Dust Mite Sublingual Immunotherapy for Allergic Rhinitis: A Meta-Analysis_Chinese Journal of Evidence-Based Medicine

Authors：

CUI Xiao , TIAN Ying , YU Gang ,  JIANG Xuejun

Department of Otolaryngology, The First Affiliated Hospital of China Medical University, Shenyang 110001, China;

Corresponding author：

JIANG Xuejun, Email: djiangxj@163.com

Keywords：

Dust mite; Allergic rhinitis; immunotherapy; Dust mite drops; Systematic review; Meta-analysis; Randomized controlled trial

DOI：

10.7507/1672-2531.20130155

Video：

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Objective 　To assess the effectiveness of dust mite sublingual immunotherapy (SLIT) for treating allergic rhinitis.
Methods 　The randomized controlled trials (RCTs) about SLIT treating allergic rhinitis were collected in MEDLINE, EMbase, The Cochrane library (Issue 10, 2012), CNKI, VIP, WanFang Data and CBM from inception to October, 2012. Two reviewers independently screened the literature according to the inclusion and exclusion criteria, extracted the data, and assessed the quality, and then the meta-analysis was performed by using RevMan 5.1 software.
Results 　A total of 8 RCTs involving 788 patients were included. The results of meta-analysis showed that, compared with the control group, SLIT showed no obvious difference in the total effective rate (RR=1.15, 95%CI 0.88 to 1.50, P=0.29), but it was superior in decreasing the scores of both nasal symptom (SMD= −1.13, 95%CI −2.07 to −0.20, P=0.02) and drug intake (SMD= −0.60, 95%CI −1.06 to −0.15, P=0.009).
Conclusion 　SLIT can improve the symptoms of patients with allergic rhinitis, and it can also decrease the using frequency of antihistamine, beta-blocker and nasal spray steroids.

Citation： CUI Xiao,TIAN Ying,YU Gang,JIANG Xuejun. Dust Mite Sublingual Immunotherapy for Allergic Rhinitis: A Meta-Analysis. Chinese Journal of Evidence-Based Medicine, 2013, 13(7): 885-889. doi: 10.7507/1672-2531.20130155 Copy

1.	王成硕, 张罗, 韩德民, 等. 北京地区变应性鼻炎患者吸入变应原谱分析. 临床耳鼻咽喉科杂志, 2006, 20(5): 204-206.
2.	Higgins JPT, Green S. Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0 [updated March 2011]. The Cochrane Collaboration, 2011.
3.	Higgins JPT, Thompson SG. Quantifying heterogeneity in a meta-analysis. Stat Med, 2002, 21(11): 1539-1558.
4.	陈建军, 孔维佳, 项济生, 等. 标准化粉尘螨滴剂治疗变应性鼻炎的半年期疗效济安全性研究. 华中科技大学学报, 2008, 37(6): 823-827.
5.	de Bot CM, Moed H, Berger MY, et al. Sublingual immunotherapy not effective in house dust mite-allergic children in primary care. Pediatric allery and immunology, 2012 23(2): 150-158.
6.	Guez S, Vatrinet C, Fadel R, et al. House-dust-mite sublingual-swallow immunotherapy (SLIT) in perennial rhinitis: a double-blind, placebo-controlled study. Allergy, 2000, 55(4): 369-375.
7.	Passalacqua G, Pasquali M, Ariano R, et al. Randomized double-blind controlled study with sublingual carbamylated allergoid immunotherapy in mild rhinitis due to mites. Allergy, 2006, 61(7): 849-854.
8.	苏芳, 谢景华, 孟庆翔. 粉尘螨疫苗治疗过敏性鼻炎疗效与个体化用药. 河北医学, 2011, 17(6): 772-774.
9.	Tseng SH, Fu LS, Nong BR, et al. Changes in serum specific IgG4 and IgG4/IgE ratio in mite-sensitized Taiwanese children with allergic rhinitis receiving short-term sublingual-swallow immunotherapy: a multicenter, randomized, placebo-controlled trial. Asian Pac J Allergy Immunol, 2008, 26(2-3): 105-112.
10.	谢永汉, 林福荣, 范振兰. 舌下含服粉尘螨滴剂治疗变应性鼻炎100例临床分析. 临床医药实践, 2009, 18(6): 462-464.
11.	Yonekura S, Okamoto Y, Sakurai D, et al. Sublingual immunotherapy with house dust extract for house dust-mite allergic rhinitis in children. Allergol Int, 2010 59(4): 381-388.
12.	NOON L. Prophylactic inoculation against hay fever. Int Arch Allergy Appl Immunol, 1953, 4(4): 285-288.
13.	Compalati E, Passalacqua G, Bonini M, et al. The efficacy of sublingual immunotherapy for house dust mites respiratory allergy: results of a GA2LEN meta-analysis. Allergy, 2009 64(11): 1570-1579.
14.	Ippoliti F, De Sanctis W, Volterrani A, et al. Immunomodulation during sublingual therapy in allergic children. Pediatr Allergy Immunol, 2003, 14(3): 216-221.
15.	Lue KH, Lin YH, Sun HL, et al. Clinical and immunologic effects of sublingual immunotherapy in asthmatic children sensitized to mites: a double-blind, randomized placebo-controlled study. Pediatr Allergy Immunol, 2006, 17(6): 408-415.
16.	Moingeon P, Batard T, Fadel R, et al. Immune mechanisms of allergen-specific sublingual immunotherapy. Allergy, 2006, 61(2): 151-165.
17.	Lu FM, Chou CC, Chiang BL, et al. Immunologic changes during immunotherapy in asthmatic children: increased IL-13 and allergen-specific IgG4 antibody levels. Ann Allergy Asthma Immunol, 1998, 80(5): 419-423.
18.	Pajno GB. Sublingual immunotherapy: the optimism and the issues. J Allergy Clin Immunol, 2007, 119(4): 796-801.
19.	Passalacqua G, Durham SR. Allergic rhinitis and its impact on asthma update: allergen immunotherapy. J Allergy Clin Immunol, 2007, 119(4): 881-891.
20.	Pfaar O, Klimek L. Efficacy and safety of specific immunotherapy with a high-dose sublingual grass pollen preparation: a double-blind, placebo-controlled trial. Ann Allergy Asthma Immunol, 2008, 100(3): 256-263.

