JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY) ›› 2017, Vol. 31 ›› Issue (4): 103-108.doi: 10.6040/j.issn.1673-3770.0.2016.475

Previous Articles     Next Articles

A meta-analysis of subcutaneous immunotherapy and sublingual immunotherapy in the treatment of dust mite-allergic rhinitis.

WAN Wenjin, WANG Wen, CHENG Lei   

  1. Department of Otorhinolaryngology, The First Affiliated Hospital, Nanjing Medical University, Nanjing 210029, Jiangsu, China
  • Received:2016-12-25 Online:2017-08-16 Published:2017-08-16

PDF (PC)

396

Abstract: Objective To evaluate the effectiveness, compliance and safety of subcutaneous immunotherapy(SCIT)and sublingual immunotherapy(SLIT)in the treatment of dust mite-allergic rhinitis. Methods Randomized controlled trials or case-control studies of SCIT and SLIT in treatment of dust mite induced allergic rhinitis were searched in PubMed, EMBASE, Web of Science, the Cochrane Library, WANFANG, VIP, CNKI and CBMdisc databases. The literatures were quality evaluated, filtered and data extracted according to the standard of Oxford CASP, 2004, and the Review Manager 5.2 software was used for meta-analysis. Results 11 literatures including 712 patients were finally selected for analysis, 6 in Chinese and 5 in English. The results showed that there was no significant difference both in the improving nasal symptom scores(SMD=0.05; 95%CI: -0.27-0.38)and in the treatment compliance(RR=1.11, 95%CI: 0.98-1.26)between the SCIT and the SLIT groups. Each was safe and effective treatment although more adverse reactions were observed in SCIT than in SLIT(RR=1.89, 95% CI: 1.00-3.60). Conclusion Both SCIT and SLIT are safe and effective in the treatment of dust mite-allergic rhinitis, while adverse reactions were more frequently observed in SCIT.

Key words: Sublingual immunotherapy, Meta-analysis, Allergic rhinitis, Mites subcutaneous immunotherapy

CLC Number: 

