Humans ; Consensus ; Hypersensitivity ; Desensitization, Immunologic/adverse effects* ; Immunotherapy/adverse effects* ; Injections, Subcutaneous ; Allergens

Objective: To investigate the incidence and risk factors of systemic allergic reactions induced by subcutaneous immunotherapy (SCIT) in patients undergoing SCIT injections in Peking Union Medical College Hospital (PUMCH). Methods: This is a single center retrospective cohort study. Using the outpatient information system of PUMCH, the demographic information and injection-related reaction data of patients undergoing SCIT injection in Allergy Department of PUMCH from December 2018 to December 2022 were retrospectively analyzed to count the incidence and risk factors of systemic allergic reactions caused by SCIT. Mann-Whitney nonparametric test or chi-square test was used for single-factor analysis, and multiple logistic regression was used for multiple-factor analysis. Results: A total of 2 897 patients received 18 070 SCIT injections in Allergy Department during the four years, and 40 systemic allergic reactions occurred, with the overall incidence rate of 0.22%. The incidence of systemic allergic reaction was 0.37% when using imported dust mite preparation and 0.15% when using domestic multi-component allergen preparation. The risk factors significantly related with SCIT-induced systemic allergic reactions in patients using imported dust mite preparation were age less than 18 years old (OR=3.186,95%CI: 1.255-8.085), highest injection concentration (OR value could not be calculated because all patients with systemic reactions were injected with highest concentration), and large local reaction in previous injection (OR=22.264,95%CI: 8.205-60.411). The risk factors for SCIT-induced systemic allergic reactions in patients using domestic allergen preparation were 5 or more types of allergens (OR=3.455,95%CI: 1.147-10.402), highest injection concentration (OR=3.794,95%CI: 1.226-11.740) and large local reaction in previous injection (OR=63.577,95%CI: 22.248-181.683). However, SCIT injection in pollen allergic patients during the pollen season did not show a correlation with systemic allergic reaction. Conclusion: The incidence of SCIT-induced systemic allergic reactions was low in the Chinese patient population of this study. Patients with one or more risk factors, such as multiple allergen injection, highest injection concentration, large local reaction in previous injection, should be given high attention and vigilance against systemic allergic reactions.
Humans ; Allergens ; Asian People ; Desensitization, Immunologic/adverse effects* ; Hypersensitivity/epidemiology* ; Retrospective Studies

Objective: To investigate the incidence and risk factors of systemic allergic reactions induced by subcutaneous immunotherapy (SCIT) in patients undergoing SCIT injections in Peking Union Medical College Hospital (PUMCH). Methods: This is a single center retrospective cohort study. Using the outpatient information system of PUMCH, the demographic information and injection-related reaction data of patients undergoing SCIT injection in Allergy Department of PUMCH from December 2018 to December 2022 were retrospectively analyzed to count the incidence and risk factors of systemic allergic reactions caused by SCIT. Mann-Whitney nonparametric test or chi-square test was used for single-factor analysis, and multiple logistic regression was used for multiple-factor analysis. Results: A total of 2 897 patients received 18 070 SCIT injections in Allergy Department during the four years, and 40 systemic allergic reactions occurred, with the overall incidence rate of 0.22%. The incidence of systemic allergic reaction was 0.37% when using imported dust mite preparation and 0.15% when using domestic multi-component allergen preparation. The risk factors significantly related with SCIT-induced systemic allergic reactions in patients using imported dust mite preparation were age less than 18 years old (OR=3.186,95%CI: 1.255-8.085), highest injection concentration (OR value could not be calculated because all patients with systemic reactions were injected with highest concentration), and large local reaction in previous injection (OR=22.264,95%CI: 8.205-60.411). The risk factors for SCIT-induced systemic allergic reactions in patients using domestic allergen preparation were 5 or more types of allergens (OR=3.455,95%CI: 1.147-10.402), highest injection concentration (OR=3.794,95%CI: 1.226-11.740) and large local reaction in previous injection (OR=63.577,95%CI: 22.248-181.683). However, SCIT injection in pollen allergic patients during the pollen season did not show a correlation with systemic allergic reaction. Conclusion: The incidence of SCIT-induced systemic allergic reactions was low in the Chinese patient population of this study. Patients with one or more risk factors, such as multiple allergen injection, highest injection concentration, large local reaction in previous injection, should be given high attention and vigilance against systemic allergic reactions.
Humans ; Allergens ; Asian People ; Desensitization, Immunologic/adverse effects* ; Hypersensitivity/epidemiology* ; Retrospective Studies

