Oral Hyposensitisation with Enteric-Coated Allergens as Extension Therapy following a Basic Subcutaneous Course of Injections

Abstract

We investigated in grass-pollen-sensitive adults the efficacy and safety of a therapeutic hyposensitisation regimen consisting of a basic pre-seasonal course of tyrosine-adsorbed glutaraldehyde-modified grass pollen extract (Pollinex), followed by oral extension treatment using encapsulated, particulate, enteric-coated grass pollen allergen. The daily recorded symptom scores both of these patients and of others treated with complete basic and extension courses of Pollinex indicated that both sets of patients had fared better during the grass pollen season than control patients who had received only the basic Pollinex injections.

Local immunotherapy: pharmacokinetics and efficacy

“…According to the presently available data, the use of OIT as extension and prosecution of a course of subcutaneous IT is not justified (60,61). Interestingly, in two comparison studies (62,63), SLIT appeared to be as effective as SIT and better accepted and tolerated, and these results have been confirmed in a rigorous double-blind, doubledummy fashion (63).…”

Allergen immunotherapy

“…Local nasal, sublingual, and oral routes for immunotherapy also may be effective in reducing symptoms of pollen-and mite-induced rhinitis in children as well as adults [24][25][26][27][28][29][30][31][32]. Allergens administered orally may be destroyed by gastric digestion and therefore must be administered at doses at least 100 to 1000 times greater than those required by the subcutaneous route to induce serologic and clinical effects.…”

“…Allergens administered orally may be destroyed by gastric digestion and therefore must be administered at doses at least 100 to 1000 times greater than those required by the subcutaneous route to induce serologic and clinical effects. However, oral immunotherapy with grass pollen extract in enteric-coated capsules has been used effectively as booster therapy after a short course of conventional subcutaneous immunotherapy for priming [28]. In a more recent study, microencapsulated short ragweed pollen extract administered at doses only slightly higher than those used in high-dose subcutaneous immunotherapy reduced symptom-medication scores and blunted the seasonal rise in specific IgE antibodies [30].…”

Immunogenicity in Guinea Pigs and Tolerance in Grass Pollen-Sensitive Volunteers of Enteric-Coated Grass Pollen Allergens

“…Further work is in progress to study the effect of oral immunotherapy with enteric-coated allergen fol lowing a short course of parenteral injections in grass pollen-sensitive individuals [6].…”