Course Of Sublingual Immunotherapy Research Articles

Enhancing quality of life with 3-year course of sublingual immunotherapy for house dust mite-induced allergic rhinitis: An observational prospective study in real-life settings

PurposeThis prospective study aims to provide further supportive evidence by assessing the sustained effectiveness and safety of sublingual immunotherapy (SLIT) using a vaccine containing house dust mite (HDM) extracts in patients diagnosed with allergic rhinitis (AR) with/without conjunctivitis (AR/C). Materials and methodsAR/C patients (n = 111, SLIT group: 57, control group: 54) allergic to HDM were treated with standardized SLIT drops or symptomatic drugs from October to December in 2020. The patients were directed by the investigators to attend annual hospital visits for the assessment of various parameters including the Rhinoconjunctivitis Quality of Life Questionnaire (RQLQ), visual analog scale (VAS), total nasal symptom score (TNSS), total ocular symptom score (TOSS) and total medication score (TMS). During the study period, all participants were mandated to maintain comprehensive records of any adverse events (AEs) on diary cards, which were then communicated to the investigators via telephone. ResultsAt baseline (2020), TNSS, TOSS, TMS, VAS, and RQLQ scores were comparable between SLIT and control groups (P > 0.05). After one year of treatment (2021), significant reduction in all scores compared to the baseline for both groups (P < 0.001). At the end of the second year of treatment (2022), TNSS and RQLQ score in the SLIT group continued to decrease significantly compared to 2021 (P < 0.05). In the third year (2023), the control group showed a rebound in TNSS, TOSS, TMS, and RQLQ scores, significant differences compared to 2022 or 2021 (P < 0.05). Besides, the SLIT group had significantly lower scores across all domains of RQLQ compared to the control group (P < 0.001). Symptomatic treatment influenced the scores of Nasal Symptoms, Eye Symptoms, Practical Problems, and Emotions domains significantly in 2023 compared to 2021 or 2022 (P < 0.05). Within the SLIT group, no significant differences in TNSS, TMS, VAS, and RQLQ scores were observed between monosensitized and polysensitized patients throughout the three years of treatment (P > 0.05). All AEs were mild to moderate. ConclusionThe 3-year course of HDM-SLIT has shown significant therapeutic efficacy and a favorable safety profile in patients with AR/C. Importantly, our study presents initial evidence suggesting that the greater impact of AR/C on quality of life (QoL) may primarily stem from nasal symptoms, eye symptoms, practical issues, and emotional well-being.

RNA sequencing of single allergen-specific memory B cells after grass pollen immunotherapy: Two unique cell fates and CD29 as a biomarker for treatment effect.

Sublingual immunotherapy (SLIT) for grass pollen allergy can modify the natural history of allergic rhinitis and is associated with increased allergen-specific IgG4 . IgG4 competitively inhibits functional IgE on the surface of effector cells, such as mast cells and basophils, from binding to allergens. To further understand the important role memory B-cell (Bmem) responses play in mediating the beneficial effects of SLIT, we assessed changes in allergen-specific Bmem subsets induced by SLIT for grass pollen allergy. Blood samples were collected twice outside the pollen season from twenty-seven patients with sensitization to ryegrass pollen (RGP; Lolium perenne) and seasonal rhinoconjunctivitis. Thirteen received 4-month pre-seasonal SLIT for grass pollen allergy, and 14 received standard pharmacotherapy only. Single-cell RNA sequencing was performed on FACS-purified Lol p 1-specific Bmem before and after SLIT from four patients, and significant genes were validated by flow cytometry on the total cohort. Four months of SLIT increased RGP-specific IgE and IgG4 in serum and induced two Lol p 1-specific Bmem subsets with unique transcriptional profiles. Both subsets had upregulated expression of beta 1 integrin ITGB1 (CD29), whereas IGHE (IgE), IGHG4 (IgG4 ), FCER2 (CD23), and IL13RA1 were upregulated in one subset. There was an increase in the proportion of Lol p 1+ Bmem expressing surface IgG4 , CD23, and CD29 after SLIT. A clinically successful 4months course of SLIT for grass pollen allergy induces two transcriptionally unique Bmem fates. Associated changes in surface-expressed proteins on these Bmem subsets can be used as early biomarkers for treatment effects.

