BOLETÍN BIBLIOGRÁFICO
DE INMUNOTERAPIA
Artículo destacado – Junio 2019
1
La ITE en asma mejora no solo los síntomas, sino también la función pulmonar.
Effect of sublingual immunotherapy on airway inflammation and airway wall thickness in allergic asthma.
Hoshino M, Akitsu K, Kubota K
J Allergy Clin Immunol Pract. 2019 Jun 19. pii: S2213-2198(19)30552-5. doi: 10.1016/j.jaip.2019.06.003. [Epub ahead of print]
BACKGROUND
The efficacy of the standardized quality (SQ) house dust mite (HDM) sublingual immunotherapy (SLIT) has been demonstrated for respiratory allergic disease. However, the effect of SLIT on inflammation and structural changes of the airways are still unknown.
OBJECTIVE
The aim of this study was to assess the effects of the 6 SQ-HDM SLIT on airway inflammation and airway geometry in allergic asthma and rhinitis.
METHODS
One hundred two asthmatic patients with rhinitis sensitized to HDM were randomized to receive either SLIT plus pharmacotherapy or standard pharmacotherapy alone, for 48 weeks. Fractional exhaled nitric oxide (FeNO), pulmonary function, quantitative computed tomography and clinical symptoms were performed at baseline and end of the study.
RESULTS
Compared to pharmacotherapy, SLIT demonstrated a significant reduction of FeNO (P < .01), airway wall area /body surface area (WA/BSA, P < .001), wall thickness (T/√BSA, P < .001), percentage wall area (WA/Ao, P < .01), increase in luminal area (Ai/BSA, P < .05) and improvement of airflow limitation (P < .001) and clinical symptom scores (P < .05). The change in FEV1 correlated with both changes in FeNO and airway dimensions. Multiple regression analysis showed that the change in FeNO was independently associated with an increase in FEV1 in the SLIT group (r2 = 0.623, P = .037).
CONCLUSIONS
Adding 6 SQ-HDM SLIT to standard asthma therapy provides a significant improvements in symptoms and pulmonary function compared with pharmacotherapy. Improvement of airflow limitation with SLIT was associated with the decrease in eosinophilic airway inflammation.