Application of Subcutaneous Immunotherapy in Pediatric Patients with Allergic Rhinitis and Analysis of Logistic Regression Models
Abstract
This study aimed to investigate the clinical efficacy of subcutaneous immunotherapy (SCIT) in pediatric patients with allergic rhinitis (AR) and to analyze influencing factors associated with treatment outcomes.
A total of 153 pediatric AR patients receiving SCIT were retrospectively enrolled. Patients were categorized into effective and ineffective groups according to treatment response. Clinical characteristics were collected and compared between groups. Differential variables were subjected to multicollinearity analysis and subsequently included in logistic regression analysis to identify risk factors for poor treatment response. A nomogram prediction model was established, and its predictive performance was internally validated using receiver operating characteristic (ROC) analysis.
Following SCIT treatment, 20 patients (13.07%) showed no therapeutic response, while the overall response rate reached 86.93%. Significant differences between groups were observed in sex, family history, place of residence, total immunoglobulin E (IgE), dust mite-specific IgE, and eosinophil count (EOS). Variance inflation factor (VIF) analysis demonstrated no multicollinearity among variables. Logistic regression identified all above indicators as independent risk factors for treatment failure (OR>1). The nomogram model showed excellent predictive performance, with an AUC of 0.924 (95% CI, 0.856–0.991).
SCIT demonstrated favorable clinical efficacy in pediatric AR patients. Gender, family history, place of residence, total IgE, dust mite sIgE, and EOS were independent predictors of poor treatment outcomes and may facilitate early identification of high-risk populations.
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23. Zhu W, Gao P, Zhang Q, Chen J. Efficacy and Safety of Subcutaneous Immunotherapy for Local Allergic Rhinitis: A Meta-Analysis of Randomized Controlled Trials. Am J Rhinol Allergy. 2022;36(2):245–52.
24. Stefanovic N, Irvine AD, Flohr C. The Role of the Environment and Exposome in Atopic Dermatitis. Curr Treat Option Al. 2021;8(3):222–41.
25. Tukaj S. Dual role of autoantibodies to heat shock proteins in autoimmune diseases. Front Immunol. 2024;15:1421528.
26. Sharma A, Deshmukh P, Jain S, Gaurkar S, Sharma A. Unraveling the Molecular Threads: A Comprehensive Review of the Pathogenesis and Therapeutic Insights Into Allergic Rhinitis. Cureus J Med Science. 2024;16(7):e64410.
27. Chen D, Liu W, Li Y. Successful treatment of severe and recurrent hand eczema with infection in human immunodeficiency virus patients: A case report. Sage Open Med Case R. 2024;12:2050313X241260471.
28. Komolafe K, Pacurari M. CXC Chemokines in the Pathogenesis of Pulmonary Disease and Pharmacological Relevance. Int J Inflamm. 2022;2022:4558159.
29. Liao W, Chen L, Bai J. Systemic reactions to subcutaneous immunotherapy for bronchial asthma and/or allergic rhinitis in children and their risk factors. Zhongguo Dang Dai Er Ke Za Zhi = Chinese Journal of Contemporary Pediatrics. 2020;22(11):1204–8.
30. Lane MR, Lowe A, Vukcevic J, Clark RG, Madani G, Higgins DP, et al. Health Assessments of Koalas after Wildfire: A Temporal Comparison of Rehabilitated and Non-Rescued Resident Individuals. Animals-Basel. 2023;13(18):2863.
31. Li B, Ma X, Lai S, Sun X, Sun M, Chang B. Development and validation of a prognostic nomogram for colorectal cancer after surgery. World J Clin Cases. 2021;9(21):5860–72.
2. Lin Y, Liu J, He J, Wu L, Li S, Cheng B, et al. Effects of subcutaneous immunotherapy in allergic rhinitis children sensitive to dust mites. Allergol Immunopath. 2023;51(1):84–91.
