الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
Asthma is a heterogeneous disease characterized by chronic inflammation of the airway defined by history recurrent respiratory symptoms such as wheezes cough and shortness of breath variable over time and intensity with variable expiratory airflow limitation. The significant of eosinophilic inflammation in asthma is well established. Immunotherapy acts by modifying T cell responses either by immune derivation (increase in Th0/Th1) or T cell energy (decrease Th2/Th0) or both, depending on a number of factors including the nature of the allergen, the allergen dose, adjuvants used. Successful desensitization might be associated with a shift in IL-4/IFN- production either as a consequence of down regulation of Th2 responses or increased Th1 responses. The aim of this study was to evaluate the efficacy of sublingual allergen immunotherapy versus subcutaneous allergen immunotherapy as regard clinical response, serum IgE and sputum eosinophils as an objective assessment of SCIT and SLIT efficacy. This randomized controlled clinical trial included 100 patients with bronchial asthma. Patients in the study were randomly allocated into two groups: the sublingual immunotherapy (SLIT) group (n = 50) and the subcutaneous immunotherapy (SCIT) group (n = 50) who attended to Mansoura University Asthma and Allergy clinic from August 2021 to August 2023. The study was accepted by Institutional Research Board (IRB) with a code number (MD.21.09.522.R1). The results showed that: The mean age of studied patients received immunotheraphy was 26years and most of the patients were females from rural. Sixty percent (60%) and (54%) of studied patient in SCIT and SLIT group receptivelly were BA alone while the remaining 40% in SLIT & 46 % in SLIT were BA and AR (combined airway disease) with no significant difference between both groups. Molds, HD-Mites & pollens were the commonest offending allergens found in SPT results of both groups. There was statistically significant decrease in IgE levels and sputum eosinophil results at 6,12 months and more at 18 months (P 0.001) after of starting either SCIT or SLIT. Conclusions: Both treatment modalities SCIT and SLIT were equally effective in the treatment of bronchial asthma. SLIT had a higher safety profile than SCIT. Additionally, SLIT is more convenient to the patient and avoids pain and discomfort associated with the repeated injections of SCIT. Therefore SLIT is an effective alternative to SCIT in these patient groups. Clinical improvement may precede immunological effects of AIT.