Sublingual Immunotherapy For Allergic Rhinitis Research Articles

Efficacy of sublingual immunotherapy for allergic rhinitis in children: a systematic literature review

Efficacy of sublingual immunotherapy for allergic rhinitis in children: a systematic literature review

Sublingual immunotherapy adherence in patients with allergic rhinitis: Effects of an intervention based on the information-motivation-behavioral skills model

ObjectiveThis study aimed to confirm the efficacy of an intervention based on the information-motivation-behavior skills (IMB) model in improving the sublingual immunotherapy adherence score, medication beliefs score, self-efficacy score, and medication knowledge score of patients with allergic rhinitis. MethodsA total of 120 patients with allergic rhinitis from an otorhinolaryngology clinic were divided into the control group (n = 60) and experimental group (n = 60); the study was conducted from August 2021 to March 2022. The control group received routine intervention, whereas the experimental group received intervention based on the IMB model. The medication adherence, medication beliefs, self-efficacy, and medication knowledge levels of the two groups were evaluated at baseline, post-intervention, at 1-month follow-up, and at 3-month follow-up. ResultsAfter intervention, a total of 116 patients completed the trial in the experimental and control groups (58 cases each). The results revealed differences in the scores of medication adherence, belief, self-efficacy, and knowledge between the two groups post-intervention, at 1-month follow-up, and at 3-month follow-up (P < 0.05). Further, the scores of the four indexes of the two groups were different with time, and better changes were noted among experimental group participants. ConclusionImplementing interventions based on the IMB model for people receiving sublingual immunotherapy for allergic rhinitis can effectively improve patients' medication beliefs, self-efficacy, and knowledge of medication, thereby improving their medication adherence, ensuring efficacy, and providing medication care for outpatients.

Soluble TAM Receptor Tyrosine Kinases Correlate with Disease Severity and Predict the Early Responsiveness of Sublingual Immunotherapy in Allergic Rhinitis.

Allergic rhinitis (AR) is a common allergic disease, and SLIT has shown effectiveness as a treatment method. This study focuses on the evaluation of serum TAM receptor tyrosine kinases (TYRO3, AXL, and MER) levels as potential indicators of disease severity and predictive markers for sublingual immunotherapy (SLIT) responsiveness in AR patients. A total of 160 AR subjects, including 40 mild AR (MAR) and 120 moderate-severe AR (MSAR) patients, and 40 healthy controls (HC) were recruited. Serum concentrations of TYRO3, AXL, and MER were measured and their relationships with disease severity were examined. In the MSAR group, 102 patients underwent SLIT, and the early efficacy was evaluated. The correlations between the baseline serum concentrations of TYRO3, AXL, and MER and the early responsiveness of SLIT were analyzed. Serum concentrations of TYRO3, AXL, and MER were significantly reduced in AR patients, particularly in those MSAR subjects. Correlation analysis results indicated that serum TYRO3 and MER levels were negatively correlated with the visual analog scale (VAS) and the total nasal symptom score (TNSS). After one year of follow-up, 80 AR patients completed the treatment and were divided into effective and ineffective groups. Serum baseline levels of TYRO3 and MER were found to be lower in the effective group compared to the ineffective group. Additionally, there was a significant increase in serum TYRO3 and MER levels compared to baseline levels. Receiver operating characteristic (ROC) analysis revealed that circulating TYRO3 and MER had potential values for reflecting AR severity and predicting early SLIT responsiveness. Serum TYRO3 and MER concentrations were decreased in AR patients and negatively associated with disease severity. Circulating TYRO3 and MER seem to be promising indicators for monitoring the efficacy of SLIT in AR patients.