  • R765.21
[1] 中华医学会耳鼻咽喉头颈外科学分会鼻科学组,中华耳鼻咽喉头颈外科杂志编辑委员会鼻科组. 变应性鼻炎诊断和治疗指南(2015年,天津)[J]. 中华耳鼻咽喉头颈外科杂志,2016, 51(1):6-24. Subspecialty Group of Rhinology, Editorial Board of Chinese Journal of Otorhinolaryngology Head and Neck Surgery; Subspecialty Group of Rhinology, Society of Otorhinolaryngology Head and Neck Surgery, Chinese Medical Association. Chinese guidelines for diagnosis and treatment of allergic rhinitis[J]. Chin J Otorhinolaryngol Head Neck Surg, 2016, 51(1):6-24.
[2] Pawankar R, Canonica GW, Holgate ST, et al. Allergic diseases and asthma: a major global health concern[J]. Curr Opin Allergy Clin Immunol, 2012, 12(1):39-41.
[3] Zhang Y, Zhang L. Prevalence of allergic rhinitis in china[J]. Allergy Asthma Immunol Res, 2014, 6(2):105-113.
[4] Jutel M, Akdis CA. Immunological mechanisms of allergen-specific immunotherapy[J]. Allergy, 2011, 66(6):725-732.
[5] Alvarez-Cuesta E, Bousquet J, Canonica GW, et al. Standards for practical allergen-specific immunotherapy[J]. Allergy, 2006, 61 Suppl 82:1-20.
[6] 程雷,陈若希. 变应原特异性免疫治疗的现状与展望[J]. 中华耳鼻咽喉头颈外科杂志, 2011, 46(12): 972-975. CHENG Lei, CHEN Ruoxi. Allergen-specific immunotherapy: current concepts and future directions[J]. Chin J Otorhinolaryngol Head Neck Surg, 2011, 46(12):972-975.
[7] 王忠喜,李文静. 舌下含服粉尘螨滴剂治疗变应性鼻炎临床疗效观察[J]. 中国医院药学杂志, 2008, 28(18): 1573-1575.
[8] Mungan D, Misirligil Z, Gurbuz L. Comparison of the efficacy of subcutaneous and sublingual immunotherapy in mite-sensitive patients with rhinitis and asthma—a placebo controlled study[J]. Ann Allergy Asthma Immunol,1999,82(5):485-490.
[9] Tahamiler R, Saritzali G, Canakcioglu S, et al. Comparison of the long-term efficacy of subcutaneous and sublingual immunotherapies in perennial rhinitis[J]. ORL J Otorhinolaryngol Relat Spec, 2008, 70(3):144-150.
[10] Keles S, Karakoc-Aydiner E, Ozen A, et al. A novel approach in allergen-specific immunotherapy: combination of sublingual and subcutaneous routes[J]. J Allergy Clin Immunol,2011,128(4):808-815.
[11] Yukselen A, Kendirli SG, Yilmaz M, et al. 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[J]. Int Arch Allergy Immunol, 2012, 157(3):288-298.
[12] Eifan AO, Akkoc T, Yildiz A, 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[J]. Clin Exp Allergy, 2010, 40(6):922-932.
[13] 周艾,李琦,姜艳荷. 舌下免疫和皮下免疫治疗儿童变应性鼻炎1年疗效观察[J]. 重庆医学,2012, 41(12):1183-1185. ZHOU Ai, LI Qi, JIANG Yanhe. Curative effect analysis of sublingual immunotherapy and subcutaneous immunotherapy after 1 year in children with allergic rhinitis[J]. Chongqing Med, 2012, 41(12):1183-1185.
[14] 王娟,王桂兰,姚苗苗. 舌下含服粉尘螨滴剂治疗儿童过敏性鼻炎依从性及安全性的临床观察[J]. 中国实用护理杂志,2011, 27(5):53-55. WANG Juan, WANG Guilan, YAO Miaomiao. Clinical investigation of dermatophagoides farinae drops by sublingual medication in treating children with allergic rhinitis[J]. Chin J Prac Nur, 2011, 27(5):53-55.
[15] 朱亮,朱鲁平,陈若希,等. 皮下免疫和舌下免疫治疗尘螨变应性鼻炎的疗效分析[J]. 中华耳鼻咽喉头颈外科杂志,2011, 46(12):986-991. ZHU Liang, ZHU Luping, CHEN Ruoxi, et al. Clinical efficacy of subcutaneous and sublingual immunotherapy in mite-sensitized patients with allergic rhinitis[J]. Chin J Otorhinolaryngol Head Neck Surgery, 2011, 46(12):986-991.
[16] 王鹏,谢晓凤,罗雪梅,等. 变应性鼻炎(AR)患者尘螨变应原皮下免疫治疗(SCIT)和舌下免疫治疗(SLIT)的对照研究[J]. 复旦学报(医学版), 2014, 41(4):534-539, 550. WANG Peng, XIE Xiaofeng, LUO Xuemei, et al. Comparison of the efficacy of subcutaneous immunotherapy(SCIT)and sublingual immunotherapy(SLIT)for dermatophagoides pteronyssinus in patients with allergic rhinitis(AR)[J]. Fudan Univ J Med Sci, 2014, 41(4):534-539, 550.
[17] 尤少华,秦晓燕,徐丛,等.舌下含服和皮下注射特异性免疫治疗变应性鼻炎的疗效研究[J].临床耳鼻咽喉头颈外科杂志,2016,30(9):689-693. YOU Shaohua, QIN Xiaoyan, XU Cong, et al. Comparison study of subcutaneous immunotherapy and sublingual immunotherapy in patients with allergic rhinitis[J]. J Clin Otorhinolaryngol Head Neck Surg(China), 2016, 30(9):689-693.
[18] Canonica GW, Cox L, Pawankar R, et al. Sublingual immunotherapy: World Allergy Organization position paper 2013 update[J]. World Allergy Organ J, 2014, 7(1):6.
[19] Shao J, Cui YX, Zheng YF, et al. Efficacy and safety of sublingual immunotherapy in children aged 3-13 years with allergic rhinitis[J]. Am J Rhinol Allergy, 2014, 28(2):131-139.
[20] 程雷,张严文. 过敏性鼻炎特异性免疫治疗的几个临床问题[J]. 医学与哲学, 2015, 36(14):19-21.
