***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 Subcutaneous allergen-specific immunotherapy ( SIT ) has an early onset of action , whereas repeated injections and safety concerns have limited its use in the pediatric age group . Meanwhile , the improved safety profile of the sublingual route has been accepted as an alternative despite its relatively late onset of action . OBJECTIVE We sought to improve the efficacy and safety of SIT with a combination of the subcutaneous route in the build-up phase and sublingual maintenance in comparison with the sublingual or subcutaneous routes alone . METHODS Fifty-one house dust mite-sensitized children with mild-to-moderate asthma were r and omized into one of 4 groups to receive either ( 1 ) subcutaneous immunotherapy ( SCIT ) , ( 2 ) sublingual immunotherapy ( SLIT ) , ( 3 ) SCIT plus SLIT , or ( 4 ) pharmacotherapy . Clinical parameters were evaluated at baseline and months 1 , 4 , 12 , and 18 . Allergen-specific immunoglobulin levels and allergen-induced IL-5 , IL-10 , IL-13 , IL-17 , TGF-β , and IFN-γ levels were evaluated as well . RESULTS In the SCIT and SCIT plus SLIT groups , the number of asthma attacks and inhaled corticosteroid dosage decreased compared with baseline values at the months 4 , 12 , and 18 but only at month 12 in the SLIT group . The improvement in visual analog scores for rhinitis was significant only in the SCIT plus SLIT group . Increases in the levels of regulatory and T(H)1 cytokines were observed both in the SCIT and SLIT groups , with some differences in dynamics . Antigen-specific IgG(4 ) levels increased in the SCIT and SCIT plus SLIT groups but not in the SLIT group . Clinical symptom scores were correlated positively with IL-5 levels and negatively with antigen-specific IgG(4 ) , IFN-γ , and TGF-β levels . CONCLUSION Our novel regimen of immunotherapy , SCIT plus SLIT , appeared promising in that it successfully combined the advantages of the 2 alternatives : rapid onset and potency in SCIT and safety and avoidance of injections in SLIT OBJECTIVE We evaluated , by means of a multicentre , prospect i ve observational trial , the severity in term of symptoms and symptomatic drugs use and the presence of asthma in subjects with tree or cypress or olive , or ragweed or parietaria allergy and we evaluated also the efficacy of a consecutive 2-year specific sublingual immunotherapy treatment . PATIENTS AND METHOD Consecutive patients suffering of respiratory allergies ( rhinoconjunctivitis and /or mild moderate asthma ) due to one of the described allergens were enrolled During the specific relevant pollen seasons for each allergens nose and eye symptoms and medication scores ( SS and MS ) were evaluated Global score ( GS ) was calculated as the sum of SS and MS . An Asthma symptom score if present , were also , calculated A total of 162 patients were enrolled in 14 Italian Allergic Clinics . Patients were treated with the relevant specific sublingual immunotherapy ( SLITOne , ALK ) for two consecutive pollen seasons . RESULTS At baseline prevalence of allergies was the following : tree 18 % ( 30 patients ) ; ragweed 14 % ( 23 patients ) ; olive 7 % ( 11 patients ) ; cypress 7 % ( 12 patients ) and pellitory 53 % ( 86 patients ) . At baseline asthma was detected in 65 patients ( 40 % ) . Asthma was more common in poli-sensitive subjects in comparison with mono-sensitive ( 51 % vs. 300/o ) . According to allergen type , asthma was present in 47 % of pellitory allergic patients , in 45 % of olive allergic subjects , in 38 % of ragweed allergic patients , in 26 % of tree allergic patients and only in 9 % of cypress allergic subjects . In pellitory , olive and ragweed allergic patients the frequency of asthma was statistically significant ( P=0.0055 ) higher in comparison with other groups . At baseline GS mean ( SD ) in the whole population was 17(7 ) . GS during the following 2 consecutive seasons with SLIT treatment decreased significantly ( P=0.0001 ) to 9 ( 5 ) and to 7 ( 5 ) , respectively ( a reduction of 59 % in comparison with baseline ) . In patients with asthma the mean clinical score decreased significantly from baseline value of 2 . 7 to 0.3 at the end of the observation period No serious adverse events were reported Local side effects , mainly oral itching , were reported by 14 % of patients and were mild and transient in nature . CONCLUSION In this population pellitory , olive and ragweed allergies are associated with a more severe clinical picture in comparison with tree and cypress allergy . A two-year SLIT treatment was associated with a significant reduction in SS , MS , GS and asthma score in comparison with baseline . SLIT was also safe and well BACKGROUND The association between genetic predisposition and environmental risk factors such as passive smoke in determining respiratory allergies is still uncertain ; even less is known about the role played by passive smoking in influencing the success of therapy for rhinitis and allergic asthma . OBJECTIVE The purpose of this prospect i ve , r and omised study was to determine whether passive smoking influences the outcome of therapies in paediatric patients with allergic respiratory