A comparative study of sublingual and subcutaneous immunotherapy in mite-sensitive asthmatic children: a single center experience of 90 Chinese patients

Objective: Asthma is a heterogeneous disease with the geographic and ethnic diversity. Present study aimed to compare between sublingual (SLIT) and subcutaneous immunotherapy (SCIT) in Chinese asthma children with respect to the clinical efficacy, adverse effects and immunological mechanisms. Methods: The prevalence of pediatric asthma in the single center of China was investigated. Ninety patients were recruited and randomized into 3 groups to receive SLIT, SCIT, or pharmacotherapy alone. Asthma control test (SCT), asthma symptom, and medication score were collected. Total and specific IgE were determined, as well as allergen-specific IL-4 and IFN-gamma. Results: 1648 cases of pediatric asthma were screened out, 42.2% (696) were allergen positive. There was a slight gender difference with boy predominance. Patients aged 0-3 years showed much lower allergen positivity ratios than other age groups. Both the SLIT and SCIT caused a significant reduction in asthma symptom and medication score and an increase in ACT score and lung functions. No statistical difference was found between the two groups. Less and negligible adverse effects were observed in SLIT group when compared with SCIT group. The decreased productions of IL-4 and sIgE with an increased IFN-gamma production were detected in both the SCIT and SLIT groups. Conclusion: Both SLIT and SCIT demonstrated the favorable effects on pediatric asthma treatment, with no significant difference in asthma symptom, medication use, and immune response. However, SCIT caused much more and severe adverse effects, suggesting that SLIT may be a favorable therapy for asthma in Chinese children.