[21] Epstein TG, Liss GM, Murphy-Berendts K, et al. AAAAI/ACAAI surveillance study of subcutaneous immunotherapy, years 2008-2012: an update on fatal and nonfatal systemic allergic reactions[J]. J Allergy Clin Immunol Pract, 2014, 2(2):161-167.
[22] 桂晓钟,陈涌,赵军,等. 变应性鼻炎皮下注射和舌下含服特异性免疫治疗依从性对比[J]. 中国耳鼻咽喉头颈外科, 2010, 17(12):631-633. GU Xiaozhong, CHEN Yong, ZHAO Jun, et al. A comparative study of the compliance between subcutaneous immunotherapy and sublingual immunotherapy in patients with allergic rhinitis[J]. Chin Arch Otolaryngol Head Neck Surgery, 2010, 17(12):631-633.
[23] 龚霄阳,程雷. 变应性鼻炎的诊治现状与进展[J]. 中国中西医结合耳鼻咽喉科杂志, 2015, 23(3):161-165, 207.
[24] 程雷.变应性鼻炎特异性舌下免疫治疗[J].临床耳鼻咽喉头颈外科杂志,2015, 29(3):197-199. CHENG Lei. Sublingual specific immunotherapy for allergic rhinitis[J]. J Clin Otorhinolaryngol Head Neck Surg(China), 2015, 29(3):197-199.
[1] WANG Tan, WU Ke, LI Lianqing, GONG Lili. Factors associated with systemic adverse reactions after subcutaneous immunotherapy injections and treatment options [J]. J Otolaryngol Ophthalmol Shandong Univ, 2018, 32(5): 71-74.
[2] LU Hangui, LIN Xinsheng, YAO Danmian, WEI Yongxin, LI Chuangwei. Expression of IL-35 in allergic rhinitis and its effect on the immunoregulation of T cells [J]. J Otolaryngol Ophthalmol Shandong Univ, 2018, 32(5): 66-70.
[3] PU Hongbo, DU Xiaodong. Allergen test results in 2 000 patients with allergic rhinitis in Wuxi District [J]. J Otolaryngol Ophthalmol Shandong Univ, 2018, 32(4): 105-107.
[4] CHEN Ming, YU Xuefei. Opinions on the treatment of chronic rhinosinusitis with allergic rhinitis [J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2018, 32(3): 18-22.
[5] WU Xiangping. Influence of patient management on the clinical effect of sublingual dermatophagoides farinae drops in patients [J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2018, 32(3): 68-72.
[6] LI Song, WANG Zonggui, YANG Jingpu, ZHANG Zhuping. Progress of transnasal endoscopic vidian neurectomy [J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2018, 32(1): 72-76.
[7] LIN Xing, LIN Zongtong, SHEN Ling.. Outcomes of sinus balloon catheter dilation in treatment of pediatric chronic rhinosinusitis: a systematic review and meta-analysis. [J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2017, 31(6): 79-86.
[8] ZHI Lili, SONG Daoliang. Expressions of eosinophils and IL5 in antrochoanal polyps and nasal polyps. [J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2017, 31(4): 43-46.
[9] CHENG Lei, QIAN Junjun, TIAN Huiqin. Research progresses on allergic rhinitis. [J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2017, 31(3): 1-3.
[10] XU Yu， TAO Zezhang. Pharmacotherapeutic strategies for allergic rhinitis:Ithe importance of individualization and normalization. [J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2017, 31(3): 4-8.
[11] LI Lizhu, WU Qing, YI Xin, TIAN Li. Research progress on the animal model of allergic rhinitis in traditional Chinese medicine. [J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2017, 31(3): 60-63.
[12] SHA Jichao, ZHANG Ce, ZHU Dongdong. Immunocompetence of nasal epithelial cells in allergic rhinitis. [J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2017, 31(3): 55-59.
[13] XIANG Nan, ZHANG Qinxiu. Experience of professor Zhang Qinxiu in the treatment of perennial allergic rhinitis. [J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2017, 31(3): 100-102.
[14] LIU Huaitao, MA Ruixia, CHENG Lei. Surgical treatment of refractory allergic rhinitis. [J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2017, 31(3): 18-21.
[15] GUAN Kai, LI Lisha. Nasal irrigation and its role in the treatment of allergic rhinitis. [J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2017, 31(3): 22-27.
Viewed
Full text


Abstract

Cited
  Shared   
  Discussed   
[1] QIN He, SUN Jian-jun. Application of acellular dermal matrix in otorhinolaryngological reconstructive surgery[J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2012, 26(4): 75 -77 .
[2] . [J]. J Otolaryngol Ophthalmol Shandong Univ, 2013, 27(4): 86 .
[3] . Treatment of tumors in pterygopalatine fossa by endoscopy.[J]. J Otolaryngol Ophthalmol Shandong Univ, 2017, 31(2): 12 -15 .
Website Copyright: Editorial Office of Journal of Otolaryngology and Ophthalmology of Shandong University
Address: No.27 Shanda South Road, Jinan, Shandong, China. Post code: 250100 Tel: +86-0531-88366912 Email: ebhxb@sdu.edu.cn Supported by Beijing Magtech Co.Ltd