Serum proteomics identifies S100A11 and MMP9 as novel biomarkers for predicting the early efficacy of sublingual immunotherapy in allergic rhinitis

BackgroundAllergic rhinitis (AR) is a chronic inflammatory disorder, and sublingual immunotherapy (SLIT) is an important therapy. However, SLIT exhibits a wide range of fluctuations and lacks objective monitoring indicators. Therefore, exploring biomarkers for early prediction of the efficacy of SLIT is urgently needed. MethodsWe recruited two independent cohorts. In the discovery cohort, house dust mite (HDM) -induced AR patients underwent SLIT for at least 1 year, and were categorized into response and no response groups based on early efficacy. Serum proteomics was conducted to detect variations in protein expression levels between the two groups. The candidate proteins were confirmed in the validation cohort with enzyme-linked immunosorbent assay (ELISA), and their predictive values and levels of change before and after treatment were evaluated. ResultsSerum proteomics identified a total of 113 differential proteins between the two groups, including 41 proteins upregulated and 72 downregulated in the no response group than the response group. The top 5 up- and down-regulated proteins were selected for further validation, and ELISA results revealed that serum CCL14, LTA4H, S100A11 and MMP9 levels were significantly elevated, and TGFBI and MASP1 were decreased in the response group than those in the no response group(P < 0.05). Moreover, receiver operating characteristic curves revealed that serum S100A11 and MMP9 exhibited greater ability in predicting the early effectiveness of SLIT (AUC > 0.7, P < 0.05). Furthermore, these two biomarkers exhibited significant reductions 1 year after SLIT, particularly in those patients who responded positively to the treatment (P < 0.05). ConclusionSerum S100A11 and MMP9 have the potential to serve as biomarkers for early prediction of the effectiveness of SLIT and monitoring the therapeutic effects. The circulating proteomic alterations might contribute to guiding treatment and understanding the mechanism of SLIT in AR patients.

Circulating exosomal has-miR-24-3p and has-miR-128-3p reflect early efficacy of sublingual immunotherapy in allergic rhinitis

ObjectiveSublingual immunotherapy (SLIT) can improve the symptoms of allergic rhinitis (AR) and modify its natural course, but its effectiveness varies among individuals. This study aims to analyze miRNAs from serum exosomes and evaluate their predictive values for the early response of SLIT in AR. MethodsRNA sequencing was performed to investigate the differential expressions of serum exosomal miRNAs between ineffective and effective AR patients who treated with SLIT. The identified candidate miRNAs were validated in two independent cohorts, and the predictive capabilities of these miRNAs and alterations of their expression levels between pre- and 1 year post-SLIT were evaluated. ResultsThe serum exosome-derived miRNA profiles were significantly different between the effective and ineffective groups. The five most up-regulated and down-regulated miRNAs were verified in the first validation cohort, and the results demonstrated that serum exosomal has-miR-24-3p and has-miR-206 were reduced, while has-miR-128-3p was increased in the effective group compared to the ineffective group (P < 0.05). Additionally, the receiver operating characteristic (ROC) curves revealed that serum levels of has-miR-24-3p and has-miR-128-3p displayed potential values for predicting the early efficacy of SLIT (P < 0.05). In the second validation cohort, it was observed that the baseline levels of serum exosomal has-miR-24-3p were significantly lower, while has-miR-128-3p levels were significantly higher in the effective group compared to the ineffective group (P < 0.05). After 1 year of SLIT, there was a significant decrease in serum exosomal levels of has-miR-24-3p compared to baseline. On the other hand, effective patients showed a notable increase in serum exosomal levels of has-miR-128-3p (P < 0.05). ConclusionSerum exosome-derived miRNAs have the potential to impact the efficacy of SLIT in AR patients. Among them, serum exosomal has-miR-24-3p and has-miR-128-3p show promise as biomarkers for predicting the early effectiveness of SLIT and monitoring therapeutic outcomes.

The relationship between sublingual immunotherapy for allergic rhinitis and the risk of symptoms in patients with COVID-19 infection

