQ 3rd, Tunno J. Immunotherapy: a one-year prospective study to evaluate risk factors of systemic reactions. J Allergy Clin Immunol. 1995;95(1 Pt 1):8–14. https://doi.org/10.1016/s0091-6749(95)70146-x.CrossRefPubMed

Lockey RF, Nicoara-Kasti GL, Theodoropoulos DS, Bukantz SC. Systemic reactions and fatalities associated with allergen immunotherapy. Ann Allergy Asthma Immunol. 2001;87(1 Suppl 1):47–55. https://doi.org/10.1016/s1081-1206(10)62195-3.CrossRefPubMed

Bernstein DI, Wanner M, Borish L, Liss GM, Immunotherapy Committee AAoAA, Immunology. Twelve-year survey of fatal reactions to allergen injections and skin testing: 1990–2001. J Allergy Clin Immunol. 2004;113(6):1129–36. https://doi.org/10.1016/j.jaci.2004.02.006.

Roberts G, Hurley C, Turcanu V, Lack G. Grass pollen immunotherapy as an effective therapy for childhood seasonal allergic asthma. J Allergy Clin Immunol. 2006;117(2):263–8. https://doi.org/10.1016/j.jaci.2005.09.054.CrossRefPubMed

10.

Eifan AO, Akkoc T, Yildiz A, Keles S, Ozdemir C, Bahceciler NN, et al. Clinical efficacy and immunological mechanisms of sublingual and subcutaneous immunotherapy in asthmatic/rhinitis children sensitized to house dust mite: an open randomized controlled trial. Clin Exp Allergy. 2010;40(6):922–32. https://doi.org/10.1111/j.1365-2222.2009.03448.x.CrossRefPubMed

11.

Yukselen A, Kendirli SG, Yilmaz M, Altintas DU, Karakoc GB. Effect of one-year subcutaneous and sublingual immunotherapy on clinical and laboratory parameters in children with rhinitis and asthma: a randomized, placebo-controlled, double-blind, double-dummy study. Int Arch Allergy Immunol. 2012;157(3):288–98. https://doi.org/10.1159/000327566.CrossRefPubMed

12.

Novak N. Allergen specific immunotherapy for atopic dermatitis. Curr Opin Allergy Clin Immunol. 2007;7(6):542–6. https://doi.org/10.1097/ACI.0b013e3282f1d66c.CrossRefPubMed

13.

Bussmann C, Bockenhoff A, Henke H, Werfel T, Novak N. Does allergen-specific immunotherapy represent a therapeutic option for patients with atopic dermatitis? J Allergy Clin Immunol. 2006;118(6):1292–8. https://doi.org/10.1016/j.jaci.2006.07.054.CrossRefPubMed

14.

Gur Cetinkaya P, Esenboga S, Uysal Soyer O, Tuncer A, Sekerel BE, Sahiner UM. Subcutaneous venom immunotherapy in children: efficacy and safety. Ann Allergy Asthma Immunol. 2018;120(4):424–8. https://doi.org/10.1016/j.anai.2018.01.015.CrossRefPubMed

15.

Boyle RJ, Elremeli M, Hockenhull J, Cherry MG, Bulsara MK, Daniels M, et al. Venom immunotherapy for preventing allergic reactions to insect stings. Cochrane Database Syst Rev. 2012;10:CD008838. https://doi.org/10.1002/14651858.CD008838.pub2.

16.

Di Bona D, Plaia A, Leto-Barone MS, La Piana S, Macchia L, Di Lorenzo G. Efficacy of allergen immunotherapy in reducing the likelihood of developing new allergen sensitizations: a systematic review. Allergy. 2017;72(5):691–704. https://doi.org/10.1111/all.13104.CrossRefPubMed

17.

•• Gradman J, Halken S. Preventive effect of allergen immunotherapy on asthma and new sensitizations. J Allergy Clin Immunol Pract. 2021;9(5):1813–7. https://doi.org/10.1016/j.jaip.2021.03.010. Excellent overview of the preventative effect of allergen immunotherapy.CrossRefPubMed

18.

Kristiansen M, Dhami S, Netuveli G, Halken S, Muraro A, Roberts G, et al. Allergen immunotherapy for the prevention of allergy: a systematic review and meta-analysis. Pediatr Allergy Immunol. 2017;28(1):18–29. https://doi.org/10.1111/pai.12661.CrossRefPubMed

19.

