***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: The present study aim ed to evaluate the efficacy of three-year subcutaneous SQ-st and ardized specific immunotherapy ( SCIT ) in house dust mite (HDM)-allergic children with asthma . Ninety children with allergic asthma to HDMs , with or without allergic rhinitis , were r and omly divided into two groups , the treatment group and the control group . The treatment group received SCIT combined with st and ardized glucocorticoid management and the control group received st and ardized glucocorticoid management alone for a period of three years . The mean daily dose of inhaled corticosteroids ( ICSs ) , a four-week diary recording the symptom scores of asthma , peak expiratory flow ( PEF ) measurements , skin prick test results and serum immunoglobulin E ( IgE ) levels were assessed prior to treatment and following one , two and three years of treatment . The median dose of ICS  was reduced in the treatment group after two and three years of treatment compared with that of the control group . After three years of treatment , the discontinuation percentage of ICS in the treatment group was higher than that in the control group . The treatment group demonstrated significantly reduced daytime and night-time asthmatic symptom scores , increased PEF values and reduced serum IgE levels after two and three years of treatment compared with those in the control group ( P<0.05 ) . In conclusion , three-year SCIT treatment combined with ICS is an effective immunotherapy for children with allergic asthma and result ed in a reduction of the required ICS dose Forty‐six asthmatics with verified allergy to the house dust mite , D. pteronyssinus ( Dp ) , participated in a double‐blind study comparing the effect of 2 years ' hyposensitization with two different Dp extracts .  Two groups received either monomethoxypolyethylene glycol modified ( mPEG ) Dp extract or the corresponding non‐modified extract , and a third group acted as controls receiving no injections . Medicine consumption , symptom scores , and peak expiratory flow ( PEF ) were recorded daily from September to December prior to and after 6 and 18 months of treatment . Changes were calculated choosing changes 10 % as relevant . In addition , patients were asked to give their direct assessment of the clinical effect at the end of the study . After 6 months , there was an improvement in symptoms + medication in 11/14 of Dp‐treated , 6/17 of the mPEG‐Dp group ( P > 0.05 ) and 3/15 of openly treated controls . Few patients had changed in PEF . During the second year , several Dp‐treated relapsed and some controls improved . At the end of the study the same improvement rate was seen in all groups . Similarly , the retrospective question naire data did not disclose any significant differences between groups after 2 years . In conclusion , hyposensitization with unmodified Dp extract seemed to have a favourable short‐term effect on bronchial symptoms + medication in the majority of patients . When mainly on maintenance dose , the beneficial effect was reduced . The mPEG modification of the extract had reduced not only allergenicity but also the clinical effect of equal doses . Changes in medicine and symptom scores only partly correlated to retrospective assessment , thus stressing the problems in this kind of evaluation A double-blind clinical trial of hyposensitization with aqueous extracts of Dermatophagoides pteronyssinus ( the house-dust mite ) and human skin scales showed a substantial improvement in symptoms in 11 asthmatics allergic to house dust treated with the D. pteronyssinus extract  and a reduction in their need for other therapy . Five patients were well for a year but six relapsed . These results contrasted with the generally unfavourable course of the patients treated with the extract of human skin scales .  Asthma due to house-dust allergy may be substantially improved by hyposensitization with D. pteronyssinus extract IMPORTANCE The house dust mite ( HDM ) sublingual allergen immunotherapy ( SLIT ) tablet is a potential novel treatment option for HDM allergy-related asthma . OBJECTIVES To evaluate the efficacy and adverse events of the HDM SLIT tablet vs placebo for asthma exacerbations during an inhaled corticosteroid ( ICS ) reduction period . DESIGN , SETTING S , AND PARTICIPANTS Double-blind , r and omized , placebo-controlled  trial conducted between August 2011 and April 2013 in 109 European trial sites . The trial included 834 adults with HDM allergy-related asthma not well controlled by ICS or combination products , and with HDM allergy-related rhinitis . Key exclusion criteria were FEV1 less than 70 % of predicted value or hospitalization due to asthma within 3 months before r and omization .  