Research On Level Changes Of Serum IL-10, IL-35, Other Indicators With SLIT And Clinical Efficacy

Objectives: This study was aimed to explore the mechanism of specificsublingual immunotherapy (SLIT) by comparing levels of serum IL-10, IL-17, IL-35,specific IgE(sIgE) and specific IgG4(sIgG4) between Dermatophagoidesfarinae-allergic rhinitis and/or asthma children with the SLIT treatment and healthycontrol children, and to evaluate the clinical effect as well as security of the SLIT.Method: The study was performed between a case group with30Dermatophagoides farinae-allergic rhinitis and/or asthma children(aged4-14yr), anda normal control group with30healthy ones（aged4-14yr）. The case group has beentreated with Dermatophagoides farinae drops for2years. For each group, thefollowing indicators were measured, including the ratio of forced expiratory volumein one second (FEV1) and its expected value, or the ratio of airway resistance and itsexpected value, peripheral blood eosinophil（Eos）count, and the level of serumindicators (IL-10,IL-17,IL-35,sIgE,sIgG4). Besides, indicators of the case group wasmeasured respectively, i.e. before using SLIT, after the SLIT treatment for1year and2years. At the same time, the rhinitis/asthma symptom scores of case group wererated. The efficacy and adverse reactions of treatment were also assessed.Results:1IL-10and IL-35comparison: For the case group, before using SLIT and afterthe SLIT treatment for1year, the level of serum IL-10and IL-35are significantlylower than the normal control group(P＜0.01); after the SLIT treatment for1year,the level of serum IL-10and IL-35are significantly higher than that before usingSLIT(P＜0.01); after the SLIT treatment for2years, the level of serum IL-10andIL-35are significantly higher than that after the SLIT treatment for1year(P＜0.01);after the SLIT treatment for2years, the level of serum IL-10and IL-35are slightlylower than the normal control group(P＞0.05).2IL-17comparison：For the case group, before using SLIT and after the SLITtreatment for1year, the level of serum IL-17is significantly higher than the normalcontrol group(P＜0.01); after the SLIT treatment for1year, the level of serum IL-17 is significantly lower than that before using SLIT(P＜0.01); after the SLIT treatmentfor2years, the level of serum IL-17is significantly lower than that after the SLITtreatment for1year(P＜0.01); after the SLIT treatment for2years, the level of serumIL-17is slightly higher than the normal control group(P＞0.05).3sIgE comparison: For the case group, before using SLIT and after the SLITtreatment for1year and2years, the level of serum sIgE is significantly higher thanthe normal control group(P＜0.01); the level of serum sIgE after the SLIT treatmentfor1year is slightly lower than that before using SLIT(P＞0.05); after the SLITtreatment for2years, the level of serum sIgE is significantly lower than that after theSLIT treatment for1year(P＜0.01).4sIgG4comparison: For the case group, before using SLIT, the level of serumsIgG4is slightly higher than the normal control group(P＞0.05); after the SLITtreatment for1year and2years, the level of serum sIgG4is significantly higher thanthe normal control group(P＜0.01); after the SLIT treatment for1year, the level ofserum sIgG4is significantly higher than that before using SLIT(P＜0.01); after theSLIT treatment for2years, the level of serum sIgG4is significantly higher than thatafter the SLIT treatment for1year(P＜0.01).5For the case group, after the SLIT treatment for1year, the value of Eos count,the ratio of airway resistance and its expected value, total rhinitis symptomsscore(TRSS), total asthma symptoms score(TASS) and total symptoms score(TSS)are lower than that before using SLIT(P＜0.01); after the SLIT treatment for2years,the value of Eos count, the ratio of airway resistance and its expected value, TRSS,TASS and TSS are lower than that after the SLIT treatment for1year(P＜0.01); afterthe SLIT treatment for1year, the value of the ratio of FEV1and its expected value ishigher than that before using SLIT(P＜0.01); after the SLIT treatment for2years, thevalue of the ratio of FEV1and its expected value is higher than that after the SLITtreatment for1year(P＜0.01).6The correlation among serum cytokines and the correlation between serumcytokines and TSS: for the case group, before using SLIT and after the SLITtreatment for1year and2years, sIgG4is positively correlated with IL-10, butnegatively correlated with TSS; before using SLIT and after the SLIT treatment for1 year and2years, IL-10is negatively correlated with TSS; before and after SLIT for1year, IL-35is negatively correlated with both IL-17and TSS.7Treatment efficacy: For the case group, with SLIT treatment for2years, theimproved percentage of TSS is significantly higher than that for1yea（rP＜0.01）；theefficacy of SLIT treatment for1year reveals markedly effective73.3%, effective26.7%, ineffective0%; while the SLIT treatment for2years reveals markedlyeffective100%, effective0%, ineffective0%.8Adverse reactions: For the case group, some mild local adverse reactions (suchas oral discomfort and local itching) happened in17patients during the SLITtreatment for1year; all of local adverse reactions can quickly relive without specialtreatment; no systemic adverse reactions happened in the treatment; and no local orsystemic adverse reactions happened during the SLIT treatment for2years.Conclusion:1SLIT can inhibit the expression of IL-17, promote the expressionof IL-10, IL-35and sIgG4, bring the level of IL-10, IL-17and IL-35to normal state;2SLIT may gain the treatment effects by modulating the expression of IL-10, sIgG4and IL-35, IL-17.3SLIT is a safe and effective treatment for children with allergicrhinitis and asthma, and the efficacy of SLIT treatment for2years is better than thatfor1year.