•• Valovirta E, Petersen TH, Piotrowska T, Laursen MK, Andersen JS, Sorensen HF, et al. Results from the 5-year SQ grass sublingual immunotherapy tablet asthma prevention (GAP) trial in children with grass pollen allergy. J Allergy Clin Immunol. 2018;141(2):529–38 e13. https://doi.org/10.1016/j.jaci.2017.06.014. Study showing that grass immunotherapy reduced risk of asthma symptoms in children with grass pollen allergic rhinoconjunctivitis.

20.

Polosa R, Li Gotti F, Mangano G, Paolino G, Mastruzzo C, Vancheri C, et al. Effect of immunotherapy on asthma progression, BHR and sputum eosinophils in allergic rhinitis. Allergy. 2004;59(11):1224–8. https://doi.org/10.1111/j.1398-9995.2004.00537.x.CrossRefPubMed

21.

Calderon MA, Simons FE, Malling HJ, Lockey RF, Moingeon P, Demoly P. Sublingual allergen immunotherapy: mode of action and its relationship with the safety profile. Allergy. 2012;67(3):302–11. https://doi.org/10.1111/j.1398-9995.2011.02761.x.CrossRefPubMed

22.

•• Tankersley M, Han JK, Nolte H. Clinical aspects of sublingual immunotherapy tablets and drops. Ann Allergy Asthma Immunol. 2020;124(6):573–82. https://doi.org/10.1016/j.anai.2019.12.025. Great overview of SLIT and formulations of SLIT.CrossRefPubMed

23.

Rodríguez Pérez N, Ambriz Moreno Mde J. Safety of immunotherapy and skin tests with allergens in children younger than five years. Rev Alerg Mex. 2006;53(2):47–51.

24.

Coop CA, Tankersley MS. Patient perceptions regarding local reactions from allergen immunotherapy injections. Ann Allergy Asthma Immunol. 2008;101(1):96–100. https://doi.org/10.1016/S1081-1206(10)60841-1.CrossRefPubMed

25.

Calabria CW, Coop CA, Tankersley MS. The LOCAL Study: local reactions do not predict local reactions in allergen immunotherapy. J Allergy Clin Immunol. 2009;124(4):739–44. https://doi.org/10.1016/j.jaci.2009.07.048.CrossRefPubMed

26.

Roy SR, Sigmon JR, Olivier J, Moffitt JE, Brown DA, Marshall GD. Increased frequency of large local reactions among systemic reactors during subcutaneous allergen immunotherapy. Ann Allergy Asthma Immunol. 2007;99(1):82–6. https://doi.org/10.1016/S1081-1206(10)60626-6.CrossRefPubMed

27.

Wang L, Wang C, Lou H, Zhang L. Antihistamine premedication improves safety and efficacy of allergen immunotherapy. Ann Allergy Asthma Immunol. 2021;127(3):363–71 e1. https://doi.org/10.1016/j.anai.2021.05.023.

28.

Ohashi Y, Nakai Y, Murata K. Effect of pretreatment with fexofenadine on the safety of immunotherapy in patients with allergic rhinitis. Ann Allergy Asthma Immunol. 2006;96(4):600–5. https://doi.org/10.1016/s1081-1206(10)63556-9.CrossRefPubMed

29.

Reimers A, Hari Y, Muller U. Reduction of side-effects from ultrarush immunotherapy with honeybee venom by pretreatment with fexofenadine: a double-blind, placebo-controlled trial. Allergy. 2000;55(5):484–8. https://doi.org/10.1034/j.1398-9995.2000.00520.x.CrossRefPubMed

30.

Brockow K, Kiehn M, Riethmuller C, Vieluf D, Berger J, Ring J. Efficacy of antihistamine pretreatment in the prevention of adverse reactions to Hymenoptera immunotherapy: a prospective, randomized, placebo-controlled trial. J Allergy Clin Immunol. 1997;100(4):458–63. https://doi.org/10.1016/s0091-6749(97)70135-0.CrossRefPubMed

31.

•• Epstein TG, Liss GM, Berendts KM, Bernstein DI. AAAAI/ACAAI Subcutaneous Immunotherapy Surveillance Study (2013–2017): Fatalities, Infections, Delayed Reactions, and Use of Epinephrine Autoinjectors. J Allergy Clin Immunol Pract. 2019;7(6):1996–2003 e1. https://doi.org/10.1016/j.jaip.2019.01.058. Study showing that prescribed epinephrine for SCIT does not affect outcomes of delayed systemic reactions.

