Allergy immunotherapy as an early intervention in patients with child-onset atopic asthma

Background: In patients with bronchial asthma an effective treatment is required at early stages of the disease to prevent irreversible structural changes of the airways. The objective of this study was to evaluate the beneficial effects of our routine immunotherapy as an early intervention on FEV₁ in patients with child-onset atopic asthma. Methods: Beneficial effects of successful immunotherapy on FEV₁ were analyzed retrospectively in 43 unselected patients who received our routine standard subcutaneous immunotherapy with periodic FEV₁ measurements and became asymptomatic. Results: Although there was no significant correlation between the duration of asthma symptoms prior to immunotherapy and the changes in FEV₁ before and after immunotherapy in 43 unselected patients, there was a significant inverse correlation between these two parameters in 23 patients whose asthma duration was less than 20 years. As the FEV₁ increased after immunotherapy in all 14 patients whose asthma duration was less than 5 years, the 43 patients were divided into a group 1 including these 14 patients and a group 2 including 29 patients whose asthma duration was more than 5 years. The FEV₁ decreased in 7 of the 29 asymptomatic patients in group 2. There was no difference in the initial FEV₁ between the two groups, but the final FEV₁ and the mean of the average increase in FEV₁ per year by immunotherapy were significantly higher in group 1 than in group 2. Conclusions: Immunotherapy should be started as early as possible at the youngest age in order to increase a beneficial effect of successful immunotherapy on FEV₁ improvement.