The effect of component-resolved diagnosis on specific immunotherapy prescription in children with hay fever.
Обработка статьи · этапы, ошибки и управление
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Stringari Giovanna, Tripodi Salvatore, Caffarelli Carlo, Dondi Arianna, Asero Riccardo, Di Rienzo Businco Andrea, Bianchi Annamaria, Candelotti Paolo, Ricci Giampaolo, Bellini Federica, Maiello Nunzia, Miraglia del Giudice Michele, Frediani Tullio, Sodano Simona, Dello Iacono Iride, Macrì Francesco, Peparini Ilaria, Povesi Dascola Carlotta, Patria Maria Francesca, Varin Elena, Peroni Diego, Comberiati Pasquale, Chini Loredana, Moschese Viviana, Lucarelli Sandra, Bernardini Roberto, Pingitore Giuseppe, Pelosi Umberto, Tosca Mariangela, Cirisano Anastasia, Faggian Diego, Travaglini Alessandro, Plebani Mario, Matricardi Paolo Maria, Italian Pediatric Allergy Network (I-PAN)
Аннотация
OBJECTIVES: We sought to measure the effect of CRD on SIT prescription in children with pollen-related AR.
METHODS: Children (n = 651) with moderate-to-severe pollen-related AR were recruited between May 2009 and June 2011 in 16 Italian outpatient clinics. Skin prick test (SPT) reactivity to grass, cypress, olive, mugwort, pellitory, and/or Betulaceae pollen was considered clinically relevant if symptoms occurred during the corresponding peak pollen season. IgE sensitization to Phl p 1, Phl p 5, Bet v 1, Cup a 1, Art v 1, Ole e 1, Par j 2, and Phl p 12 (profilin) was measured by using ImmunoCAP. SIT prescription was modeled on SPT responses first and then remodeled considering also CRD according to GA(2)LEN-European Academy of Allergology and Clinical Immunology guidelines and the opinions of 14 pediatric allergists.
RESULTS: No IgE to the respective major allergens was detected in significant proportions of patients with supposed clinically relevant sensitization to mugwort (45/65 [69%]), Betulaceae (146/252 [60%]), pellitory (78/257 [30%]), olive (111/390 [28%]), cypress (28/184 [15%]), and grass (56/568 [10%]). IgE to profilins, polcalcins, or both could justify 173 (37%) of 464 of these SPT reactions. After CRD, the SPT-based decision on SIT prescription or composition was changed in 277 (42%) of 651 or 315 (48%) of 651 children according to the European or American approach, respectively, and in 305 (47%) of 651 children according to the opinion of the 14 local pediatric allergists.
CONCLUSIONS: In children with pollen-related AR, applying CRD leads to changes in a large proportion of SIT prescriptions as opposed to relying on clinical history and SPT alone. The hypothesis that CRD-guided prescription improves SIT efficacy deserves to be tested.