A prospective study of asthma desensitization in 1,182 children, 592 asthmatic children and 590 nonatopic controls

A. Cantani, M. Micera

Department of Pediatrics, Division of Allergy and Immunology, University “La Sapienza” – Rome (Italy)

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• Immunology

Background: The aim of this prospective study was to evaluate the prevalence of allergic asthma and or rhinitis (AR) in 1182 children. Systemic reactions (SRs) to asthma desensitization, previously, specific immunotherapy (SIT) in children with allergic asthma and or AR are scarcely known.

Materials and Methods: Since 1999, we have consecutively enrolled all children ranging in age from 3 to 11 years attending our Division because affected with severe asthma (592). Controls were 590 nonatopic children matched for age and sex recruited from our outpatient clinic. The study children were treated with a personalized asthma desensitization, the controls were treated with all usual medications. The parents of all children gave their informed consent. Data were analyzed using the X2 method.

Results: The 592 atopic children with severe asthma, 370 males and 222 females, aged 3.5 to 10.5 years, tested positive for Der p and Der f (47.1%) or for pollen allergens (52.9%). We have demonstrated a high increase of ashma incidence, since at the start there were 135 asthmatic children and 215 during 2000, with a 62.5% increase. During 2001 there were 242 children, with a 88.8% increase compared to 1999. All of these children were subjected to asthma desensitization, previously SIT (SARM, Roma). At the third yearly control, the study children had a significantly greater reduction as regards days (p = 0.0001) and nights (p = 0.0005) without asthma and drug usage (p = 0.0003) compared with drug-treated children. The number of SPTs and/or sIgE to inhalants also decreased, spirometry data were also notably improved The clinically adverse events only were mild or transient.

Discussion: The positive results obtained in this large study add to its safety in our opinion because the children were followed by their doctors also on the basis of “as frequently as needed”. Accordingly, the early onset of childhood asthma emphasizes that an early treatment is the only means to significantly abate the march of atopic asthma. We have documented an unexpected prevalence of pediatric asthma that should by evaluated in light of the very early asthma development in children which is present even before asthma would be diagnosed based on clinical symptoms The causes of this dramatic increment (10.4%/month in the last six months) may be identified chiefly in the worldwide increase in air pollution and secondhand tobacco smoke.

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