Haemophilus abundance is associated with response to sublingual immunotherapy in children with allergic rhinitis.
Elevated nasal Haemophilus levels are linked to more severe allergic rhinitis in children, and its reduction after treatment may indicate a positive response to sublingual immunotherapy.
Where it sits
this study against the rest of the zenagamtide corpusSummary and findings
This study evaluated the relationship between Haemophilus abundance and response to sublingual immunotherapy (SLIT) in children with allergic rhinitis (AR). A total of 63 children with AR and 40 healthy controls were enrolled, with patients stratified by disease severity. Results indicated that elevated nasal Haemophilus is associated with AR severity and its depletion correlates with SLIT efficacy.
Abstract
<h4>Background</h4>The nasal microbiome's role in predicting sublingual immunotherapy (SLIT) efficacy in children with allergic rhinitis (AR) remains unclear. Haemophilus, a Proteobacteria genus linked to respiratory inflammation, is a promising candidate biomarker.<h4>Objective</h4>To evaluate Haemophilus dynamics as a potential predictor of SLIT response in children with moderate-severe AR.<h4>Methods</h4>In this prospective cohort, 63 children with AR and 40 healthy controls (CG) were enrolled. AR patients were stratified by disease severity (mild [MAR] vs. moderate-severe [MSAR]), with MSAR patients receiving 1-year standardized house dust mite SLIT. Based on >20% reduction in Total Nasal Symptom Score (TNSS), patients were classified as responders (RG, n = 25) or non-responders (NRG, n = 15). Nasal microbiome was profiled via 16S rDNA sequencing.<h4>Results</h4>Compared to CG, AR children showed increased alpha diversity (Chao1, p < .05; Shannon, p < .01) and enrichment of Staphylococcus. MSAR patients had significantly higher Proteobacteria abundance, particularly Haemophilus, compared to MAR (LDA score >4, p < .001). After SLIT, RG patients showed normalized microbial evenness (Pielou E index) to CG levels, driven by marked Haemophilus depletion (p < .001). In contrast, NRG patients maintained high Haemophilus abundance. Haemophilus and Moraxella showed strong positive correlation (r = .68, p < .001), with both decreasing in RG post-SLIT.<h4>Conclusion</h4>Elevated nasal Haemophilus is associated with AR severity, and its depletion correlates with SLIT efficacy. Haemophilus may serve as a clinically actionable microbial biomarker for monitoring SLIT response in pediatric AR, offering a novel precision medicine approach to allergen immunotherapy.
Background
The role of the nasal microbiome in predicting the efficacy of sublingual immunotherapy (SLIT) in children with allergic rhinitis (AR) is not well understood. Previous research has suggested that specific microbial profiles may influence respiratory inflammation and treatment outcomes. This study aims to clarify the association between Haemophilus dynamics and SLIT response, potentially identifying a biomarker for monitoring treatment efficacy in pediatric AR.
Methods
This prospective cohort study included 63 children with AR and 40 healthy controls. AR patients were stratified by disease severity into mild (MAR) and moderate-severe (MSAR) groups, with MSAR patients receiving 1-year standardized house dust mite SLIT. Patients were classified as responders or non-responders based on a >20% reduction in Total Nasal Symptom Score (TNSS). The nasal microbiome was profiled using 16S rDNA sequencing.
Results
Compared to healthy controls, AR children exhibited increased alpha diversity (Chao1, p<0.05; Shannon, p<0.01) and higher levels of Staphylococcus. MSAR patients had significantly greater Proteobacteria abundance than MAR patients (LDA score >4, p<0.001). Following SLIT, responders showed normalized microbial evenness (Pielou E index) to levels comparable to healthy controls, driven by significant Haemophilus depletion (p<0.001), while non-responders retained high Haemophilus levels.
Interpretation
The findings suggest that elevated Haemophilus levels are associated with increased severity of AR and that its depletion may indicate a positive response to SLIT. However, the clinical significance of these findings should be interpreted with caution, as the effect sizes may not be substantial enough to warrant changes in practice without further validation. Limitations such as small sample size and the observational nature of the study may confound the conclusions drawn.
Key findings
- Increased alpha diversity in AR children compared to controls (Chao1, p<0.05; Shannon, p<0.01).
- MSAR patients had significantly higher Proteobacteria abundance compared to MAR (LDA score >4, p<0.001).
- RG patients showed marked Haemophilus depletion post-SLIT (p<0.001).
- NRG patients maintained high Haemophilus abundance.
- Strong positive correlation between Haemophilus and Moraxella (r=0.68, p<0.001).
Limitations
- small sample size of 63 AR children
- observational cohort design
- short follow-up duration
- no long-term outcome data