OBJECTIVE: To observe the adverse effects of specific immunotherapy (SIT) with standardized dust mite allergen preparation in the treatment of allergic rhinitis. METHOD: Three hundred and eighty-six patients with allergic rhinitis who received subcutaneous SIT with a standardized dust mite allergen preparation were enrolled in this study. The patients were treated for at least 15 weeks,adverse effects after each injection from dosing phase to maintenance phase were recorded and incidence of adverse effects were analyzed. RESULT: Of all the patients,adverse reactions occurred in 42 patients (10. 9%),10 local reactions (2. 6%) and 36 systemic side effects (9. 3%) which included 34 mild ,1 moderate and 1 severe side effects (no fatal) were reported respectively. None had anaphylactic shock. Among three treatment options, incidence of routine program was the highest (21.1%),followed by adult cluster program (11. 9%), adverse effects of children cluster program was the least (1. 5%). The adverse effects often happened in the middle and late phase of does addition period and early phase of maintenance period. CONCLUSION SIT with standardized dust mite allergen preparation in the treatment of allergic rhinitis is a safe and effective treatment by complying with the guidelines and taking specific interventions.
Adult ; Animals ; Antigens, Dermatophagoides ; adverse effects ; therapeutic use ; Child ; Desensitization, Immunologic ; Humans ; Immunotherapy ; Pyroglyphidae ; Rhinitis, Allergic ; therapy ; Treatment Outcome

OBJECTIVETo retrospectively assess serious systemic adverse effects of standardized dust-mite vaccine in children with asthma.

METHODSMedical records of 704 children (5-17 years in age) with asthma between January, 2005 and December, 2011 were reviewed. Serious systemic adverse events following treatment with a standardized dust-mite vaccine in these children were analyzed.

RESULTSA total of 336 systemic adverse reactions were observed in 17.0% (120/704) of the patients analyzed of these adverse reactions, 18 (5.4%) were serious (level 3), 318 (94.6%) were not serious (below level 3), and no single case of anaphylactic shock (level 4) was recorded. Systemic adverse events occurred most frequently in the 5 to 11-year age group and in the summer season (from June to August). In the 18 severe cases, the peak expiratory flow (PEF) dropped by 20% immediately after the vaccine injection, and other major clinical symptoms included cough, wheezing and urticaria. All children with serious systemic adverse effects were given inhaled hormone and atomized short-acting beta agonists, oral antihistamines, intravenous dexamethasone and/or intramuscular adrenaline. After these treatments, the clinical symptoms were significantly relieved.

CONCLUSIONSThe rate of serious systemic adverse events following allergen-specific immunotherapy is relatively low in children with allergic asthma. Conventional medications are effective in managing these immunotherapy-associated adverse events.

Adolescent ; Animals ; Asthma ; physiopathology ; therapy ; Child ; Child, Preschool ; Desensitization, Immunologic ; adverse effects ; Female ; Humans ; Male ; Peak Expiratory Flow Rate ; Pyroglyphidae ; immunology ; Retrospective Studies ; Vaccines ; adverse effects

OBJECTIVETo evaluate the efficacy and safety of the sublingual immunotherapy with Dermatophagoides fannie drops on children with allergic rhinitis of different age groups (4 - 5 years old group and 11 - 12 years old group).