ABSTRACT To evaluated the risk ratio of Allergic rhinitis (AR) people on the symptoms after COVID-19 infection, and explored the relationship between AR and the symptoms after COVID-19 infection. An observational study was performed of people from outpatient department of the Hospital of Chengdu University of Chinese Medicine. Participants completed an electronic survey and between January 10 to January 20, 2023. We divided the participants into three groups according to the disease information of the population: non-AR people group (AR-N), AR patients with sublingual immunotherapy group (AR-S), and AR patients with conventional therapy group (AR-C). A total of 1116 participants were included in the study, with an average age of 21.76 ± 8.713, women accounted for 62.5%, men accounted for 37.5%. The final results showed that the risk of most symptoms after AR-C infection was not different from that of AR-N, except for sore throat, dry and itchy, chest distress, shortness of breath, and dyspnea. AR-S could effectively reduce the risk of post-infection symptoms including: dry and itchy (OR = 0.484, 95%CI: 0.335–0.698), pain (OR = 0.513, 95%CI:0.362–0.728), cough (OR = 0.506, 95% CI:0.341–0.749), expectoration (OR = 0.349, 95% CI:0.244–0.498), fever (OR = 0.569, 95% CI:0.379–0.853), head and body pain (OR = 0.456, 95% CI:0.323–0.644), fatigue (OR = 0.256, 95% CI:0.177–0.371), cold limbs (OR = 0.325, 95%CI:0.227–0.465), diarrhea (OR = 0.246, 95% CI:0.132–0.457), constipation (OR = 0.227, 95%CI:0.100–0.513), hyposmia (OR = 0.456, 95% CI:0.296–0.701), hypogeusia (OR = 0.397, 95% CI:0.259–0.607), chest distress (OR = 0.534, 95% CI:0.343–0.829), shortness of breath (OR = 0.622, 95% CI:0.398–0.974), palpitations (OR = 0.355, 95% CI:0.206–0.613). The risk of symptoms after COVID-19 infection in allergic rhinitis population receiving sublingual immunotherapy is lower.

Efficacy and safety of sublingual immunotherapy for allergic rhinitis: A network meta-analysis.

To systematically evaluate the clinical efficacy and safety of sublingual immunotherapy for allergic rhinitis (AR) and provide evidence for clinical treatment. A literature search was performed on the China National Knowledge Infrastructure (CNKI), Wanfang database, PubMed, Web of Science, Cochrane Library, and Embase database. Data from randomized controlled trials (RCTs) of sublingual immunotherapy for AR were screened and extracted from the establishment of those databases to November 2022. Subsequently, a network meta-analysis was performed using a statistical software R 4.2. Totally 22 RCTs that met the inclusion and exclusion criteria and screened from 1,164 literature were included. A total of 4,941 AR patients were involved in the 22 trials, as well as five interventions including placebo, pharmacotherapy, subcutaneous immunotherapy_dust mite, sublingual immunotherapy_dust mite, and sublingual immunotherapy_ grass mix plus pollen extract. The results of network meta-analysis showed that, based on symptom scores after different interventions for AR, the most effective treatments for AR were in order as follows: sublingual immunotherapy_dust mite, subcutaneous immunotherapy_dust mite, sublingual immunotherapy_ grass mix plus pollen extract, placebo, and pharmacotherapy. Importantly, sublingual immunotherapy had fewer adverse reactions and higher safety. Sublingual immunotherapy_dust mite for AR has the best efficacy, whereas traditional medicine has the worst. More high-quality studies with a large sample and multiple centers are needed to verify this conclusion in the future, so as to further provide more reliable evidence-based medical evidence for the clinical treatment options of AR patients.

Malaysian Society of Allergy and Immunology Consensus Statement on Sublingual Immunotherapy in Allergic Rhinitis.

Allergic rhinitis (AR) is an IgE-mediated inflammatory disease of the upper airway. AR affects the patients' quality of life, is a known risk factor for asthma and a socio-economic burden. Allergen-specific immunotherapy (AIT), comprising sublingual immunotherapy (SLIT) and subcutaneous immunotherapy (SCIT), involves administering increasing doses of the causative allergen to induce clinical and immunologic tolerance to the allergens. It is the only currently available treatment for AR that has been proven to induce disease-modifying effects (i.e., long-term remission of allergic symptoms or potential prevention of asthma and new sensitizations). Although AIT is conventionally recommended for patients who are non-responsive to symptom-relieving pharmacotherapy, it is presently recommended as a first-line treatment for patients with moderate to severe AR who prefer a treatment with the potential for long-term remission. In light of the relatively recent implementation of AIT in Malaysia, guidelines on its appropriate indication and application are important to attain optimal outcomes. This consensus statement was developed by an expert group formed by the Malaysian Society of Allergy and Immunology to provide evidence-based recommendations for the practice of AIT in Malaysia. Patient and product selection, choice of AIT, and strategy towards an effective treatment outcome in AIT are presented.

