الفهرس 
BRONCHIAL ASTHMAOnly 14 pages are availabe for public view
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Abstract
Immune modulation offers the only opportunity to modify the underlying disease processes of asthma in the long-term as number of medication have been successfully used in the prevention and treatment of immediate and late-phase hypersensitivity responses which define the allergic diathesis however, only allergic immune-therapy (IT) has proven effective in the reversal of the hypersensitivity reaction. (Certicoet al , 2003)
Clinical studies are currently addressing the efficacy of sublingual (oral) Immune-therapy in the treatment of allergies. (plaser et al, 2005).
The aim of the work in this study was designed to evaluate efficacy of sublingual-swallow Immunotherapy in comparison to the traditional subcutaneous Immunotherapy in reduction of the bronchial hyperreactivity in asthmatic patients sensitive to house dust.
This study is an intervention study( controlled randomized clinical trial) , done at el Demerdash hospital from September 2007 to November 2008.
This study included 100 asthmatic patients sensitive to house dust according to history & skin test their mean ages were 26.6 , 26.5 years for 2 groups respectivly.
Male were 48%, female 52% among group 1 while male were 50% , female 50% among group 2.
They were classified & received specific Immunotherapy for 6 months as follows:-
• Group 1 50 asthmatics received sublingual-swallow Immunotherapy in addition to usual measure on demand.
Group 2 50 asthmatics received regular subcutaneous Immunotherapy in addition to usual measure on demand
METHODS:-
4) All patients are subjected to full history and clinical examination
5) Routine laboratory tests: CBC by automated blood counter, kidney function test by colorimetric methods(Henary et al 1974), liver function test (verley et al 1984)
6) Specific tests: done before & after immunotherapy :
a. Bronchial provocation test to assess the bronchial
Hyper reactivity (specific & non specific).
b. peak expiratory flow rate.
c. Skins prick tests.
d. Esinophils counts.
e. Serum IgE.
4)-Immunotherapy
Our results shows the following Our study showed Demographic characteristic of the study groups as age, sex, duration , family history are match together with no statistically significant difference , matching is necessary to eliminate effect of any confounding variable to our study.
Our study show reduction in levels of Eosionphelia (1.5), Immunoglobulin E level (137.2)and after oral immunotherapy,Eosinophilia become(.82), Immunoglobulin E level become(97.4) which is statistically highly significant .
Our results show also highly significant difference after oral immunotherapy , more cases become in the normal levels (from 6% to 24%) , cases with sever elevation was 22% before treatment and become zero after treatment which reflect efficacy of treatment
Our study shows measurment of peak expiratory flow rate which classify asthmatics patients as mild, moderate and sever with improvement in severity of cases after oral immunotherapy , more cases become mild , before treatment mild cases were(34%) of our study group but after oral treatment become (62%).as regard severe cases were (22%) before treatment and Zero % after treatment.
Our study show marked reduction in levels of Eosionphelia(3.8) before treatment , Immunoglobulin E level (304.9) and after SC immunotherapy Eosinophilia (.08) , Immunoglobulin E (94.7) which is statistically highly significant.
It show also highly significant difference after SC immunotherapy , more cases become in the normal levels (from 16% to 52%)and cases with sever immunoglobulin elevation was 15% before treatment and become zero after treatment which reflect efficacy of treatment. .
Our study shows measurement of PEFR which classify asthmatics patients as mild , moderate, severe after SC immunotherapy more cases become mild before treatment was (62%) and after treatment mild case represent ( 90%) and as regard severe cases before treatment were ( 18%) and after treatment severe cases were zero %. As shown in table
Our results shows more improvement with subcutaneous immunotherapy than sublingual immunotherapy