Sublingual allergen-specific therapy in a child with diabetes mellitus

A description of a clinical case of a pediatric patient (boy, age 12 at the start of observation) with pollen allergy (allergic rhino-conjunctivitis to grass pollen) in combination with insulin-dependent diabetes mellitus is presented. Initiation criteria of allergen-specific immunotherapy (clear seasonal peak of exacerbations, high and concordant data of allergotesting In vivo and In vitro, progredient course of pollinosis clinical signs during years before allergen-specific immunotherapy was started) discussed in case of comorbid patient. Possible risks were analyzed and absence of diabetes mellitus as contraindication for immunotherapy stated. The patient underwent 2 pre-coseasonal courses of sublingual immunotherapy with grass pollen allergens in 2020 and 2021 with a pronounced positive effect. In the second year of treatment, remission of the disease was achieved: almost complete absence of hay fever symptoms in the flowering season of 2021, no progression of the disease, a significant decrease in the need for therapy to relieve symptoms. During the course of therapy, the patient did not show any deterioration in the course of diabetes mellitus, and the daily dose of insulin did not change. The patient is being monitored, and the third course of sublingual immunotherapy with grass pollen allergens is started.

Allergen immunotherapy against house dust mites in patients with local allergic rhinitis and asthma

Local allergic rhinitis (LAR) is a clinical rhinitis phenotype characterized by the presence of nasal symptoms of AR in nonatopic patients with a negative skin prick test and undetectable specific IgE (sIgE) in serum against inhalant allergens but with a positive nasal allergen provocation test. This study evaluated the effectiveness of a 12-month course of sublingual immunotherapy (SLIT) for house dust mite (HDM) allergies in adult patients with confirmed LAR and concomitant asthma. Methods The study was a prospective, double-blind, placebo-controlled trial with patients diagnosed with LAR to HDMs and with concomitant asthma who underwent a 12-month treatment course of SLIT for HDM allergies. Seventeen patients were randomized to SLIT with the use of allergen extracts of D. pteronyssinus and D. farinae (50/50%) in SQ-HDM SLIT tablets and 15 patients were randomized to the placebo group. The total rhinitis score (TRSS), total asthma symptom score (TASS), combined total symptom score (TSS), total medication score (TMS), and FEV1 were analyzed. Results: In the final analysis, 16 patients who received SLIT and 14 who received placebo who completed the study protocol were included. Significant reductions in TRSS, TASS, TSS, and TMS after 12 months of treatment were observed in patients after SLIT (p < 0.05). A significant increase in the mean FEV1 between baseline and after 12 months of therapy was observed in the study, with p = 0.03 in the study group. Conclusion: SLIT can improve nasal and bronchial symptoms and reduce symptomatic treatment in patients with LAR and asthma and with hyperresponsiveness to HDMs.

Efficacy of a 3-year course of sublingual immunotherapy for mite-induced allergic rhinitis with a 3-year follow-up.

Aim: To evaluate the long-term efficacy of sublingual immunotherapy (SLIT) in treating mite-sensitized allergic rhinitis (AR). Materials & methods:150AR children were randomly divided into SLIT and pharmacotherapy (PT)groups, receiving a 3-year course of SLIT along with PT or PT only. Results: The symptom and medication scores at the 3- and 6-year follow-up were significantly lower compared with the baseline levels in both groups, while the values were significantly lower in SLIT group than in PT group. No significant differences were observed between 3- and 6-year follow-up in SLIT group. Conclusion: 3-year SLIT along with PT appeared more effective compared with PT only for mite-induced AR in children, and the treatment was effective for at least 3consecutive years even after SLIT ceased.

Determinants and Factors of Satisfaction with Sublingual Immunotherapy in Patients with Allergic Rhinitis.

