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Short-term house dust mite subcutaneous immunotherapy improves symptoms and reduces total IgE and TGF-β1 in children with allergic rhinitis, regardless of coexisting asthma.
House dust mite (HDM)–driven allergic rhinitis (AR) and asthma are becoming increasingly common in children worldwide, and tropical settings such as Indonesia create ideal conditions for mite growth and exposure, making these allergies especially relevant in pediatric care. While subcutaneous immunotherapy (SCIT) is recognized as a disease-modifying approach for respiratory allergies, evidence from tropical pediatric populations remains limited, particularly regarding its early clinical and immunological effects.
Researchers evaluated whether HDM SCIT could improve symptom control and influence immune biomarkers in children with AR alone and in those with AR + asthma. A double-blind randomized controlled trial (RCT) was conducted involving 41 Indonesian children diagnosed with either AR (n=20) or AR with concomitant asthma (n=21). Participants received weekly injections of HDM SCIT over a 14-week treatment period.
Clinical efficacy was assessed using the Combined Symptom Medication Score (CSMS) and the visual analog scale (VAS), while immunological responses were evaluated through measurements of total immunoglobulin E (IgE), HDM-specific IgE, interleukin-10 (IL-10), and transforming growth factor-beta 1 (TGF-β1). Pre- and post-treatment outcomes were compared using appropriate parametric and non-parametric statistical methods, with statistical significance defined at p<0.05.
HDM immunotherapy led to clear clinical improvement over 14 weeks and was linked with lower total IgE, TGF-β1, CSMS, and VAS scores. Changes in HDM-specific IgE and IL-10 were modest, and the therapeutic response was comparable in children with AR alone and those with AR and asthma. Short-term HDM SCIT delivered clear clinical benefit and improved key markers of allergic inflammation in Indonesian children suffering from respiratory allergy.
Although early immunologic shifts were modest, the treatment was well-tolerated and showed similar potency in children with and without asthma. These findings support HDM immunotherapy as a promising adjunct treatment for pediatric allergic airway disease in tropical settings.
Respiratory Medicine
Subcutaneous immunotherapy with house dust mite extract in Indonesian children with allergic rhinitis and asthma: A double-blind randomized controlled trial
Azwin Mengindra Putera et al.
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