Serum exosomal miR-146a-3p associates with disease severity and efficacy of sublingual immunotherapy in allergic rhinitis

BackgroundSublingual immunotherapy (SLIT) is an effective treatment for allergic rhinitis (AR), but its efficacy is variable among individuals. This study aimed to characterize serum exosome-derived microRNAs (miRNAs) and evaluate their abilities in predicting the efficacy of SLIT in AR. MethodsRNA sequencing was performed to explore differentially expressed exosomal miRNAs in serum exosomes between AR patients and healthy controls (HCs). Sequencing analysis results were verified in an independent cohort, and the correlations between the levels of exosome-derived miRNAs and disease severity were evaluated. The most promising miRNAs were further tested in two AR cohorts treated with SLIT to assess their abilities in predicting short and long-term efficacy, respectively. ResultsThe exosome-derived miRNAs profiling in the AR group was significantly different from the HC group, and differentially expressed genes were enriched and clustered in pathways such as PI3K-Akt and ErbB signalling pathways. The top three most significant miRNAs were verified by reverse transcription-polymerase chain reaction (qRT-PCR), and results showed that miR-146a-3p levels were significantly elevated in the AR group and correlated with the total and specific gE levels, the visual analogue scale of the total nasal symptom score (all p < 0.05). Further data in the first validation cohort suggested that miR-146a-3p levels were significantly downregulated in the effective group, and logistic regression showed that miR-146a-3p levels were associated with the short-term efficacy of SLIT(p < 0.05). The receiver operating characteristic (ROC) curve showed that miR-146a-3p could early predict SLIT efficacy (AUC = 0.669, p = 0.047). In the second validation cohort, miR-146a-3p levels were also decreased in the effective group and the ROC curve further confirmed its reliable accuracy in predicting the long-term efficacy of SLIT in AR patients (AUC = 0.749, p < 0.001). ConclusionSerum exosome-derived miRNAs may be involved in the development of AR and associated with its disease severity. Serum exosome-derived miR-146a-3p seems to be a novel biomarker for predicting the short and long-term efficacies of SLIT in AR patients.

Circulating MMP-12 as Potential Biomarker in Evaluating Disease Severity and Efficacy of Sublingual Immunotherapy in Allergic Rhinitis.

Background Allergic rhinitis (AR) is a highly heterogeneous disease, and allergen-specific immunotherapy (AIT) is an effective treatment. This study aims to evaluate the circulating mas-related G protein-coupled receptor-X2 (MRGPRX2) and matrix metalloproteinase-12 (MMP-12) levels in evaluating disease severity and predicting efficacy of SLIT in AR patients. Methods We enrolled 110 moderate-severe persist AR patients (AR group) and 40 healthy controls (HC group). Circulating levels of MRGPRX2 and MMP-12 were measured, and their associations with disease severity were evaluated. All AR patients were assigned to receive sublingual immunotherapy (SLIT), and the efficacy was evaluated, and serum samples were collected at 1 year and 3 years after treatment. The correlations between serum MRGPRX2 and MMP-12 and clinical efficacy were assessed. Results The serum concentrations of MRGPRX2 and MMP-12 were significantly higher in the AR group than the HC group, and the elevated MMP-12 levels were correlated with VAS and TNSS, and serum MRGPRX2 levels were correlated with VAS. Finally, 100 and 80 patients completed 1-year and 3-year follow-up and were classified into effective and ineffective groups. Serum MRGPRX2 and MMP-12 levels were lower in the effective group than the ineffective group. Although serum MRGPRX2 and MMP-12 levels did not significantly change after 1 year SLIT, serum MMP-12 levels were decreased 3 years post-SLIT than baseline and 1 year post-SLIT levels. Receiver operating characteristic (ROC) showed that serum MMP-12 was a potential biomarker for predicting the efficacy of SLIT. Conclusion Serum MRGPRX2 and MMP-12 appeared to be promising biological indicators in reflecting disease severity in AR patients. Moreover, circulating MMP-12 might serve as a reliable predictor for clinical responsiveness of SLIT.