1. 王成硕, 张罗, 韩德民, 等. 北京地区变应性鼻炎患者吸入变应原谱分析. 临床耳鼻咽喉科杂志, 2006, 20(5): 204-206.
2. Higgins JPT, Green S. Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0 [updated March 2011]. The Cochrane Collaboration, 2011.
3. Higgins JPT, Thompson SG. Quantifying heterogeneity in a meta-analysis. Stat Med, 2002, 21(11): 1539-1558.
4. 陈建军, 孔维佳, 项济生, 等. 标准化粉尘螨滴剂治疗变应性鼻炎的半年期疗效济安全性研究. 华中科技大学学报, 2008, 37(6): 823-827.
5. de Bot CM, Moed H, Berger MY, et al. Sublingual immunotherapy not effective in house dust mite-allergic children in primary care. Pediatric allery and immunology, 2012 23(2): 150-158.
6. Guez S, Vatrinet C, Fadel R, et al. House-dust-mite sublingual-swallow immunotherapy (SLIT) in perennial rhinitis: a double-blind, placebo-controlled study. Allergy, 2000, 55(4): 369-375.
7. Passalacqua G, Pasquali M, Ariano R, et al. Randomized double-blind controlled study with sublingual carbamylated allergoid immunotherapy in mild rhinitis due to mites. Allergy, 2006, 61(7): 849-854.
8. 苏芳, 谢景华, 孟庆翔. 粉尘螨疫苗治疗过敏性鼻炎疗效与个体化用药. 河北医学, 2011, 17(6): 772-774.
9. Tseng SH, Fu LS, Nong BR, et al. Changes in serum specific IgG4 and IgG4/IgE ratio in mite-sensitized Taiwanese children with allergic rhinitis receiving short-term sublingual-swallow immunotherapy: a multicenter, randomized, placebo-controlled trial. Asian Pac J Allergy Immunol, 2008, 26(2-3): 105-112.
10. 谢永汉, 林福荣, 范振兰. 舌下含服粉尘螨滴剂治疗变应性鼻炎100例临床分析. 临床医药实践, 2009, 18(6): 462-464.
11. Yonekura S, Okamoto Y, Sakurai D, et al. Sublingual immunotherapy with house dust extract for house dust-mite allergic rhinitis in children. Allergol Int, 2010 59(4): 381-388.
12. NOON L. Prophylactic inoculation against hay fever. Int Arch Allergy Appl Immunol, 1953, 4(4): 285-288.
13. Compalati E, Passalacqua G, Bonini M, et al. The efficacy of sublingual immunotherapy for house dust mites respiratory allergy: results of a GA2LEN meta-analysis. Allergy, 2009 64(11): 1570-1579.
14. Ippoliti F, De Sanctis W, Volterrani A, et al. Immunomodulation during sublingual therapy in allergic children. Pediatr Allergy Immunol, 2003, 14(3): 216-221.
15. Lue KH, Lin YH, Sun HL, et al. Clinical and immunologic effects of sublingual immunotherapy in asthmatic children sensitized to mites: a double-blind, randomized placebo-controlled study. Pediatr Allergy Immunol, 2006, 17(6): 408-415.
16. Moingeon P, Batard T, Fadel R, et al. Immune mechanisms of allergen-specific sublingual immunotherapy. Allergy, 2006, 61(2): 151-165.
17. Lu FM, Chou CC, Chiang BL, et al. Immunologic changes during immunotherapy in asthmatic children: increased IL-13 and allergen-specific IgG4 antibody levels. Ann Allergy Asthma Immunol, 1998, 80(5): 419-423.
18. Pajno GB. Sublingual immunotherapy: the optimism and the issues. J Allergy Clin Immunol, 2007, 119(4): 796-801.
19. Passalacqua G, Durham SR. Allergic rhinitis and its impact on asthma update: allergen immunotherapy. J Allergy Clin Immunol, 2007, 119(4): 881-891.
20. Pfaar O, Klimek L. Efficacy and safety of specific immunotherapy with a high-dose sublingual grass pollen preparation: a double-blind, placebo-controlled trial. Ann Allergy Asthma Immunol, 2008, 100(3): 256-263.

Chinese Journal of Evidence-Based Medicine

Dust Mite Sublingual Immunotherapy for Allergic Rhinitis: A Meta-Analysis

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