METHODSSixty-two children aged 4 - 5 years, and 71 children aged 11 - 12 years, who suffered from dust mite induced allergic rhinitis, was randomly divided into the sublingual immunotherapy (SLIT) + drug group and drug group. SLIT + drug group was treated with a standardized sublingual immunotherapy drops of Dermatophagoides fannie and combined with symptomatic therapy, drug group was treated with mometasone furoate nasal spray and desloratadine tablets as symptomatic treatment. These children were followed up for 2 years with one visit in every 3 months, then visited at the end of the study and 2-years after the treatment ended. Symptom scores and medication scores were recorded at each visit. Comprehensive evaluation of symptoms, medication, and patients' degree of satisfaction were used.

RESULTSTwo years after SLIT finished, symptom scores (SLIT + drug group: 1.13 ± 1.05; drug group: 4.68 ± 3.09), medication scores (SLIT + drug group: 0.07 ± 0.04; drug group: 0.36 ± 0.25) of SLIT + drug group were significantly lower than those in drug group (t value were -8.43, -8.87, respectively, all P < 0.01). Also, the subjective assessment of patients' symptoms, medication, and treatment satisfaction in SLIT + drug group was significantly lower than those in drug group. Subjective assessment symptoms, medication, and treatment satisfaction in age group 4 - 5 was the same as in age group 11 - 12. After SLIT ended for 2 years, subjective assessment and treatment satisfaction in age 11 - 12 group was better than those in age 4-5 group in medication score.

CONCLUSIONSSLIT demonstrated clinical improvement in children of different ages during 2 years treatment. Two years after withdrawal, the symptom scores, medication score and subjective satisfaction in 11 years old group are better than those in 4-5 years old group.

Administration, Sublingual ; Antigens, Dermatophagoides ; administration & dosage ; immunology ; Child ; Child, Preschool ; Desensitization, Immunologic ; adverse effects ; methods ; Female ; Humans ; Male ; Rhinitis, Allergic ; Rhinitis, Allergic, Perennial ; therapy ; Treatment Outcome

OBJECTIVETo study the efficacy and safety of specific sublingual immunotherapy with dermatophagoides farinae drops in the treatment of cough variant asthma in children.

METHODSA total of 106 children aged 4-14 years old with cough variant asthma and positive skin prick test responses to dermatophagoides farinae allergens were randomly divided into two groups: SLIT group (n=53), which received specific sublingual immunotherapy with dermatophagoides farinae drops as well as standardized treatment and conventional treatment group (n=53), which received standardized treatment alone. Improvement in cough/asthma symptom scores and the time taken for symptoms to improve were observed after treatment. Serum eosinophil (EOS) level and peak expiratory flow (PEF) were measured after treatment. The side effects were observed.

RESULTSCompared with the conventional treatment group, the SLIT group showed significant decrease in symptom scores and serum EOS level and significant increase in PEF (P<0.05). The time at which symptoms began to improve in the SLIT group was earlier than in the conventional treatment group (P<0.05). The effective rate in the SLIT group was significantly higher than in the conventional treatment group (85% vs 68%; P<0.05). Local reactions such as redness, swelling, and itching occurred in some children of the SLIT group but disappeared on the following day.

CONCLUSIONSSpecific sublingual immunotherapy with dermatophagoides farinae drops is an effective and highly safe treatment for cough variant asthma in children.

Administration, Sublingual ; Adolescent ; Antigens, Dermatophagoides ; immunology ; Asthma ; therapy ; Child ; Child, Preschool ; Cough ; therapy ; Desensitization, Immunologic ; adverse effects ; Eosinophils ; physiology ; Female ; Humans ; Male

OBJECTIVETo evaluate the therapeutic efficacy of 3-year subcutaneous immunotherapy (SCIT) in asthmatic children allergic to mite.

