The Evaluation Value of the Modified Lund-Kennedy Nasal Endoscopy Score on the Efficacy of Sublingual Immunotherapy for Allergic Rhinitis

Abstract

Objective

Allergic rhinitis (AR) is a growing public health problem worldwide. Respecting the significance of the modified Lund-Kennedy (MLK) score in rhinitis assessment, we delved into its evaluation value on the sublingual immunotherapy (SLIT) efficacy in AR patients.

Methods

Totally 100 AR patients were enrolled, with pre- and post-SLIT MLK score, total nasal symptoms score (TNSS), total medication score (TMS), visual analogue scale (VAS), inflammatory cytokines, and immune function-related parameters compared. The correlations of MLK score with TNSS/TMS/VAS, as well as with IL-4/INF-γ/eosinophil (EOS)/percentage/specific immunoglobulin (sIgE)/sIgG were assessed by Spearman correlation analysis. The value of MLK score on assessing SLIT efficacy in AR patients was analyzed.

Results

SLIT treatment reduced MLK/TNSS/TMS/VAS scores, abated IL-4 level/EOS percentage/sIgE, and elevated INF-γ/sIgG levels. MLK score was positively correlated with pre- and post-SLIT TNSS score (r_{pre−treatment}= 0.592, r_{post−treatment}= 0.756), TMS score (r_{pre−treatment}= 0.385, r_{post−treatment}= 0.718), VAS score (r_{pre−treatment}= 0.369, r_{post−treatment}= 0.704), IL-4 (r_{pre−treatment}= 0.553, r_{post−treatment}= 0.639), EOS percentage (r_{pre−treatment}= 0.511, r_{post−treatment}= 0.632), and sIgE (r_{pre−treatment}= 0.472, r_{post−treatment}= 0.524), and negatively with INF-γ (r_{pre−treatment}= −0.418, r_{post−treatment}= −0.578) and sIgG4 (r_{pre−treatment}= −0.460, r_{post−treatment}= −0.613). The MLK score had an area under curve of 0.846 (77.01% sensitivity, 76.92% specificity, 4 cut-off value) and 0.944 (91.67% sensitivity, 92.11% specificity, 2 cut-off value) for assessing SLIT treatment as effective and markedly effective for the patients, respectively.

Conclusion

The MLK score had good evaluation value on the efficacy of SLIT treatment in AR patients.