Evaluation of patients with allergen specific immunotherapy as clinical and laboratory

Aim and Background: In this research, it is aimed that the examination of the long term effects, clinical evaluation, and comparison of laboratory parameters on illness with application of pharmacotherapy and allergen specific immunotherapy and application of one proper pharmacotherapy exclusively. Method: 86 asthma and/or allergic rhinitis diagnosed patients in between 5-17 age groups with sensivity to allergen who take pharmacotherapy with allergen specific immunotherapy (AIT) and 150 patients who were applied only proper pharmacotherapy as control group were included in this research. The operation of treatment were examined with data from 5 different periods. Patients were evaluated by laboratory parameters (skin prick tests, respiratory function tests, specific IgE measure, total IgE measure, eosinophilia measure on their 0th year, 6th month, 1st year, 2nd year and 3rd year visits. Besides, clinical evaluation parameters were used for 15 patients who take immunotherapy. The asthma symptom score of 0th year, 6th month and 1st year periods, asthma medicine score, visual analog measuring device, asthma control test, asthma control measuring device, life quality measuring device for children with asthma were evaluated as questionnaire records. Clinical and laboratory long-term conversations were made for the two groups in the form of calls comparisons of all periods and comparisons within groups. Quantitative distribution suitability to normal distribution Kolmogorov-Smirnov, Shapiro-Wilk test and in qualitative comparison, Pearson Chi-Square test and Fisher-Freeman-Halton Exact test. Results: : In the group receiving immunotherapy, the induration measurements at the 1st year, 2nd year and 3rd year for the 1st allergen (primary p = 0.010; p = 0.001; p = 0.001; p <0.05), for the 2nd allergen (below p = 0.012 ; p = 0.019; p = 0.007; p <0.05) when we see it in the past. Decrease in specific IgE measurements in the group receiving immunotherapy for the 1st year, 2nd year, and 3rd year for the 1st allergen (primary p = 0.001; p = 0.001; p <0.01), for the 2nd allergen (major p = 0.041; p = 0.001 ; p <0.05), decrease in total IgE level (previously p = 0.001; p = 0.001; p <0.01), decrease in eosinophil measurements (previously p = 0.006; p = 0.001; p = 0.001; p <0.01) really significant was found. Change in FEV1% measurements at 1 year, 2 years and 3 years (p = 0.022; p <0.05), increase in FVC% measurements in the group receiving immunotherapy (p = 0.0267; p = 0.001; p = 0.001; p <0.05) Similarly, the increase in FEV25-75% measurements at the 3rd year after treatment compared to the 1st year (p = 0.001; p <0.01), the increase in the PEF% measurements at the 2nd year after the treatment compared to the start of treatment (p = 0.017; p <0.05) significant. At the beginning of the treatment, 5.8% (n = 5) of the patients who received immunotherapy, low dose inhaler steroid, 46.5% (n = 40) medium dose inhaler steroid, 25.6% (n = 22) high dose inhaler steroid and 22.1% I (n = 19) were using montelukast, 24.6% (n = 17) of the patients did not use medication, 21.7% (n = 15) of them were using low-dose inhaler steroid, 30.4% (n = 21) where they used dose inhaler steroid and 23.2% (n = 16) montelukast. Asthma treatment steps of the patients who received immunotherapy were 25.6% (n = 22) 2nd step, 18.6% 3rd step, 37.2% 4th step, and 18.6% 5th step, while the cases were treated in the 3rd year after treatment. Where 24.6% were receiving 1st step, 27.5% 2nd step, 8.7% 3rd step, 30.4% 4th step and 8.7% 5th step treatment. While evaluating the clinical parameters, the decrease in VAS measurements at the 1st year after treatment (p = 0.003), the change in the 6th month and 1st year AKT measurements after the treatment (p = 0.001; p <0.01), the change in the ACQ measurements (p = 0.001; p <0.01), change in asthma symptom score parameters (p <0.05), decrease in asthma quality of life questionnaire scoring measures (p <0.01) were similarly significant. Conclusion: The result of our research ,allergen specific immunological therapy provide benefit to polisensitize patient in the terms of clinical and immunological. Due to the decrease in drug utilization with clinical improvement SCIT has the potential to alter the natural history of the disease in children with allergic asthma and / or allergic rhinitis.