Low-dose Local Nasal Immunotherapy in Children with Perennial Allergic Rhinitis Due to Dermatophagoides

hyperresponsiveness was significantly reduced in the SIT group, both in and out of season, when compared with controls (P .05). Of nonasthmatics, asthma developed in 19 of 79 in SIT group and 32 of 72 controls. Children receiving SIT had improved VAS scores for conjunctivitis (P .001) and rhinitis (P .01). Conclusions. This study indicates that specific immunotherapy for seasonal rhinoconjunctivitis can reduce development of asthma. The authors also demonstrate a reduction in symptom profiles and medication usage in the active treatment group. Reviewer’s Comments. Allergic rhinitis is a known risk factor for the development of asthma. Additionally, other investigators have demonstrated a link between upper airway disease and bronchial hyperresponsiveness. This study profiles a group of children with clinically relevant seasonal rhinoconjunctivitis and suggests that specific immunotherapy may have a role preventing the development of asthma. This study challenges clinicians to evaluate children with significant upper airway disease and consider the benefits of allergen immunotherapy. Additional work is needed to further define the role of allergen immunotherapy in the prevention of asthma development in children with both seasonal and perennial disease. Additionally, this study highlights the importance of surveillance for asthma symptoms in children with allergic rhinoconjunctivitis.