32.

Greenhawt M, Oppenheimer J, Nelson M, Nelson H, Lockey R, Lieberman P, et al. Sublingual immunotherapy: a focused allergen immunotherapy practice parameter update. Ann Allergy Asthma Immunol. 2017;118(3):276–82 e2. https://doi.org/10.1016/j.anai.2016.12.009.

33.

Coop CA, Yip SK, Tankersley MS. Perceptions regarding injection number and technique. Ann Allergy Asthma Immunol. 2014;113(2):227–8. https://doi.org/10.1016/j.anai.2014.05.008.CrossRefPubMed

34.

Hirsch SR, Kalbfleisch JH, Golbert TM, Josephson BM, McConnell LH, Scanlon R, et al. Rinkel injection therapy: a multicenter controlled study. J Allergy Clin Immunol. 1981;68(2):133–55. https://doi.org/10.1016/0091-6749(81)90172-x.CrossRefPubMed

35.

Grier TJ, Converse LM, Rekkerth DJ, Renahan KE. Math-free guides for glycerin and allergens at variable subcutaneous injection volumes: How’s my dosing? Update Ann Allergy Asthma Immunol. 2016;116(5):455–60. https://doi.org/10.1016/j.anai.2016.02.015.CrossRefPubMed

36.

Nelson HS. Allergy immunotherapy for inhalant allergens: Strategies to improve efficacy. Allergy Asthma Proc. 2020;41(1):26–37. https://doi.org/10.2500/aap.2020.41.190013.CrossRefPubMed

37.

Hunt KJ, Valentine MD, Sobotka AK, Benton AW, Amodio FJ, Lichtenstein LM. A controlled trial of immunotherapy in insect hypersensitivity. N Engl J Med. 1978;299(4):157–61. https://doi.org/10.1056/NEJM197807272990401.CrossRefPubMed

38.

Freeman TM, Hylander R, Ortiz A, Martin ME. Imported fire ant immunotherapy: effectiveness of whole body extracts. J Allergy Clin Immunol. 1992;90(2):210–5. https://doi.org/10.1016/0091-6749(92)90073-b.CrossRefPubMed

39.

Pajno GB, Vita D, Caminiti L, Arrigo T, Lombardo F, Incorvaia C, et al. Children’s compliance with allergen immunotherapy according to administration routes. J Allergy Clin Immunol. 2005;116(6):1380–1. https://doi.org/10.1016/j.jaci.2005.07.034.CrossRefPubMed

40.

Ragwitek (Short Ragweed Pollen Allergen Extract Tablet for Sublingual Use): Full Prescribing Information. 2021. Accessed.

41.

Grastek (Timothy Grass Pollen Allergen Extract Tablet for Sublingual Use): Full Prescribing Information. Whitehouse Station, NJ: Merck Sharp & Dohme Corp; 2021.

42.

Oralair (Sweet Vernal, Orchard, Perennial Rye, Timothy, and Kentucky Blue Grass Mixed Pollens Allergen Extract Tablet for Sublingual Use): Full Prescribing Information. Antony, France: Stallergenes S.A.; 2021.

43.

ODACTRA (House Dust Mite Allergen Extract Tablet for Sublingual Use): Full Prescribing Information. Hørsholm, Denmark: ALK-Abelló A/S; 2021.

44.

Birnie KA, Chambers CT, Taddio A, McMurtry CM, Noel M, Pillai Riddell R, et al. Psychological interventions for vaccine injections in children and adolescents: Systematic review of randomized and quasi-randomized controlled trials. Clin J Pain. 2015;31(10 Suppl):S72-89. https://doi.org/10.1097/AJP.0000000000000265.CrossRefPubMedPubMedCentral

Titel: Allergen Immunotherapy in Young Children
verfasst von: Venusa Phomakay
Mike Tankersley
Publikationsdatum: 25.04.2022
Verlag: Springer US
Erschienen in: Current Allergy and Asthma Reports / Ausgabe 8/2022
Print ISSN: 1529-7322
Elektronische ISSN: 1534-6315
DOI: https://doi.org/10.1007/s11882-022-01035-0

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Allergen Immunotherapy in Young Children

Abstract

Purpose of Review

Recent Findings

Summary

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