***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: BACKGROUND The natural history of allergic sensitization is complex and poorly understood . A prospect i ve nonr and omized study was carried out in a population of asthmatic children younger than 6 years of age whose only allergic sensitivity was to house dust mites ( HDMs ) . OBJECTIVES The study was design ed to determine whether specific immunotherapy ( SIT ) with st and ardized allergen extracts could prevent the development of new sensitizations over a 3-year follow-up survey . METHODS We studied 22 children monosensitized to HDM who were receiving SIT with st and ardized allergen extracts and 22 other age-matched control subjects who were monosensitized to HDM .  The initial investigation included a full clinical history , skin tests with a panel of st and ardized allergens , and the measurement of allergen-specific IgE , depending on the results of skin tests . Children were followed up on an annual basis for 3 years , and the development of new sensitizations in each group was recorded . RESULTS Ten of 22 children monosensitized to HDM who were receiving SIT did not have new sensitivities compared with zero of 22 children in the control group ( p = 0.001 , chi square test ) . CONCLUSIONS This study suggests that SIT in children monosensitized to HDM alters the natural course of allergy in preventing the development of new sensitizations Background : The clinical efficacy and safety of a  six‐grass pollen allergoid  has been studied . The advent of more exacting clinical guidelines and a better appreciation of the possible mechanisms of treatment prompted this re appraisal Background : Although widely practice d for over 80 years , the role of specific immunotherapy ( SIT ) in pediatric asthma treatment is still controversial . We assessed the effects of a 3‐year period of subcutaneous administration of a st and ardized preparation of Dermatophagoides pteronyssinus ( D pt ) on the respiratory health in a group of asthmatic children monosensitized to house dust mite ( HDM ) BACKGROUND Previous studies have suggested that single-allergen-specific immunotherapy ( SIT ) may prevent sensitization to other airborne allergens in monosensitized children . We aim ed to assess the prevention of new sensitizations in monosensitized children treated with single-allergen SIT injections in comparison with monosensitized patients given appropriate pharmacologic treatment for their disease . METHODS A total of 147 children with rhinitis and /or asthma monosensitized to house dust mite were studied ; 45 patients underwent SIT with adsorbed extracts and 40 patients underwent SIT with aqueous extracts for 5 years . The control group was comprised of 62 patients given only pharmacologic treatment for at least 5 years . Skin prick tests , medication scores for rhinitis and asthma , and atopy scores according to skin prick tests were evaluated at the beginning and after 5 years of treatment . RESULTS All groups were comparable in terms of age , sex , and disease characteristics . At the end of 5 years , 64 out of 85 ( 75.3 % ) in the SIT group showed no new sensitization , compared to 29 out of 62 children ( 46.7 % ) in the control group ( P = .002 ) . There were no differences between the SIT subgroups with regard to onset of new sensitization ( P = .605 ) . The patients developing new sensitizations had higher atopy scores ( P = .002 ) and medication scores for both rhinitis ( P = .008 ) and asthma ( P = .013 ) in comparison to patients not developing new sensitizations after 5 years of SIT . CONCLUSION According to our data , SIT has the potential to prevent the onset of new sensitizations in children with rhinitis and /or asthma monosensitized to house dust mite BACKGROUND Allergen immunotherapy ( desensitization ) by injection is effective for seasonal allergic rhinitis and has been shown to induce long-term disease remission . The sublingual route also has potential , although definitive evidence from large r and omized controlled trials has been lacking . OBJECTIVE The aim was to confirm the efficacy of a rapidly dissolving grass allergen tablet ( GRAZAX , ALK-Abelló , Hørsholm , Denmark ) compared with placebo in patients with seasonal rhinoconjunctivitis . METHODS A longitudinal , double-blind , placebo-controlled , parallel-group study that included 51 centers from 8 countries . Subjects were r and omized ( 1:1 ) to receive a grass allergen tablet or placebo