3. Rodriguez-Plata E, Callero Viera A, Ruiz-Garcia M, Gomez-Cardenosa A, Nieto E, García-Robaina JC. House dust mite subcutaneous immunotherapy has sustained long-term effectiveness on allergic rhinitis and asthma: A 10-year follow-up. Immun Inflamm Dis. 2023;11(10):e1004.
4. Zeng X, Li J, Liu J, Mo L, Liu Y, Zhang A, et al. Nasal mucosal fibroblasts produce IL-4 to induce Th2 response. Innate Immun-London. 2024;30(2-4):55–65.
5. Fan K, Zhou S, Jin L, Tan S, Lai J, Zhang Z, et al. Identification of key genes and the pathophysiology associated with allergen-specific immunotherapy for allergic rhinitis. Bmc Immunol. 2023;24(1):19.
6. Tversky J, Patel P, Sowho M, Natarajan R, Chung T, Whelton A, et al. Randomized double-blind pilot study of universal, species abundant, multiallergen subcutaneous immunotherapy for moderate-severe allergic rhinitis. Annals of Allergy, Asthma & Immunology: Official Publication of the American College of Allergy, Asthma, & Immunology. 2023;131(1):89–95.
7. Drazdauskaitė G, Layhadi JA, Shamji MH. Mechanisms of Allergen Immunotherapy in Allergic Rhinitis. Curr Allergy Asthm R. 2020;21(1):2.
8. Field K, Blaiss MS. Sublingual Versus Subcutaneous Immunotherapy for Allergic Rhinitis: What Are the Important Therapeutic and Real-World Considerations? Curr Allergy Asthm R. 2020;20(9):45.
9. Feng X, Liu J. A novel dose-adjustment protocol for interrupted subcutaneous immunotherapy for allergic rhinitis. Immunotherapy-Uk. 2023;15(14):1171–81.
10. Tie K, Miller C, Zanation AM, Ebert CSJ. Subcutaneous Versus Sublingual Immunotherapy for Adults with Allergic Rhinitis: A Systematic Review with Meta-Analyses. The Laryngoscope. 2022;132(3):499–508.
11. Pavon-Romero GF, Larenas-Linnemann DE, Xochipa Ruiz KE, Ramirez-Jimenez F, Teran LM. Subcutaneous Allergen-Specific Immunotherapy Is Safe in Pediatric Patients with Allergic Rhinitis. Int Arch Allergy Imm. 2021;182(6):553–61.
12. Subspecialty Group Of Rhinology EBOC, Subspecialty Group Of Rhinology SOOH. Chinese guidelines for diagnosis and treatment of allergic rhinitis. Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi = Chinese Journal of Otorhinolaryngology Head and Neck Surgery. 2016;51(1):6–24.
13. Tamasauskiene L, Gasiuniene E, Sitkauskiene B. Translation, adaption and validation of the total nasal symptom score (TNSS) for Lithuanian population. Health Qual Life Out. 2021;19(1):54.
14. Endaryanto A, Nugraha RA. Safety Profile and Issues of Subcutaneous Immunotherapy in the Treatment of Children with Allergic Rhinitis. Cells-Basel. 2022;11(9):1584.
15. Wang N, Song J, Sun S, Zhu K, Li J, Wang Z, et al. Immune signatures predict response to house dust mite subcutaneous immunotherapy in patients with allergic rhinitis. Allergy. 2024;79(5):1230–41.
16. Valero A, Ibáñez-Echevarría E, Vidal C, Raducan I, Castelló Carrascosa JV, Sánchez-López J. Efficacy of subcutaneous house dust mite immunotherapy in patients with moderate to severe allergic rhinitis. Immunotherapy-Uk. 2022;14(9):683–94.
17. Wang C, Bao Y, Chen J, Chen X, Cheng L, Guo YS, et al. Chinese Guideline on Allergen Immunotherapy for Allergic Rhinitis: The 2022 Update. Allergy Asthma Immun. 2022;14(6):604–52.
