Changes of eNO levels in children with asthma and allergic rhinitis after sublingual immunotherapy with Dermatophagoides farinae drops
Objective To study the changes of fractional exhaled nitric oxide (FeNO) and nasal exhaled nitric oxide (FnNO) in children with asthma and allergic rhinitis after sublingual immunotherapy (SLIT) with Dermatophagoides farinae drops and evaluate the impact of SLIT on airway. Methods A total of 60 children aged 6-12 years,who were allergic to dust mites with asthma and allergic rhinitis and visited Donghua Hospital between October 2021 and September 2022,were selected as the study objects. Randomly divided the patients into a control group and an experimental group. The control group received routine treatment with Fluticasone propionate aerosol,montelukast sodium chewable tablets and loratadine tablets. The experimental group received these routine treatments along with sublingual Dermatophagoides farinae drops for 12 months. The levels of FeNO and FnNO,as well as the changes of clinical symptom scores of the children in both groups were recorded dynamically before treatment and at 3,6 and 12 months after treatment. The differences in FeNO and FnNO levels and the improvement rate of clinical symptom scores between the two groups were compared at different time points. Results (1) In the experimental group,the FeNO and FnNO levels were lower at 3,6 and 12 months after treatment compared to before treatment. The FeNO level was lower at 12 months compared to 3 months after treatment;the FnNO levels were lower at 6 and 12 months compared to 3 months after treatment,and the FnNO level was lower at 12 months compared to 6 months after treatment. (2) In the control group,the FeNO and FnNO levels were lower at 6 and 12 months after treatment compared to before treatment. The FeNO level at 12 months after treatment was lower than before treatment and at 3 and 6 months after treatment;the FnNO levels at 6 and 12 months after treatment were lower than before treatment and at 3 months after treatment. (3) There were significant differences in FeNO and FnNO levels at 3,6 and 12 months after treatment between the two groups (P<0.05),with experimental group having lower levels than control group. (4) The improvement rates of asthma control and rhinitis attack frequency in experimental group were higher than control group after 6 months of treatment (P<0.05),and the improvement rate of rhinitis attack frequency in experimental group remained higher than control group after 12 months of treatment (P<0.05). Conclusion SLIT with Dermatophagoides farinae drops can significantly reduce FeNO and FnNO levels and improve airway inflammation and clinical symptoms in children with asthma and allergic rhinitis.
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