Allergen specific immunotherapy provides effective treatment of allergic rhinitis. Despite its efficacy, it can be signifi-cantly compromised by a possible treatment dissatisfaction of patients. To explore determinants and factors of satisfaction with sublingual immunotherapy in patients with allergic rhinitis. A total number of 191 patients with allergic rhinitis who completed a three-year course of sublingual im-munotherapy were included in the study. Of these, 76 had house dust mite (HDM) allergy - 42 men (55.26%) and 115 had grass pollen allergy - 63 men (54.78%) (mean age 27.3 years, SD: 6.14). The patients assessed their satisfaction using a visual analog scale. Health- Related Quality of Life was assessed by Rhinoconjunctivitis Quality of Life questionnaire. A visual analog scale was used to determine severity of the allergic rhinitis. The mean overall satisfaction, compared with that in previous therapy, increased significantly from 4.80 (SD 2.16) to 7.47 (SD 2.05) in the grass pollen allergy group and from 3.42 (SD 2.31) to 7.61 (SD 2.38) in the patients with HDM SLIT (p< 0.001). No relation between satisfaction and sex, type of immunotherapy extracts and duration of the disease was established. A strong correlation was found between satisfaction with treatment and quality of life (R=0.62) and severity of allergic rhinitis (R=0.69) after a three-year course. The results of this real-life study demonstrated that most patients with allergic rhinitis appeared to be satisfied with a three-year course of sublingual immunotherapy. The study provided evidence that reduction in severity of symptoms and improvement in quality of life could determine satisfaction with treatment.

The effect of the standard length of the first prescription on the adherence to sublingual immunotherapy for patients with allergic rhinitis.

Poor adherence to sublingual immunotherapy (SLIT) has become a major cause of unsatisfactory clinical efficacy for patients with allergic rhinitis (AR). This study was designed to identify the effect of different first prescription lengths on the adherence to SLIT. The clinical data of 306 patients with AR who started SLIT between January 2017 and June 2018 were retrospectively reviewed. Patients were divided into 3 groups according to the length of their first prescription (group A: less than 3 months, group B: 3 to 6 months, group C: more than 6 months). The numbers of adherent or nonadherent patients in each group and the main reasons of nonadherence were analyzed. Groups A, B, and C included 102, 161, and 43 patients, respectively. The average lengths of the first prescription for group A, B, and C were 62.52 ± 17.63, 102.21 ± 9.22, and 189.07 ± 17.97 days. There were significance differences among the 3 groups (p < 0.05). There were 42 (41.18%), 112 (69.57%), and 37 (86.05%) adherent patients in group A, B, and C. There were 60 (58.82%), 49 (30.43%), and 6 (13.95%) nonadherent patients in group A, B, and C. There were significant differences in the proportions of adherent and nonadherent patients among the 3 groups (p < 0.05). The following reasons were cited for nonadherence to SLIT: the long course of SLIT; inconvenience of getting the prescription; ineffectiveness; side effects; and other reasons. Under certain conditions, 6 months is recommended as the standard length for the first prescription, which can significantly improve adherence to SLIT in patients with AR.

Grass pollen allergy: a disease-modifying sublingual allergen-specific immunotherapy with the SQ timothy grass extract tablet

Introduction. Nowadays pollen allergy (hay fever) is one of the most common allergic diseases. Due to the ubiquity of grass species and the long pollination season, grass pollen allergy is an important social and economic problem. Summary. In this review we discuss the clinical data on the use of the SQ timothy grass sublingual immunotherapy (SLIT) tablet for the treatment of allergic diseases caused by grass pollen. The data of various studies demonstrate a significant long-term clinical effect after 1 course of SLIT with this allergen. Conclusions. Based on the studies, the SQ grass SLIT-tablet is established to be a disease-modifying therapy.

A Three-Year Course of House Dust Mite Sublingual Immunotherapy Appears Effective in Controlling the Symptoms of Allergic Rhinitis.