Efficacy was assessed during the last 6 months of the trial when ICS was reduced by 50 % for 3 months and then completely withdrawn for 3 months . INTERVENTIONS 1:1:1 r and omization to once-daily treatment with placebo ( n = 277 ) or HDM SLIT tablet ( dosage groups : 6 SQ-HDM [ n = 275 ] or 12 SQ-HDM [ n = 282 ] ) in addition to ICS and the short-acting β2-agonist salbutamol . MAIN OUTCOMES AND MEASURES Primary outcome was time to first moderate or severe asthma exacerbation during the ICS reduction period . Secondary outcomes were deterioration in asthma symptoms , change in allergen-specific immunoglobulin G4 ( IgG4 ) , change in asthma control or asthma quality -of-life question naires , and adverse events . RESULTS Among 834 r and omized patients ( mean age , 33 years [ range , 17 - 83 ] ; women , 48 % ) , 693 completed the study . The 6 SQ-HDM and 12 SQ-HDM doses both significantly reduced the risk of a moderate or severe asthma exacerbation compared with placebo ( hazard ratio [ HR ] : 0.72 [ 95 % CI , 0.52 - 0.99 ] for the 6 SQ-HDM group , P = .045 , and 0.69 [ 95 % CI , 0.50 - 0.96 ] for the 12 SQ-HDM group , P = .03 ) . The absolute risk differences based on the observed data ( full analysis set ) in the active groups vs the placebo group were 0.09 ( 95 % CI , 0.01 - 0.15 ) for the 6 SQ-HDM group and 0.10 ( 95 % CI , 0.02 - 0.16 ) for the 12 SQ-HDM group . There was no significant difference between the 2 active groups . Compared with placebo , there was a reduced risk of an exacerbation with deterioration in asthma symptoms ( HR , 0.72 [ 95 % CI , 0.49 - 1.02 ] for the 6 SQ-HDM group , P = .11 , and 0.64 [ 95 % CI , 0.42 - 0.96 ] for the 12 SQ-HDM group , P = .03 ) and a significant increase in allergen-specific IgG4 . However , there was no significant difference for change in asthma control question naire or asthma quality -of-life question naire for either dose . There were no reports of severe systemic allergic reactions . The most frequent adverse events were mild to moderate oral pruritus ( 13 % for the 6 SQ-HDM group , 20 % for the 12 SQ-HDM group , and 3 % for the placebo group ) , mouth edema , and throat irritation . CONCLUSIONS AND RELEVANCE Among adults with HDM allergy-related asthma not well controlled by ICS , the addition of HDM SLIT to maintenance medications improved time to first moderate or severe asthma exacerbation during ICS reduction , with an estimated absolute reduction at 6 months of 9 to 10 percentage points ; the reduction was primarily due to an effect on moderate exacerbations . Treatment-related adverse events were common at both active doses . Further studies are needed to assess long-term efficacy and safety . TRIAL REGISTRATION clinical trialsregister.eu Identifier : 2010 - 018621 - 19 BACKGROUND Cockroach allergy is a key contributor to asthma morbidity in children living in urban environments . OBJECTIVE We sought to document immune responses to cockroach allergen and provide direction for the development of immunotherapy for cockroach allergy . METHODS Four pilot studies were conducted : ( 1 ) an open-label study to assess the safety of cockroach sublingual immunotherapy ( SLIT ) in adults and children ; ( 2 ) a r and omized , double-blind biomarker study of cockroach SLIT versus placebo in adults ; ( 3 ) a r and omized , double-blind biomarker study of 2 doses of cockroach SLIT versus placebo in children ; and ( 4 ) an open-label safety and biomarker study of cockroach subcutaneous immunotherapy ( SCIT ) in adults . RESULTS The adult SLIT trial ( n = 54 ; age , 18 - 54 years ) found a significantly greater increase in cockroach-specific IgE levels between the active and placebo groups ( geometric mean ratio , 1.92 ; P < .0001 ) and a trend toward increased cockroach-specific IgG4 levels in actively treated subjects ( P = .09 ) but no evidence of functional blocking antibody response . The pediatric SLIT trial ( n = 99 ; age , 5 - 17 years ) found significant differences in IgE , IgG , and IgG4 responses between both active groups and the placebo group but no consistent differences between the high- and low-dose groups . In the SCIT study the treatment result ed in significant changes from baseline in cockroach IgE , IgG4 , and blocking antibody levels . The safety profile of cockroach immunotherapy was reassuring in all studies . CONCLUSIONS The administration of cockroach allergen by means of SCIT is