This paper reviews the literature regarding immunotherapy in the management of childhood asthma.
Immunotherapy is a well established treatment of venom allergy and allergic rhinitis, however its use in asthma remains controversial.
We reviewed the pediatric literature from 1966 to 1994 and evaluated the existing studies for clinical efficacy of immunotherapy in childhood asthma.
Only 12 purely pediatric studies existed over the time period that we reviewed.
The studies used a variety of different antigens including house dust, house dust mite, grass, mold, cat, dog, and combinations of antigens.
In reviewing the studies, we assessed study duration, number of subjects, whether it was blinded, placebo controlled or open labeled, the measures of clinical efficacy and the assessments of specific and nonspecific bronchial reactivity.
The studies were very heterogeneous, and therefore direct comparison and extrapolation of conclusions was difficult.
The majority of the studies demonstrated either an improvement in asthmatic symptoms or a decrease in bronchial reactivity to the specific antigen employed, or both.
The minority of studies demonstrated no clinical efficacy.
The most consistent evidence of benefit was suggested in those trials employing house dust mite therapy, while immunotherapy for grass and cats demonstrated some benefit but the number of studies employing these treatments was very small.
Mots-clés Pascal : Asthme, Allergie, Traitement, Immunothérapie, Intérêt, Indication, Résultat, Revue bibliographique, Enfant, Homme, Appareil respiratoire pathologie, Bronchopneumopathie obstructive, Immunopathologie
Mots-clés Pascal anglais : Asthma, Allergy, Treatment, Immunotherapy, Interest, Indication, Result, Bibliographic review, Child, Human, Respiratory disease, Obstructive pulmonary disease, Immunopathology
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Cote : 96-0250407
Code Inist : 002B06F. Création : 199608.