Background Allergic rhinitis is the most common allergic disorder. Although the management of the disease is successful in many patients, based on guidelines, some of them remain with symptoms uncontrolled with pharmacotherapy. Presently, there is no substantiated information on the control of allergic rhinitis in patients who underwent sublingual immunotherapy. Objective The purpose of this prospective follow-up study was to assess the control of allergic rhinitis in adults after a three-year course of house dust mite sublingual immunotherapy. Methods This prospective real-life study was designed to include adults with moderate to severe allergic rhinitis sensitized to house dust mite who underwent a three-year course of sublingual immunotherapy. Control of symptoms was assessed by Rhinitis Control Assessment Test (RCAT) after three years of house dust mite sublingual immunotherapy. Additionally, patients assessed their symptoms by utilizing a visual analog scale. Results A total number of 86 consecutively enrolled patients (46 (53.49%) men; mean age 26.10 years (SD = 5.85)) with moderate to severe allergic rhinitis and clinically relevant sensitization to house dust mite were evaluated. When assessed by RCAT on the third year, 74 (86.05%) had well-controlled symptoms and 20 (27.03%) of them were completely controlled. A significant reduction in visual analog scale scores-from 7.52 cm at baseline to 2.31 cm-was established ( P < 0.0001). There was a strong negative correlation between RCAT scores and visual analog scale (r = -0.65; P < 0.01). Conclusion This study provided evidence that a three-year course of house dust mite sublingual immunotherapy appears effective in controlling the symptoms of allergic rhinitis.

Efficacy and safety of sublingual immunotherapy with Dermatophagoides farinae drops in pre-school and school-age children with allergic rhinitis

BackgroundThe safety and efficacy of sublingual immunotherapy (SLIT) have been confirmed by many studies. However, in China, the research on efficacy and safety in young and older children with allergic rhinitis (AR) is still rare. ObjectiveThe aim of this retrospective study is to evaluate the efficacy and safety of SLIT with Dermatophagoides farinae drops in pre-school and school-age children with AR. MethodsA total of 282 subjects aged 2–13 years with AR received a two-year course of sublingual immunotherapy along with pharmacotherapy. According to the age, patients were defined as the pre-school group (2–6 years old, n=116) and school-age group (7–13 years old, n=166). Total nasal rhinitis symptom scores (TNSS), visual analogue score (VAS) and total medication scores (TMS) were evaluated at four time points: baseline, after SLIT for half a year, one year and two years. The adverse events (AEs) were evaluated at each visit. ResultsAfter two-year SLIT, the four rhinitis symptom scores, TNSS, VAS and TMS scores were significantly lower than baseline (all P<0.05). The comparison of efficacy between one and two-year duration showed no significant difference in global clinical outcomes (all P>0.05). In addition, there were no significant differences between the pre-school and school-age group in TNSS (all P>0.05), VAS (all P>0.05) and TMS scores (P>0.05) after SLIT for half a year, one year and two years. No severe systemic AEs were reported. ConclusionSLIT with D. farinae drops is clinically effective and safe in pre-school and school-age patients with house dust mites (HDMs)-induced AR.

Quality of life improvement after a three-year course of sublingual immunotherapy in patients with house dust mite and grass pollen induced allergic rhinitis: results from real-life