immunologically more active than SLIT , especially with regard to IgG4 levels and blocking antibody responses . No safety concerns were raised in any age group . These pilot studies suggest that immunotherapy with cockroach allergen is more likely to be effective with SCIT Continuing study for a second year and further analysis of a double‐blind placebo controlled trial , already briefly reported , of injections of tyrosine‐adsorbed , glutaraldehyde‐modified Dermatophagoides pteronyssinus antigen in fifty‐one children with perennial asthma and positive bronchial challenge to the antigen , confirms that the patients receiving the treatment reduced their symptomatic medication more than controls , without deterioration of symptoms . Some became symptom‐free , when off all treatment BACKGROUND The safety and efficacy of specific immunotherapy for mold allergy are not known in children and adolescents . OBJECTIVE We evaluated the efficacy and safety of specific immunotherapy with a st and ardized allergen extract in a r and omized , double-blind , placebo-controlled , 3-year prospect i ve study of patients who were allergic to only Alternaria alternata . METHODS Fifty children and adolescents ( 25 girls ; 5 - 18 years of age ) with A alternata-induced seasonal allergic rhinoconjunctivitis and /or bronchial asthma were r and omly assigned to groups given treatment ( Novo-Helisen Depot , A alternata 100 % ) or placebo . The primary end point was the combined symptom medication score . Secondary end points included safety , quality of life , and sensitivity to allergen-specific nasal challenge . RESULTS Forty-five children completed the 3-year study . Although there was no significant change in year 1 , the combined symptom medication score decreased in years 2 and 3 of the study ( by 38.7 % and 63.5 % , respectively ; P < .001 for each ) . The reduction in symptoms was associated with a significant improvement in quality of life ( P < .05 ) and decrease in sensitivity after allergen-specific nasal challenge . Side effects were observed in 7 patients ; the most common ( edema at the site of injection ) occurred after 11 injections . CONCLUSIONS Allergen-specific immunotherapy with st and ardized A alternata extract reduces symptoms of asthma and rhinoconjunctivitis in children and adolescents without serious side effects Hyposensitisation with Dermatophagoides pteronyssinus tyrosine absorbate in asthmatic children with bronchial sensitivity to D. pteronyssinus  was effective in a 12-month double-blind controlled clinical trial . Compared with controls , treated children used a smaller quantity of drugs while maintaining clinical and lung function improvements . In most children who improved there was no change in immediate response to D. pteronyssinus on bronchial provocation test , but the late reaction was lost in half the patients and these showed the greatest improvement in symptoms BACKGROUND Cells producing a T(H2)-cytokine profile play an important role in the onset and maintenance of atopic diseases , and therefore specific immunotherapy is aim ed to induce a switch to cells producing a T(H1)- or T(H0)-cytokine profile . Recently , a novel form of immunotherapy making use of synthetic peptides from the major cat allergen Fel d 1 has been developed , but its mechanisms of action are unknown . OBJECTIVES We examined the effects of immunotherapy with Fel d 1 peptides on the response to bronchial provocation tests ( PD20FEV1 ) with a st and ardized Fel d 1 cat extract on Fel d 1-specific serum IgE and IgG levels and in vitro IL-4 and 
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This was robust to a prespecified sensitivity analyses , but there was evidence suggestive of publication bias .
For secondary outcomes , subcutaneous immunotherapy ( SCIT ) improved quality of life and decreased allergen-specific airway hyperreactivity ( AHR ) , but this was not the case for sublingual immunotherapy ( SLIT ) .
There were no consistent effects on asthma control , exacerbations , lung function , and nonspecific AHR .
AIT result ed in a modest increased risk of adverse events ( AEs ) .
Although relatively uncommon , systemic AEs were more frequent with SCIT ; however no fatalities were reported .
The limited evidence on cost-effectiveness was mainly available for sublingual immunotherapy ( SLIT ) and this suggested that SLIT is likely to be cost-effective .
AIT can achieve substantial reductions in short-term symptom and medication scores in allergic asthma .
It was however associated with a modest increased risk of systemic and local AEs .