{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T07:16:06Z","timestamp":1788419766462,"version":"build-2803163510"},"reference-count":57,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T00:00:00Z","timestamp":1788393600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Immunol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>House dust mite allergen immunotherapy (HDM-AIT) trials in allergic rhinitis show substantial efficacy heterogeneity, traditionally evaluated by administration route. Whether clinical efficacy differs among HDM-AIT preparations with different allergen compositional breadth remains unclear.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To compare HDM-AIT efficacy using a component-resolved framework that stratifies preparations by allergen compositional breadth.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We searched PubMed, Embase, and CENTRAL for double-blind, placebo-controlled randomized trials of HDM-AIT lasting at least 12 months. Interventions were classified as comprehensive-component subcutaneous immunotherapy (CC-SCIT), major-component-dominant subcutaneous immunotherapy (MCD-SCIT), or major-component-dominant sublingual immunotherapy tablet (MCD-SLIT-tablet) using a prespecified component-resolved framework in which the breadth of treatment-induced component-specific IgG4 responses served as the primary node-defining criterion, with component-specific IgG and proteomic evidence used as supportive evidence. Frequentist pairwise and Bayesian network meta-analyses were performed. The primary outcome was symptom score; secondary outcomes were medication score and combined symptom and medication score.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Sixteen trials involving 7,329 participants were included. For symptom score, CC-SCIT showed the most favorable estimated treatment effect versus placebo (standardized mean difference [SMD], \u22120.40; 95% credible interval [CrI], \u22120.73 to \u22120.11; surface under the cumulative ranking curve [SUCRA], 82.6%), while MCD-SLIT-tablet showed a more precise estimate supported by a larger evidence base (SMD, \u22120.30; 95% CrI, \u22120.41 to \u22120.20; SUCRA, 60.7%). For medication score, CC-SCIT (SMD, \u22120.40; 95% CrI, \u22120.81 to 0.00; SUCRA, 79.8%) and MCD-SCIT (SMD, \u22120.38; 95% CrI, \u22120.72 to \u22120.05; SUCRA, 78.5%) showed similar estimated effects, whereas MCD-SLIT-tablet showed a smaller but more precise effect (SMD, \u22120.15; 95% CrI, \u22120.28 to 0.00; SUCRA, 39.9%). For combined symptom and medication score, CC-SCIT showed the largest estimated effect versus placebo (SMD, \u22120.84; 95% CrI, \u22121.53 to \u22120.37; SUCRA, 99.5%). The network was star-shaped, and comparisons among non-placebo treatment nodes were indirect. Posterior rank distributions also indicated uncertainty in the relative ordering of the treatment nodes, particularly those supported by fewer trials.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Reported immunologic and compositional profiles of HDM-AIT preparations were associated with variability in trial-level efficacy estimates. These findings support product-level molecular characterization and direct comparative studies as priorities for future precision AIT.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Systematic review registration<\/jats:title>\n                    <jats:p>\n                      <jats:ext-link>https:\/\/www.crd.york.ac.uk\/PROSPERO\/view\/<\/jats:ext-link>\n                      , CRD420261307571.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fimmu.2026.1947642","type":"journal-article","created":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T06:40:50Z","timestamp":1788417650000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Efficacy of house dust mite allergen immunotherapy in allergic rhinitis: a network meta-analysis based on component-resolved 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Hefei","place":["Anhui, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xingyu","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology, Head and Neck Surgery, Hefei Third People\u2019s Hospital, Hefei","place":["Anhui, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dahui","family":"Zha","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology, Head and Neck Surgery, Hefei Third People\u2019s Hospital, Hefei","place":["Anhui, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yisen","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology, Head and Neck Surgery, Hefei Third People\u2019s Hospital, Hefei","place":["Anhui, 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