EVALUATION OF ADHERENCE TO SUBLINGUAL IMMUNOTHERAPY TREATMENT FOR ALLERGIC RHINITIS

Introduction: Allergic rhinitis is an inflammatory condition of the inside of the nose, mediated by Immunoglobulin E, in response to an inhaled allergen. Clinically, it presents with nasal obstruction, runny nose, nasal and/or eye itching, and sneezing. For its symptomatic treatment, environmental control is essential and nasal steroids are the gold standard in the adult and pediatric population. Another form of treatment is immunotherapy, changing the response to the allergen via the immune tolerance mechanism. Subcutaneous immunotherapy (SCIT) is applied weekly to monthly, in contrast to sublingual immunotherapy (SLIT), which is performed daily by the patient. For an effective treatment of chronic disease, the period of treatment and discipline in maintaining it must be respected. Objective: Analyze the main reasons why the patient gives up treatment with sublingual immunotherapy. Methods: This prospective and linear study evaluated patients at the IPO Hospital (Instituto Paranaense de Otorrinolaringologia, Curitiba, Brazil) who were undergoing treatment with sublingual immunotherapy for allergic rhinitis and who, for some reason, discontinued the recommended treatment. Results: The study sample consisted of 148 patients, 79 women and 69 men. The mean duration of treatment for patients who dropped out was 8.3 months. The cost was the most cited reason, which was mentioned by 47.3% of patients; followed by irregularity of use and absence of improvement with treatment, both with 23% each. The presence of side effects was included as a reason by 9.5% and still, 25% of respondents cited several other reasons as obstacles to treatment. Conclusion: The present study concluded that the main barriers found for treatment adherence are long treatment duration, cost, and regularity of use.

Increased Thrombin-Activatable Fibrinolysis Inhibitor in Response to Sublingual Immunotherapy for Allergic Rhinitis.

The objective of this study was to determine the role of thrombin-activatable fibrinolysis inhibitor (TAFI) as a candidate biomarker for therapeutic efficacy of sublingual immunotherapy (SLIT) and to identify the role of TAFI in the pathogenesis of allergic rhinitis (AR). Retrospective cohort study and laboratory study. Serum was collected from patients with allergies to Japanese cedar pollen before, during, and after treatment with SLIT. We measured the levels of immunoreactive TAFI, C3a, and C5a in serum by enzyme-linked immunosorbent assay (ELISA) and assessed their relative impact on a combined symptom-medication score. We also examined the impact of TAFI on mast cells and fibroblasts in experiments performed in vitro. Serum levels of TAFI increased significantly in response to SLIT. By contrast, serum C3a levels decreased significantly over time; we observed a significant negative correlation between serum levels of TAFI versus C3a and symptom-medication score. Mast cell degranulation was inhibited in response to TAFI, as it was the expression of both CCL11 and CCL5 in cultured fibroblasts. High serum levels of TAFI may be induced by SLIT. TAFI may play a critical protective role in pathogenesis of AR by inactivating C3a and by inhibiting mast cell degranulation and chemokines expression in fibroblasts. 4 Laryngoscope, 131:2413-2420, 2021.

Outcome of Sublingual Immunotherapy in Allergic Rhinitis.

Allergic rhinitis (AR) is one of the most common types of allergy worldwide. It has significant negative impact on the quality of life (QOL). One of the available causal treatments of AR is allergen specific immunotherapy which remains effective even after the end of treatment course, unlike symptomatic drugs. AR patients aged above five years, allergic to unavoidable allergen like house dust, mite etc., and refractory to maximal pharmacotherapy were included in present study. Patients allergic to avoidable allergen, taking beta-blocker medication, having other immunological disease, and who were pregnant, breast-feeding or lost to follow up, were excluded from the study. All patients included in the study underwent sublingual immunotherapy (SLIT). The impact of treatment is measured by calculating the difference between SNOT-20 score before and after treatment (which is 6months interval). Total 30 patients were studied. Paired-t test calculated value of cumulative score and nasal symptom score are 7.853 and 6.85 respectively. Both are greater than table value of 2.46. So paired-t test shows that SLIT is very much effective in treatment of AR. The present study re-establish the fact that SLIT not only reduces AR symptoms, it also improves the QOL. It has very good patient compliance with minimal side effects.