BackgroundAlong with its high prevalence, the burden of allergic rhinitis rests upon the serious impact on quality of life of patients. Allergic rhinitis is associated with impairments in daily activities, work and school performance, and practical problems. Patients suffer from sleep disorders and emotional problems. Тhe advantages of sublingual immunotherapy on quality of life have only recently begun to emerge. The objective of this prospective real-life study was to evaluate the effect of a three-year course of sublingual immunotherapy with house dust mite (HDM) and grass pollen extracts on quality of life in adults with allergic rhinitis.MethodsA total number of 191 adult patients [105 (54,979%) men; mean age 27.3 years (SD-6.14)] with moderate to severe allergic rhinitis and clinically relevant sensitization to house dust mites or grass pollen were prospectively evaluated in the course of management of their disease. Health-related quality of life was assessed by Rhinoconjunctivitis Quality of Life Questionnaire at baseline and after three-year course of sublingual immunotherapy.ResultsThe mean overall Qol score assessed at baseline and at the end of the third year of treatment decreased significantly in patients treated with HDM extract (from 2.95 to 0.76) as well as with Grass pollen extract (from 2.83 to 1.22) (р < 0.001). The improvements in treated with HDM extract were as followed: activities – 3.52 to 0.68; sleep- 2.48 to 0.31; general problems – 1.79 to 0.49; practical problems – 3.57 to 0.68; nasal symptoms – 3.91 to 0.74; eye symptoms – 2.92 to 0.39; emotions – 3.03 to 0.39. The improvements in grass pollen group were: activities – 3.68 to 1.69; sleep- 1.85 to 0.84; general problems – 1.74 to 0.97; practical problems – 3.52 to 1.37; nasal symptoms – 3.72 to 1.57; eye symptoms – 3.58 to 1.3; emotions – 2.48 to 1.19.ConclusionOur study conducted in real life provided evidence that a three-year course of SLIT with HDM extract as well as with grass pollen extract significantly increased QoL in patients with allergic rhinitis.

The efficacy and safety of sublingual immunotherapy in children and adult patients with allergic rhinitis

BackgroundClinical research has shown that sublingual immunotherapy (SLIT) is effective and safe in moderate-severe allergic rhinitis (AR) induced by house dust mite (HDM). However, the sample size in many studies is small. Meanwhile, the controversy on the efficacy and safety in the very young children younger than four years old still existed. ObjectiveThe aim of this retrospective study is to evaluate the efficacy and safety of SLIT with Dermatophagoides farinae (Der.f) extracts in children and adult patients with allergic rhinitis, particularly in the very young children. MethodA total of 573 subjects aged 3–69 with AR received a three-year course of sublingual immunotherapy with Der.f extracts along with pharmacotherapy. The total nasal symptoms score (TNSS), total medication score (TMS), visual analogue score (VAS) and adverse events (AEs) were evaluated at each visit. ResultTNSS, TMS, VAS were significantly improved during the three-year course of treatment in comparison to the baseline values (P<0.01). Besides, significant improvement in nasal symptoms and reduction of medication use were also observed in young children aged 3–6 years (P<0.01). No severe systemic adverse events (AEs) were reported. ConclusionSLIT with Der.f drops is clinically effective and safe in children and adult patients with HDM-induced AR, including the very young children less than four years old.

Allergic Rhinitis and its Impact on Asthma scores in asthmatic patients with and without allergic rhinitis

Abstract Allergic rhinitis and allergic asthma are chronic inflammatory conditions that frequently coexist, both with hallmark eosinophilia. Immunotherapy is an established treatment for allergic diseases. Noninjective routes for immunotherapy, such as the sublingual route, are thought to be valuable therapeutic options for respiratory allergy. In the present study, sublingual immunotherapy (SLIT) using multiple allergens was administered to allergic asthmatic patients with and without allergic rhinitis aiming to evaluate the clinical efficacy of and changes in allergen-specific antibodies during SLIT and its effect on control of asthma severity and nasal allergy scores. The study included 40 patients in two groups: group I included 20 asthmatic patients and group II included 20 patients with both proven bronchial asthma and allergic rhinitis. All patients were subjected to assessment of the status of asthma and hence its degree of control using the Global Initiative for Asthma (GINA) guidelines; patients received SLIT according to the results over a period of 1 year and were clinically reassessed monthly. In addition, for the recruited candidates, the initial total immunoglobulin E (IgE) levels were measured and pulmonary function tests were performed at the time of recruitment and repeated after 6 months and 1 year of the initiation of the course of SLIT. SLIT was stopped for asthmatic patients during acute exacerbation and resumed after complete asthma control. There was a statistically significant decrease in blood eosinophils but a statistically insignificant decrease in total IgE 1 year after SLIT in both groups. Results of specific IgE to food and inhalants revealed that there was statistically significant reduction in the number of allergens in both groups 1 year after SLIT. Results of the skin prick test revealed similar results. Our results revealed that the scores of, both Allergic Rhinitis and its Impact on Asthma and GINA had improved in all patients after 1 year of continuous therapy. SLIT is a safe treatment strategy that significantly reduces symptoms and medication requirements and improves asthma control in both asthmatic patients with and without allergic rhinitis. SLIT using multiple allergens lowered the allergen burden in both asthmatic patients with and those without allergic rhinitis. 1b (Clinical Decision Rule tested within one clinical center).

