Abstract
The demand for allergen specific immunotherapy (AIT), especially sublingual immunotherapy (SLIT), is increasing because of its efficacy in inducing clinical remission of allergic diseases and its low risk of side effects. Since not all patients that undergo SLIT demonstrate an improvement in allergic symptoms, the development of biomarkers to predict the outcome and adjuvants for SLIT is desired. Saliva is the first target with which tablets used in SLIT come into contact, and salivary pH, chemical properties or microbiome composition are reported to possibly be associated with the outcome of SLIT. Antibodies such as IgG4 and IgA not only in the serum but also in the saliva are increased after SLIT and may also be associated with the efficacy of SLIT. The development of the metagenomic sequencing technique makes it possible to determine the microbiome composition and ratio of each bacterium, and researchers can investigate the relationships between specific bacteria and the immune response. Some bacteria are reported to improve the SLIT outcome and have the potential to be used as biomarkers for the selection of patients and as adjuvants in SLIT. Here, we introduce biomarkers for SLIT and present recent findings regarding the relationship between saliva and SLIT.
Highlights
Allergen-specific immunotherapy (AIT) can reduce allergic symptoms and induce the clinical remission of patients from IgE-mediated allergic diseases including allergic rhinitis (AR), atopic asthma and venom allergy [1,2,3]
Both serum/salivary IgG4 and IgA are increased after sublingual immunotherapy (SLIT) in food allergy or allergic rhinitis patients [20,21,22]
Because the tablet used in SLIT first comes into contact with the oral cavity or saliva, the salivary microbiome may have some effects on SLIT
Summary
Allergen-specific immunotherapy (AIT) can reduce allergic symptoms and induce the clinical remission of patients from IgE-mediated allergic diseases including allergic rhinitis (AR), atopic asthma and venom allergy [1,2,3]. The effectiveness of SLIT is reported to be similar to that of SCIT, but not all patients who undergo AIT experience substantial improvement in their allergic symptoms [4]. Saliva contains various microorganisms and establishes a local microbiome, and patients with local disorders such as dental caries or periodontal diseases and systemic disorders such as allergic, inflammatory or malignant diseases are reported to have dysbiosis in their saliva [5,6,7]. According to the development of research on the salivary microbiome, the discovery of microorganisms which can be used as biomarkers to predict the effectiveness of SLIT and of probiotics to improve the outcome of SLIT is expected
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