Sublingual Immunotherapy for Allergic Rhinoconjunctivitis – The Seeming and the Real

Reider, Norbert

doi:10.1159/000086329

Cited by 11 publications

(10 citation statements)

References 80 publications

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“…Both positive [16,17] and disappointing [18,19] results have been reported. In the vast majority of studies, pollen extracts have been used via the sublingual route.…”

Section: Discussionmentioning

confidence: 99%

Comparison of the Long-Term Efficacy of Subcutaneous and Sublingual Immunotherapies in Perennial Rhinitis

Tahamiler¹,

Saritzali²,

Çanakçıoğlu³

et al. 2008

ORL

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Background: Both sublingual and subcutaneous immunotherapies have a documented clinical efficacy, but only a few comparative studies have been performed. Objectives: To evaluate and compare the long-term efficacies of subcutaneous and sublingual immunotherapy. Methods: One hundred and ninety-three patients with house dust mite allergies, out of an original total of 230, were treated with subcutaneous and sublingual house dust mite-specific immunotherapies for 3 years and also observed for 3 years after discontinuation of the treatment. The patients were randomized into 2 groups: the sublingual group (97 patients) and the subcutaneous group (96 patients). The therapy’s success was evaluated using the symptom score, skin prick test results, and the nasal allergen challenge score. The patients were evaluated at the beginning of the study, at the end of years 1, 2, and 3, and also at the end of the 1st and 3rd years after discontinuation of the specific immunotherapy treatment. Results: Immunotherapy induced a significant improvement during the treatment and the follow-up period. We found a greater improvement in the subcutaneous group compared to the sublingual group when we looked at the comparative results of the total 6 years. Conclusion: We suggest subcutaneous immunotherapy for patients with perennial allergic rhinitis due to the better results that were obtained during our study period. Nevertheless, sublingual immunotherapy is now accepted by WHO as a valid alternative to the subcutaneous route and should be used in all patients who require immunotherapy and do not accept the subcutaneous route of allergen administration.

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“…Both positive [16,17] and disappointing [18,19] results have been reported. In the vast majority of studies, pollen extracts have been used via the sublingual route.…”

Section: Discussionmentioning

confidence: 99%

Comparison of the Long-Term Efficacy of Subcutaneous and Sublingual Immunotherapies in Perennial Rhinitis

Tahamiler¹,

Saritzali²,

Çanakçıoğlu³

et al. 2008

ORL

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“…In the studies reported to date no differences in clinical efficacy were demonstrated in subjects with allergic rhinitis treated with HDM [47], mixed grass pollen [48] or birch pollen extracts [49] but SCIT was superior to SLIT in decreasing asthma scores in the HDM study [47]. More comparative studies are required before it can be concluded that SLIT can be recommended as an alternative to SCIT [50]. Some data suggest that SLIT is more cost-effective than SCIT [28,38] but again, further studies are needed.…”

Section: Clinical Efficacy and Safety Of Slitmentioning

confidence: 96%

Sublingual Allergen Immunotherapy: Immunological Mechanisms and Prospects for Refined Vaccine Preparations

O’Hehir

Sandrini²,

Anderson³

et al. 2007

CMC

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Allergic diseases constitute a major health issue worldwide. Mainstay treatment constitutes allergen avoidance and pharmacotherapy for symptom relief, but allergen immunotherapy offers advantages of specific treatment with long lasting efficacy, and being able to modify the course of the disease. Conventional immunotherapy involves the subcutaneous injection of gradually increasing amounts of allergen extract but the use of current whole allergen extracts is restricted by the risk of adverse IgE-mediated events especially for potent allergens such as peanut and latex and for asthmatics. This has lead to interest in alternative routes of immunotherapy. Oral tolerance is a well-documented immune process and the sublingual route of administration of allergen immunotherapy is attracting interest. Recent meta-analyses show that sublingual allergen immunotherapy for grass pollen and house dust mite allergy is clinically effective and safer than injection immunotherapy. Some studies show SLIT induces changes of T cell anergy, immune deviation, blocking antibodies, and induction of regulatory T cells, as described for injection immunotherapy pointing to the need to target allergen-specific T cells, there is emergent evidence that the oral mucosa presents distinct regulatory features. Evidence suggests that oral dendritic cells play a key role in inducing tolerance especially when allergen is taken up via Fc receptor bound IgE. This suggests that although both would target allergen-specific T cells, allergen formulations may differ with respect to IgE epitopes for optimal SLIT compared with SCIT. Identification of the molecular nature of the allergen-DC receptor interaction is required to determine whether short peptides or recombinant allergen preparations and of suitable adjuvants specifically tailored for the sublingual route will allow the development of improved allergen formulations and delivery strategies for efficacy of treatment whilst decreasing IgE-mediated adverse effects.

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“…SLIT in clinical practice is controversial. Both positive 7,8 and disappointing 9,10 results have been reported. In the most studies, pollen extracts have been used sublingually 11 .…”

Section: Discussionmentioning

confidence: 99%

Long‐Term Efficacy of Sublingual Immunotherapy in Patients With Perennial Rhinitis

2007

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Sublingual Immunotherapy for Allergic Rhinoconjunctivitis – The Seeming and the Real

Cited by 11 publications

References 80 publications

Comparison of the Long-Term Efficacy of Subcutaneous and Sublingual Immunotherapies in Perennial Rhinitis

Comparison of the Long-Term Efficacy of Subcutaneous and Sublingual Immunotherapies in Perennial Rhinitis

Sublingual Allergen Immunotherapy: Immunological Mechanisms and Prospects for Refined Vaccine Preparations

Long‐Term Efficacy of Sublingual Immunotherapy in Patients With Perennial Rhinitis

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