once daily . A total of 634 subjects with a history of grass pollen-induced rhinoconjunctivitis for at least 2 years and confirmation of IgE sensitivity ( positive skin prick test and serum-specific IgE ) were included in the study . Subjects commenced treatment at least 16 weeks before the grass pollen season , and treatment was continued throughout the entire season . RESULTS The primary efficacy analysis showed a reduction of 30 % in rhinoconjunctivitis symptom score ( P < .0001 ) and a reduction of 38 % in rhinoconjunctivitis medication score ( P < .0001 ) compared with placebo . Side effects mainly comprised mild itching and swelling in the mouth that was in general well tolerated and led to treatment withdrawal in less than 4 % of participants . There were no serious local side effects and no severe systemic adverse events . CONCLUSION Sublingual immunotherapy with grass allergen tablets was effective in grass pollen-induced rhinoconjunctivitis . The tablet was well tolerated with minor local side effects . CLINICAL IMPLICATION S The grass allergen tablet represents a safe alternative to injection immunotherapy suitable for home use BACKGROUND Sublingual immunotherapy ( SLIT ) has been proved to be effective in allergic rhinitis and asthma , but there are few data on its preventive effects , especially in children . OBJECTIVE To evaluate the clinical and preventive effects of SLIT in children by assessing onset of persistent asthma and new sensitizations , clinical symptoms , and bronchial hyperreactivity . METHODS A total of 216 children with allergic rhinitis , with or without intermittent asthma , were evaluated and then r and omized to receive drugs alone or drugs plus SLIT openly for 3 years . The clinical score was assessed yearly during allergen exposure . Pulmonary function testing , methacholine challenge , and skin prick testing were performed at the beginning and end of the study . RESULTS One hundred forty-four children received SLIT  and 72 received drugs only . Dropouts were 9.7 % in the SLIT group and 8.3 % in the controls . New sensitizations appeared in 34.8 % of controls and in 3.1 % of SLIT patients ( odds ratio , 16.85 ; 95 % confidence interval , 5.73 - 49.13 ) . Mild persistent asthma was less frequent in SLIT patients ( odds ratio , 0.04 ; 95 % confidence interval , 0.01 - 0.17 ) . There was a significant decrease in clinical scores in the SLIT group vs the control group since the first year . The number of children with a positive methacholine challenge result decreased significantly after 3 years only in the SLIT group . Adherence was 80 % or higher in 73.8 % of patients . Only 1 patient reported systemic itching . CONCLUSIONS In everyday clinical practice , SLIT reduced the onset of new sensitizations and mild persistent asthma and decreased bronchial hyperreactivity in children with respiratory allergy Sublingual-specific immunotherapy ( SLIT ) is considered as a valid treatment of respiratory allergies . However , there are few data on large sample size regarding its clinical role in ' real life ' in term of reduction of symptoms , rescue medications and prevention of asthma in patients suffering from allergic rhinitis ( AR ) especially in children . We performed a multicenter , case-control study to evaluate the effect of SLIT in children ( age 6 - 18 yr ) with intermittent or persistent AR . 171 children ( 27 % girls and 73 % boys ) with AR due to seasonal or perennial allergens were enrolled in a multicenter case-control study . Cases ( n = 90 ) were defined as patients with intermittent ( 64 % ) or persistent ( 36 % ) AR who were treated for at least two consecutive years with specific SLIT with the related allergen extracts ( SLITone ALK-Abellò ) .  Controls ( n = 81 ) were defined as sex-age- and type of allergen matched AR children who were never treated with specific immunotherapy and had no asthmatic symptoms at the beginning of observation period . Main outcomes of the study were the rhinoconjunctivitis symptom score ( SS ) ( sneezing , rhinorrea , nasal itch , congestion , ocular itch and watery eyes ) with a ranging scale from 0 ( = no symptoms ) to 3 ( = severe symptoms ) and the medication score ( MS ) evaluating symptomatic drug intake ( antihystamine and inhaled corticosteroids ) . SS and MS were evaluated at the end of the observational period in relation with the period , considering the last 12 months , in which patients suffered the highest symptoms