diseases . METHODS The study included 68 children ( mean age 11.51 years ; range : 5 - 17 ) suffering from perennial rhinitis and intermittent asthma monosensitised to Dermatophagoides . Thirty-four subjects were exposed to daily passive smoking in their families , 34 were not . The two groups have been then r and omised to receive continuous treatment with cetirizine or SLIT for three years . RESULTS There were 3/34 ( 8.8 % ) dropouts in the SLIT arm and 4/34 ( 11.7 % ) in the cetirizine arm . After three years , the patients exposed to passive smoking showed higher nasal eosinophilia , a worse clinical -symptomatic and pharmacological score with a worsened bronchial reactivity and functional indices of persistent asthma , regardless of how they had been treated . Nevertheless , SLIT prevented the worsening of all the clinical parameters more than the antihistamine alone either among the children exposed to smoking or not . CONCLUSIONS Exposure to passive smoking in children suffering from respiratory allergies due to Dermatophagoides decreased the clinical response to both drug therapy and SLIT . Nonetheless , while the children su bmi tted to drug therapy worsened or did not show any significant improvement , the ones treated with SLIT improved 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 : Data supporting a carry‐over effect with sublingual immunotherapy ( SLIT ) are scarce . This r and omized , double‐blind , placebo‐controlled study evaluated the efficacy , carry‐over effect and safety of grass pollen SLIT using co‐seasonal treatment BACKGROUND Few studies have compared the effects of immunotherapy and inhaled steroids . The main limitation of such studies is the long duration required to fully appreciate the effects of immunotherapy . OBJECTIVE To compare the effects of inhaled budesonide and sublingual immunotherapy ( SLIT ) in mild persistent asthma for up to 5 years . METHODS Patients with mild persistent asthma and rhinitis due to grass pollen were enrolled in an open r and omized controlled trial . After a run-in season , they were r and omized to either budesonide , 800 microg/d , in the pollen season or continuous grass SLIT for 5 years . All patients received rescue medications . Symptoms were evaluated by diary cards filled out from May to July at baseline and after 3 and 5 years . In-season nasal eosinophils and bronchial hyperresponsiveness were also assessed . RESULTS Fifty-one patients were enrolled and 46 completed the study . The bronchial symptom scores and the use of bronchodilators decreased significantly in both groups , but the improvement was greater in the SLIT patients at 3 and 5 years . The nasal symptom score and the intake of nasal steroids decreased only in the SLIT group , and the difference vs the budesonide group was always significant . In the SLIT group vs the budesonide group , a statistically significant decrease of nasal eosinophils was found at 3 and 5 years ( P < .01 ) . The bronchial hyperresponsiveness improved significantly only in the SLIT group . CONCLUSION In patients with grass pollen-induced asthma , in the long term SLIT was equally effective as inhaled budesonide in treating bronchial symptoms and provided an additional benefit in treating rhinitis symptoms and bronchial hyperresponsiveness BACKGROUND No studies have directly compared the effects of immunotherapy and antileukotrienes due to the long time required to appreciate the clinical effects of immunotherapy . We compared the effect of montelukast ( MK ) and SLIT added to st and ard therapy in moderate asthma over 5 years . METHODS Open r and omized controlled trial . Patients with moderate asthma ( and rhinitis ) solely due to birch pollen were r and omized to receive either MK ( 10 mg/d ) or birch sublingual immunotherapy ( SLIT ) in the pollen seasons , in addition to formoterol/fluticasone . All the patients also received salbutamol and cetirizine as rescue medications . Asthma and rhinitis symptoms were recorded on diary cards from February to May at baseline and after 3 and 5 years of study . In-season nasal eosinophils and bronchial hyperresponsiveness were also evaluated . RESULTS Thirty-three adult patients were enrolled and 29 completed the study . The groups were homogeneous at baseline . Bronchial and nasal symptom scores were lower at 3 and 5 years compared to baseline in the SLIT group . Bronchial hyperresponsiveness and bronchodilator use decreased significantly in both groups at 5 years , but only in the SLIT group at 3 years . In the SLIT group there was a significant decrease in nasal eosinophils compared to baseline and to the MK group . CONCLUSION In patients with birch pollen-induced moderate asthma and rhinitis , the addition of SLIT provides a greater clinical benefit than that of MK BACKGROUND Immunotherapy with the SQ-st and ardized grass tablet Grazax is efficacious and well-tolerated in adult patients 
    Output:
    
In AR patients with concomitant persistent asthma , SLIT reduces medication needs while maintaining symptom control .
This holds especially true for house dust mite SLIT .
Data on pollen SLIT and lung symptom improvement with SLIT , however , are less convincing .