Serum Periostin as a Biomarker for Predicting Clinical Response to House Dust Mite Sublingual Immunotherapy in Allergic Rhinitis

House dust mite (HDM) sublingual immunotherapy (SLIT) has proven to be effective for allergic rhinitis (AR), but its efficacy varies among patients. No candidate biomarkers for prediction of response to SLIT are available. Periostin, a matricellular protein, is involved in pathophysiology of AR, and its serum levels reflect airway allergic inflammation. To evaluate the relationship between serum periostin levels and current rhinitis control before and after standardized quality (SQ)-HDM SLIT, and to investigate the role of periostin in predicting clinical response. One hundred eleven subjects with HDM-induced AR were randomized to receive either SLIT plus pharmacotherapy or pharmacotherapy alone, for 48 weeks. At enrollment and the end of study, clinical characteristics and biomarkers that included serum periostin, serum HDM-specific IgE (s-IgE), total IgE, blood eosinophil counts, and Rhinoconjunctivitis Quality of Life Questionnaire (RQLQ) were measured. The association between clinical indices or biomarkers and clinical response to SLIT was analyzed. A response to SLIT was recorded in 64% (32 of 50) patients. High serum periostin levels (>30.2 ng/mL) were associated with an effective response to SLIT, and the magnitude of RQLQ improvement was correlated with the level of serum periostin. The sensitivity and specificity based on receiver operating characteristic analysis for periostin were higher than those of s-IgE. Multivariate regression analysis showed that serum periostin was an independent factor for SLIT responders. Serum periostin appears to be a useful biomarker for predicting the response to SQ-HDM SLIT in patients with AR.

Activated leukocyte cell adhesion molecule as a biomarker for disease severity and efficacy of sublingual immunotherapy in allergic rhinitis

BackgroundActivated leukocyte cell adhesion molecule (ALCAM) plays an important role in T cell activation and immune response, but the role of ALCAM in allergic rhinitis (AR) remains unclear. The objective of the current study was to validate serum ALCAM as a biomarker in assessing disease severity and predicting the efficacy of sublingual immunotherapy (SLIT) in AR patients. MethodsWe recruited 40 healthy controls (HC group), 38 mild AR patients (MAR group) and 80 moderate-severe AR patients (MSAR group) in this study. Serum levels of ALCAM were determined by ELISA, and the association between ALCAM levels and disease severity was evaluated. In the MSAR group, 68 patients underwent and finished 3-years of SLIT, and were divided into effective group and ineffective group, the relationship between ALCAM levels and efficacy of SLIT was exampled. ResultsALCAM levels were elevated in the serum of AR patients in comparison with HC. Moreover, serum ALCAM concentrations were higher in MSAR group than in MAR group and HC group, and levels of ALCAM significantly correlated with AR total nasal symptom score (TNSS) (r = 0.330, P < 0.001), visual analogue scale (VAS) (r = 0.387, P < 0.001) and serum total IgE levels (r = 0.442, P < 0.001). In the effective group, the ALCAM levels were significantly lower than in the ineffective group. Receiver operating characteristic (ROC) curve exhibited good accuracy for predicting clinical efficacy of SLIT (area under the curve = 0.805, P < 0.001). ConclusionsThe serum ALCAM maybe a novel biomarker for assessing disease severity and predicting clinical efficacy of SLIT in AR patients.

Highlights of the Chinese guideline on sublingual immunotherapy for allergic rhinitis and asthma（English edition）

The Chinese guideline on sublingual immunotherapy（SLIT） for allergic rhinitis and asthma（English edition） has been developed by a panel of experts on behalf of the Chinese Society of Allergy, and published in December 2019. The guideline is herein organized to outline the critical items, including the epidemiology of allergic rhinitis and asthma, clinical application and mechanisms of SLIT, standardized procedure, indications and contraindications, therapeutic process, and future perspective, to guide and improve the clinical practice of SLIT.

