Effects of subcutaneous and sublingual allergen immunotherapyon immune responses in children with bronchial asthma
Jinfeng Wei,1 Cuiying Ye,2 Xiangying Wang,1 Li Zhang,1 Suling Wu,1 Xuefeng Jin3
Affiliations:
1 Department of Respirology, Hangzhou Children’s Hospital
2 Clinical Lab, Hangzhou Children’s Hospital
3 Department of Gastroenterology, Hangzhou Children’s Hospital
Abstract
Background: Allergic asthma in children significantly impacts quality of life, and immunotherapy, including subcutaneous immunotherapy (SCIT) and sublingual immunotherapy (SLIT), has emerged as an effective treatment. However, their comparative immunological mechanisms remain unclear.
Objective: This study aimed to compare the effects of SCIT and SLIT on immune response in children with allergic asthma and to explore their underlying immunological mechanisms.
Methods: A total of 86 children aged 5–12 years with allergic asthma who visited Hangzhou Children’s Hospital were prospectively enrolled and randomly assigned to three groups: inhaled corticosteroids (ICS) group (n = 30), SCIT group (n = 30), and SLIT group (n = 26). Clinical and immunological parameters—including Childhood Asthma Control Test (C-ACT) scores, forced expiratory volume in the first second percentage (FEV1%), Th17, Treg cells, and serum levels of IL-17, IL-9, IL-10—were assessed before treatment and after one year.
Results: After treatment, all three groups showed significant improvements in C-ACT scores and FEV1% compared to baseline (all p < 0.05). The SCIT and SLIT groups demonstrated greater improvements than the ICS group (all p < 0.05), with no significant differences between the SCIT and SLIT groups (p > 0.05). In terms of immune markers, significant differences were observed in all parameters before and after treatment in the SCIT and SLIT groups (all p < 0.05), while Treg levels in the ICS group remained unchanged (p > 0.05). No statistically significant differences in immune markers were found among the three groups post-treatment (all p > 0.05).
Conclusion: Both SCIT and SLIT, when combined with ICS, offer superior efficacy compared to ICS monotherapy. The comparable immunological changes observed in SCIT and SLIT suggest a shared mechanism of immune tolerance, potentially mediated through Treg cell induction.