Long-term follow-up of oral immunotherapy for cow's milk allergy

Long-term follow-up of oral immunotherapy for cow's milk allergy

Immunotherapy – 2082. Long term prevention of asthma and rhinitis in children with atopic dermatitis four year after discontinuation of sublingual immunotherapy

Background Atopic Dermatitis is a disease with high prevalence in Italy (about 15% of the population). As known, Atopic Dermatitis is often associated with respiratory allergy to mite.We previously showed that sublingual immunotherapy (SLIT) to mite has a beneficial clinical effect in patients with allergic extrinsic Atopic Dermatititis (AD). To investigate the long term effects, we performed a 4-year follow up after the termination of SLIT. Methods 46 children with AD, aged 5-16 years and allergic to mite were re-assessed 4 years after discontinuation of a 2-year course of SLIT (or placebo). Methacholine provocation tests were carried out at baseline, after 2 years (when SLIT was stopped) and after 4 years. The development of asthma and rhinitis was assessed by clinical evaluations. Results The children who previously had received SLIT had significantly less asthma after 6 years as evaluated by clinical symptoms: odd ratio 3.73 (0.130 vs 0.511; P=0.02) as compared to the former placebo group. In addition, significantly less patients reported an increase in asthma scores P=0.003. A significant difference in bronchial methacholine responsiveness was found between the two groups (P=0.03), with an overall lower bronchial hyperreactivity in children who previously received active SLIT. Conclusions A 2-year course of SLIT to mite provided a long term clinical effect and prevented the development of asthma in children with allergic extrinsic form of Atopic Dermatitis.

Allergie sévère aux protéines de lait de vache : intérêt d’une immunothérapie sublinguale complétée par la voie orale. À propos d’un cas

An 18-month-old girl presented with a history of persistent cow's milk allergy following a severe anaphylactic reaction at two and a half months of age. She was found to be significantly sensitized to α-lactalbumin, β-lactoglobulin, casein and bovine serum albumin. Sublingual immunotherapy for 3 months followed by oral immunotherapy over a period of three years resulted in a reduction of specific IgE from greater than 100kU/L to 20kU/L, a significant increase in specific IgG4 and full tolerance to 90mL of milk as well as to various other dairy products. The authors emphasize the effectiveness of a short course of sublingual immunotherapy followed by a longer course of oral immunotherapy in such cases.

Innate and lymphocytic response of birch-allergic patients before and after sublingual immunotherapy

Functional imbalance in Th1/Th2 cell response toward allergens is a recognized hallmark of allergic patients and a major role of dendritic cells (DCs) in redirecting T-cell phenotypes after specific immunotherapy has been suggested. This study investigates the proliferative and cytokine responses of T cells cocultured with monocyte-derived DCs (MoDCs) after allergen stimulation in birch-allergic patients compared with controls and investigates whether sublingual immunotherapy (SLIT) could change the DC-driven immune response. T cells were stimulated with the major birch pollen allergen (nBet v1) and MoDCs from eight birch-allergic patients with seasonal allergic rhinitis and eight nonallergic controls. Proliferation and cytokine production were measured before and after one course of SLIT with birch allergoid. Significantly lower levels of proinflammatory (IL-1beta, p = 0.027; IL-6, p = 0.030; TNF-alpha, p = 0.019) and Th1 (interferon gamma, p = 0.032; IL-12, p = 0.05) cytokines were measured in supernatants of T cells and MoDCs cultures from allergic patients compared with nonallergic controls. After SLIT, significant increase in IL-12 (p = 0.039), IL-1beta (p = 0.040), IL-6 (p = 0.041), TNF-α (p = 0.048), and IL-10 (p = 0.048) and significant decrease in IL-13 (p = 0.001) were observed. MoDCs/T-cell cocultures, pulsed with the specific allergen, produced lower quantities of proinflammatory and Th1 cytokines in allergic patients compared with healthy subjects, suggesting an allergen-specific impairment of natural immunity and Th1 immune response. A single course of SLIT was able to enhance allergen-specific innate immunity and to modify lymphocyte response, promoting Th1 and T-cell regulatory activity.

