| Objective:To explore the role of the suppressive inflammatory factor interleukin-10 (IL-10) and pro-inflammatory cytokines interleukin-17 (IL-17) in the sublingual specific immunotherapy (SLIT) and possible mechanism of SLIT by comparing levels of serum IL-17, IL-10, specific IgE (SIgE), specific IgG4 (SIgG4) in Dermatophagoides farinae-allergic rhinitis and/or asthma patients before and after treatment with that of healthy controls, and to evaluate the safety and effectiveness of SLIT.Methods:A clinical trial was performed in 30 paediatric patients as a group of case,with allergic rhinitis and/or asthma due to Dermatophagoides farinae,and a group of 25 healthy control.their age ranged 4-14 years.The course of SLIT was treated by standardization dermaphagoides farinae drops for 24 weeks. The levels of serum IL-17, IL-10, SIgE, SIgG4 were determined by ELISA. The above-mentioned parameters were compared before and after treatment of the case group and the control group. At the same time, peripheral blood eosinophils count, lung function, airway resistance measurements, rhinitis and/or asthma symptom scores and total sympom score were also compared before and after treatment of the case group.Results:After 24 weeks of SLIT, the level of serum IL-17 was significantly decreased compared to before SLIT, P<0.01, its value was still higher than that of the control group, P<0.01. the level of serum IL-10 was significantly increased compared to before SLIT, P<0.01, but its value was still lower than that of the control group, P<0.01. The level of serum SIgE after treatment also decreased compared with before treatment, but not statistically significant, P>0.05, and the level of serum SIgG4 is significantly higher than that of before treatment, P<0.01, with statistical significance. Peripheral blood eosinophils count decreased significantly compared to before treatment, P<0.01, with statistical significance. Forced expiratory volume in one second (FEV1%:measured value/expected value) and the airway resistance (%:measured value/expected value) were also higher than those of before treatment, P<0.05, with statistical significance. Symptom scores on rhinitis and/or asthma and total scores for all paediatric patients in the case group after SLIT were decreased compared with before treatment, and statistically significant. the clinical efficacy:markedly effective 43.3%, effective 50%, ineffective 6.7%. Children with rhinitis and/or asthma symptoms of case group were significantly improved. There was positive correlation between serum IL-10 levels and serum SIgG4 levels, but negative correlation between serum IL-10 levels and total scores of symptoms, as well as between serum SIgG4 levels and total scores of symptoms, before and after treatment of the case group.Conclusion:(1) Pro-inflammatory cytokines IL-17 is an important virulence factor of respiratory allergic diseases in children. SLIT can reduce the serum IL-17 levels and improve the suppressible inflammatory factor IL-10 levels. (2) SIgG4 is confirmed that it played the role of protective antibodies in the respiratory allergic diseases in children. (3)SLIT is safe and effective in children with respiratory allergic diseases, but now a variety of allergens sublingual specific immunotherapy don't be temporarily recommended widespread application. |
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