18. Kang K, Deng X, Xie W, Chen J, Lin H, Chen Z. Rhodotorula mucilaginosa ZTHY2 Attenuates Cyclophosphamide-Induced Immunosuppression in Mice. Animals-Basel. 2023;13(21):3376.
19. Specjalski K, Maciejewska A, Romantowski J, Pawłowski R, Jassem E, Niedoszytko M. miRNA profiles change during grass pollen immunotherapy irrespective of clinical outcome. Immunotherapy-Uk. 2022;14(6):433–44.
20. Sharma M, Bhargava A, Szpunar SM, Johnson LB, Saravolatz LD. Do risk factors at the time of hospital admission differ by sex for in-hospital mortality from coronavirus disease 2019 (COVID-19)? Antimicrobial Stewardship & Healthcare Epidemiology: ASHE. 2021;1(1):e55.
21. Yonghua S, Mehrabi Nasab E, Liuo Y. Effect of Temperature and Humidity on the Allegro-inflammatory Factors and Allergic Rhinitis-related Behavior. Iranian Journal of Allergy, Asthma, and Immunology. 2022;21(6):704–10.
22. Helevä A, Murtomäki A, Huhtala H, Bousquet J, Luukkainen A, Karjalainen J, et al. Risk factors of NSAID-exacerbated respiratory disease: A population-based study. Clin Transl Allergy. 2023;13(8):e12296.
23. Zhu W, Gao P, Zhang Q, Chen J. Efficacy and Safety of Subcutaneous Immunotherapy for Local Allergic Rhinitis: A Meta-Analysis of Randomized Controlled Trials. Am J Rhinol Allergy. 2022;36(2):245–52.
24. Stefanovic N, Irvine AD, Flohr C. The Role of the Environment and Exposome in Atopic Dermatitis. Curr Treat Option Al. 2021;8(3):222–41.
25. Tukaj S. Dual role of autoantibodies to heat shock proteins in autoimmune diseases. Front Immunol. 2024;15:1421528.
26. Sharma A, Deshmukh P, Jain S, Gaurkar S, Sharma A. Unraveling the Molecular Threads: A Comprehensive Review of the Pathogenesis and Therapeutic Insights Into Allergic Rhinitis. Cureus J Med Science. 2024;16(7):e64410.
27. Chen D, Liu W, Li Y. Successful treatment of severe and recurrent hand eczema with infection in human immunodeficiency virus patients: A case report. Sage Open Med Case R. 2024;12:2050313X241260471.
28. Komolafe K, Pacurari M. CXC Chemokines in the Pathogenesis of Pulmonary Disease and Pharmacological Relevance. Int J Inflamm. 2022;2022:4558159.
29. Liao W, Chen L, Bai J. Systemic reactions to subcutaneous immunotherapy for bronchial asthma and/or allergic rhinitis in children and their risk factors. Zhongguo Dang Dai Er Ke Za Zhi = Chinese Journal of Contemporary Pediatrics. 2020;22(11):1204–8.
30. Lane MR, Lowe A, Vukcevic J, Clark RG, Madani G, Higgins DP, et al. Health Assessments of Koalas after Wildfire: A Temporal Comparison of Rehabilitated and Non-Rescued Resident Individuals. Animals-Basel. 2023;13(18):2863.
31. Li B, Ma X, Lai S, Sun X, Sun M, Chang B. Development and validation of a prognostic nomogram for colorectal cancer after surgery. World J Clin Cases. 2021;9(21):5860–72.
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| Issue | Articles in Press | |
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| Keywords | ||
| Allergic rhinitis Influencing factors Prediction model Subcutaneous immunotherapy | ||
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How to Cite
1.
Zhang S, Zhao X, Ke J, Shen X, Yang M, Xu M. Application of Subcutaneous Immunotherapy in Pediatric Patients with Allergic Rhinitis and Analysis of Logistic Regression Models. Iran J Allergy Asthma Immunol. 2026;:1-11.