METHODSNinety asthmatic children allergic to house dust mite (with or without allergic rhinitis) and aged 5-14 years were randomized into SCIT treatment group (n=45) and control group (n=45). The SCIT treatment group received SCIT combined with standardized treatment for asthma, while the control group received the standardized treatment alone. The therapeutic effects were assessed based on the daytime and nighttime symptom scores, mean daily doses of inhaled corticosteroids (ICS), skin prick test results, peak expiratory flows and total serum IgE at baseline and in the 3-year treatment.

RESULTSIn both groups, the daytime and nighttime symptom scores in the first, second, and third years of treatment were significantly lower than the baseline values (P<0.01), and the scores decreased year by year during the 3-year treatment (P<0.01). Also, the mean daily doses of ICS in the first, second, and third years of treatment were significantly lower than the baseline values (P<0.01), and the doses decreased year by year during the 3-year treatment (P<0.01). The mean daily dose was significantly lower in the SCIT treatment group than in the control group in the second and third years of treatment (P<0.05). After 3-year treatment, the SCIT treatment group had a significantly higher proportion of children who discontinued use of ICS due to remission of symptoms compared with the control group (29% vs 20%, P<0.05). At the end of the 3-year treatment, the total serum IgE was significantly lower than the baseline value in the SCIT treatment group (P<0.01), and it was significantly lower in the SCIT treatment group than in the control group (P<0.05).

CONCLUSIONSThree-year SCIT is effective in asthmatic children allergic to house dust mite and allows reduction in the dosage of ICS.

Adrenal Cortex Hormones ; administration & dosage ; Animals ; Asthma ; immunology ; therapy ; Child ; Desensitization, Immunologic ; adverse effects ; methods ; Female ; Humans ; Immunoglobulin E ; blood ; Injections, Subcutaneous ; Male ; Pyroglyphidae ; immunology

Asparaginase ; adverse effects ; Child ; Child, Preschool ; Desensitization, Immunologic ; Drug Hypersensitivity ; therapy ; Female ; Humans ; Male ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; drug therapy

OBJECTIVE: To evaluate the adverse reaction of standardized specific mite-allergen immunotherapy. METHOD: One hundred and fifty-two patients diagnosed by the pediatric immunotherapy center of our hospital were treated with increasing doses of standardized specific mite-allergen injection. Before and 30 minutes after treatment, the peak expiratory flow (PEF) and pulmonary function for the maximum lung ventilation function were checked, and the adverse reactions were recorded. RESULT: Six hundred and eighty-one injections were recorded. 84 injections (12.3%) caused immediate side effects, including 64 mild local adverse reactions (9.4%), 2 moderate local adverse reactions (0.3%), 18 systemic adverse reactions (2.6%) which were mild asthma, and no fatal anaphylactic shock and other serious adverse reactions were found. 50 injections (7.3%) cased delayed adverse reactions, all of which were mild local adverse reactions. The rate of immediate local adverse reactions and systemic adverse reactions in the maintenance treatment period was significantly higher than that in the initial treatment period (chi2 = 4.59, 19.82 respectively; P < 0.05, < 0.01 respectively). The rate of delayed adverse reactions was no significant differences (chi2 = 2.30; P > 0.05). The PEF change rate (-0.000 2 +/- 0.085 9) of the children at 681 injections and the MMEF change rate of the children at 109 injections (0.275 +/- 0.206) were not statistically different (t = -0.047, 1.39; P = 0.963, 0.166). CONCLUSION Standardized specific mite-allergen immunotherapy is safe for children with allergic rhinitis and/or asthma.
Adolescent ; Animals ; Asthma ; immunology ; therapy ; Child ; Child, Preschool ; Desensitization, Immunologic ; adverse effects ; standards ; Dose-Response Relationship, Immunologic ; Female ; Humans ; Hypersensitivity, Immediate ; Male ; Mites ; immunology ; Rhinitis, Allergic, Perennial ; immunology ; therapy