Two year sublingual immunotherapy affects serum leptin

Background It has been demonstrated that serum leptin is elevated in females with allergic rhinitis. Recently, it has been reported that one course of sublingual immunotherapy (SLIT) does not affect serum leptin levels. Objective The aim of this study was to evaluate the serum leptin levels in a cohort of patients with pollen-induced allergic rhinitis, before and after two pre-seasonal SLIT courses. Methods Forty-one patients (22 males and 19 females, median age 39 years) with AR, due to pollen allergy, and 34 healthy subjects (16 males and 18 females, median age 43 years) were included in the study. Blood sampling for assessing serum leptin was performed in all subjects before and after the second SLIT course. Results All patients were responders to SLIT. Serum leptin was significantly increased only in males ( p = 0.0056) after the second SLIT course. Conclusion This preliminary study shows that at least two pre-seasonal SLIT courses were required to induce significant modifications in serum leptin levels, but it occurred only in males. Some hypotheses might be outlined, including a leptin protective effect, however further studies must clarify this issue.

Serum Il-17 after one Course of Sublingual Immunotherapy in Allergic Rhinitis to Birch

Recently, it has been reported that IL-17 may be involved in allergic reaction. Sublingual immunotherapy (SLIT) is the unique curative treatment for allergic rhinitis. This study aims at investigating whether one course of birch SLIT could affect serum IL-17 levels. The findings provided show that some IL-17 producer patients had a reduction of serum IL-17 levels after one SLIT course. Therefore, this preliminary study shows that a single pre-seasonal SLIT course may induce a significant decreasing trend in serum IL-17 levels; further study should be carried out to define the role exerted by IL-17 in allergic rhinitis.

Sublingual immunotherapy reduces soluble HLA-G and HLA-A,-B,-C serum levels in patients with allergic rhinitis

Allergic rhinitis (AR) is characterized by Th2 polarized immune response. Soluble HLA (sHLA) molecules play an immunomodulatory activity. Specific immunotherapy is the only causal treatment for AR. So far no study investigated the effect of sublingual immunotherapy (SLIT) on sHLA molecules. The aim of the study was to evaluate sHLA-G and sHLA-A,-B,-C serum levels in AR patients with pollen allergy before and after a pre-seasonal course of SLIT. Forty AR patients with pollen allergy were enrolled and they assumed a pre-seasonal SLIT course for 3 months. Serum sHLA-G and sHLA-A,-B,-C and IFN-γ and IL-4 levels were determined by ELISA method at baseline and 3 months after the end of the SLIT course. Symptoms severity was assessed by a Visual Analogue Scale. Both sHLA-G and sHLA-A,-B,-C levels significantly diminished ( p < 0.0001 for both) after SLIT. Moreover, there was a highly significant relationship between the serum levels of these two soluble molecules ( r = 0.84). Significant relationship between symptoms evaluated by VAS and change of sHLA molecules was also evidenced ( r = 0.60 and 0.63). Serum cytokines were not affected by SLIT. Therefore, this preliminary study provides the first evidence that both sHLA-G and sHLA-A,-B,-C levels are significantly reduced by SLIT in AR patients with pollen allergy. Therefore, the clinical implication of this study is that these soluble molecules might be interpreted as biomarker of response to SLIT.