Evidence and Practicalities of Aqueous Sublingual Immunotherapy, Tablet Sublingual Immunotherapy, and Oral Mucosal Immunotherapy for Allergic Rhinitis and Allergic Asthma

Allergen immunotherapy (AIT) is the only disease-modifying treatment for allergic rhinitis (AR). Multiple modalities of AIT dosed via sublingual or oral routes are becoming available. This review discusses current evidence and practicalities of aqueous and tablet sublingual immunotherapy (SLIT) and oral mucosal immunotherapy (OMIT) in the treatment of AR and allergic asthma. Several large-scale studies demonstrate the efficacy and safety of SLIT. These studies have led to the United States Food and Drug Administration (USFDA) approval of tablet SLIT against grass, ragweed, and house dust mites (HDM). However, off-label use of aqueous SLIT is still practiced as a safe and effective alternative in polysensitized patients. Growing evidence suggests a role for SLIT in patients with allergic asthma. The literature supports the efficacy and safety of aqueous and tablet SLIT for AR, while some controversy remains over the utility of SLIT for allergic asthma. OMIT is currently in the early stages of development.

Chinese guideline on sublingual immunotherapy for allergic rhinitis and asthma

The present guideline on sublingual immunotherapy (SLIT) for allergic rhinitis (AR) and allergic asthma (AS) has been developed by a panel of experts on behalf of the Chinese Society of Allergy to guide the clinical practice of SLIT in China. The panel included eminent clinical physicians and scientific specialists, who majored in the fields of Otolaryngology, Respirology, Pediatrics, Allergy and Clinical Immunology, and focused their investigations on two common allergic airway diseases (namely AR and AS) in China. During the past few decades, AR and AS have shown increasing prevalence worldwide, and resulted in substantial direct and indirect costs (1).

Safety and Efficacy of Sublingual Immunotherapy for Allergic Rhinitis Due to Artemisia Annua

Safety and Efficacy of Sublingual Immunotherapy for Allergic Rhinitis Due to Artemisia Annua

The efficacy of sublingual immunotherapy for allergic rhinitis and the predictive role of cytokines in its therapeutic effect

Objective:The study aimed to investigate the efficacy of sublingual immunotherapy(SLIT) in treatment of adult allergic rhinitis, and to explore the predictive role of baseline serum cytokine levels in its therapeutic effect.Method:Sixty patients with moderatesevere perennial AR sensitized with house dust mites were treated for 2 years. The SLIT group(n=30) were treated with standardized dust mite vaccine SLIT and conventional drugs, and the control group(n=30) were treated with placebo and conventional drugs. The combined symptom and medication score(CSMS) were compared between the two groups to evaluate the efficacy at baseline and 2 year endpoint. According to therapeutic effect, the SLIT group and the control group were divided into subgroups respectively, and the baseline IFN-γ and IL4, IL10, IL17 levels were compared between the effective group and the ineffective group in each group. The ROC curve was drawn to find the best predictive index and the best cut-off value was calculated. Result:①There was no significant difference between the SLIT group and the control group at baseline CSMS(P>0.05). There was significant difference between the two groups at 2year endpoint CSMS(P<0.05). ②In the SLIT group, there was no significant difference between the effective group and the ineffective group with the IFN-γ and IL17(P>0.05). The IL4 level in the effective group was significantly higher than the ineffective group while the IL10 level was significantly lower(P<0.05). In the control group, there were no significant differences in the levels of IFN-γ, IL4, IL10 and IL17 between the two subgroups(P>0.05). ③Baseline IL4/IL10 has higher predictive value than IL4 and IL10 alone. The best cut-off value is 2.04, and the sensitivity and specificity of predictive value were 72.7% and 73.7% respectively. Conclusion: SLIT combined with conventional drug therapy is more effective than conventional drug therapy alone. IL4/IL10 has a better predictive role in SLIT effect than IL4 or IL10 alone. The higher the ratio, the better therapeutic effect is.