levels ( i.e. , peak of relevant pollen season ( seasonal AR ) or during the period of maximum allergen exposure in case of perennial AR ) . Secondary outcome of the study was the development of asthma symptoms during the observation period . SS ( mean + /- SD ) was 4.5 + /- 2.5 in cases and 9.0 + /- 3.0 in controls ( -50 % ) ( p = 0.0001 ) . MS ( mean + /- SD ) was 2.5 + /- 1.9 and 3.6 + /- 2.1 in the case and control groups , respectively ( -31 % ) ( p = 0.0001 ) . At the end of the observation period asthma symptoms were present in 14 subjects in the case group ( 15 % ) and in 20 children ( 24 % ) in the control group ( p = 0.13 ) . New skin sensitizations appeared in 6 % of cases ( n = 2 ) and in 36 % ( n = 12 ) of the controls ( p = 0.001 ) . The EFESO trial shows that a 2-yr once daily SLIT treatment in children with intermittent or persistent AR is associated with lower symptom and medication scores in comparison with subjects treated with symptomatic drugs only BACKGROUND We wondered whether short-term coseasonal sublingual immunotherapy ( SLIT ) can reduce the development of  asthma in children with hay fever in an open r and omized study . OBJECTIVE We sought to determine whether SLIT is as effective as subcutaneous immunotherapy in reducing hay fever symptoms and the development of asthma in children with hay fever . METHODS One hundred thirteen children aged 5 to 14 years ( mean age , 7.7 years ) with hay fever limited to grass pollen and no other clinical ly important allergies were r and omized in an open study involving 6 Italian pediatric allergy centers to receive specific SLIT for 3 years or st and ard symptomatic therapy . All of the subjects had hay fever symptoms , but at the time of study entry , none reported seasonal asthma with more than 3 episodes per season . Symptomatic treatment was limited to cetirizine , loratadine , nasal budesonide , and salbutamol on dem and . The hay fever and asthma symptoms were quantified clinical ly . RESULTS The actively treated children used less medication in the second and third years of therapy , and their symptom scores tended to be lower . From the second year of immunotherapy , subjective evaluation of overall allergy symptoms was favorable in the actively treated children . Development of asthma after 3 years was 3.8 times more frequent ( 95 % confidence limits , 1.5 - 10.0 ) in the control subjects . CONCLUSIONS Three years of coseasonal SLIT improves seasonal allergic rhinitis symptoms and reduces the development of seasonal asthma  in children with hay fever Summary The present guideline ( S2k ) on allergen-specific immunotherapy ( AIT ) was established by the German , Austrian and Swiss professional associations for allergy in consensus with the scientific specialist societies and professional associations in the fields of otolaryngology , dermatology and venereology , pediatric and adolescent medicine , pneumology as well as a German patient organization ( German Allergy and Asthma Association ; Deutscher Allergie- und Asthmabund , DAAB ) according to the criteria of the Association of the Scientific Medical Societies in Germany ( Arbeitsgemeinschaft der Wissenschaftlichen Medizinischen Fachgesellschaften , AWMF).AIT is a therapy with disease-modifying effects . By administering allergen extracts , specific blocking antibodies , toler-ance-inducing cells and mediators are activated . These prevent further exacerbation of the allergen-triggered immune response , block the specific immune response and attenuate the inflammatory response in tissue . Products for SCIT or SLIT can not be compared at present due to their heterogeneous composition , nor can allergen concentrations given by different manufacturers be compared meaningfully due to the varying methods used to measure their active ingredients . Non-modified allergens are used for SCIT in the form of aqueous or physically adsorbed ( depot ) extracts , as well as chemically modified allergens ( allergoids ) as depot extracts . Allergen extracts for SLIT are used in the form of aqueous solutions or tablets . The clinical efficacy of AIT is measured using various scores as primary and secondary study endpoints . The EMA stipulates combined symptom and medication scores as primary endpoint . A harmonization of clinical endpoints , e. g. , by using the combined symptom and medication scores 
    Output:
    
Small studies and studies with a shorter follow-up showed the highest benefit of AIT .