Sublingual Specific Immunotherapy Research Articles

Efficacy of subcutaneous specific immunotherapy for allergic rhinitis combined with asthma: a retrospective analysis.

To evaluate the efficacy of subcutaneous specific immunotherapy (SCIT) for allergic rhinitis (AR) combined with asthma. A retrospective analysis of clinical data from 93 patients with AR combined with asthma admitted to our hospital from January 2022 to January 2023 was conducted. Based on the treatment interventions received, the patients were divided into a control group (n=46, receiving sublingual specific immunotherapy [SLIT]) and an observation group (n=47, receiving SCIT). Clinical treatment response, lung function, levels of immune indicators, levels of inflammatory indicators, and occurrence of adverse reactions were compared between the two groups. The total response rate was 95.74% in the observation group and 84.78% in the control group (P > 0.05). In terms of scores for symptom assessment, Total Nasal Symptom Score (TNSS), Depression Anxiety Stress Scale (DASS), and Nasal Allergy Symptom Score (NASS) scores in both groups decreased after treatment, with greater decreases in the observation group (P < 0.05). In addition, lung function was improved in both groups after treatment as reflected by increased Forced Expiratory Volume in one second to Forced Vital Capacity ratio (FEV1/FVC) and Peak Expiratory Flow (PEF) levels, with greater increases found in the observation group (P < 0.05). Among the immune and inflammatory indicators, Cluster of Differentiation 14 (CD14) and Interleukin-33 (IL-33) levels decreased, while Secretory Protein D-1 (SPD-1), serum Immunoglobulin G4 (sIgG4), Interferon-γ (INF-γ), and Interleukin-27 (IL-27) levels increased in both groups after treatment, with greater changes observed in the observation group (P < 0.05). There was no significant difference in the incidence of adverse reactions between the observation group (14.89%) and the control group (21.74%) (P > 0.05). In the treatment of AR combined with asthma, SCIT can better alleviate clinical symptoms, improve lung function, regulate immune and inflammatory responses in patients, and does not increase the risk of adverse reactions compared to SLIT.

Analysis of adherence and determinants of sublingual immunotherapy in patients with Artemisia pollen-induced allergic rhinitis

Objective:To monitor adherence to specific sublingual immunotherapy （SLIT） in patients with seasonal allergic rhinitis（AR）, analyse factors influencing adherence, and provide research support to effectively improve adherence. Methods:Patients with AR who underwent Artemisia pollen SLIT at the Department of Otolaryngology-Head and Neck Surgery, First Hospital of Shanxi Medical University from May 2021 to April 2022 were retrospectively followed up by telephone to investigate the current status of treatment, count the causes of shedding, and extract relevant information from their medical record data for analysis. Results:Of the 112 patients surveyed, 34 discontinued treatment（30.3%）; patients who experienced adverse reactions and SLIT patients who had been on treatment for more than 6 months showed relatively good adherence（P<0.05）. The main reasons for discontinuation in patients who dropped out were: asymptomatic discomfort during the non-pollen phase and therefore discontinuation of treatment or feeling that treatment was ineffective 9 cases（26.5%）, forced discontinuation due to vaccination or pregnancy, or epidemics 6 cases（17.6%）. Conclusion:Long-term adherence of patients to Artemisia pollen SLIT still needs to be brought to the attention of healthcare professionals, especially in the early stages of treatment when good patient education and good channels of trust and communication between doctors and patients need to be established.

Clinical Efficacy of Sublingual Specific Immunotherapy in Children with Allergic Rhinitis and its Impact on their Inflammatory Factors and Immune Function

The main objective of this study is to analyze the effects of sublingual specific immunotherapy and conventional drug therapy on inflammatory factors and immune function in children with allergic rhinitis. The research subjects were divided into three groups, group A received sublingual administration of dust mite drops, group B received routine treatment such as passive intervention with topical hormones, antihistamines and nasal irrigation and group C received sublingual administration of dust mite drops and on the basis of drop therapy, conventional treatments such as topical and systemic use of corticosteroids, antihistamines and anti-leukotriene’s are combined. Comparison was done among the three different sets of indicators. After treatment, the allergic rhinitis symptom score, visual analog scale score and inflammatory factor index levels in the three groups were calculated. The score was lower in group A than in group B and lower in group C than in group A. Adverse reactions were lowest in group A and highest in group C. After treatment, the levels of whole blood cluster of differentiation 4+, cluster of differentiation 4+/cluster of differentiation 8+ cells and serum immunoglobulin E were lower in group C than group A, and lower in group B than group A. The cluster of differentiation 8+ index was highest in group C and lowest in group B. Sublingual specific immunotherapy is effective and safe for children with allergic rhinitis.

Secondary prevention of latex allergy.

The present review addresses the secondary prevention in healthcare worker, healthcare setting, and in patients outside the healthcare setting. There is sufficient knowledge of the broad aetiology of latex allergy for secondary preventive programmes to be widely adopted. Currently, avoidance of latex-containing surgical products is mandatory in the care of sensitized patients. They should also have a list of occult sources of natural rubber latex exposure and cross-reacting fruits. During all health-care procedures latex allergic patients should be treated in a 'latex-free' environment. Specific sublingual immunotherapy has been suggested as a suitable therapeutic option. It can be offered, in addition to symptomatic treatment, to selected patients, when avoidance measures are not feasible or effective. The use of omalizumab could also be extended as an adjunct to latex immunotherapy. Despite of the progress made in the secondary prevention of latex allergy, the disease still continues to be a global health problem.

The Role of Allergen-Specific Immunotherapy in ENT Diseases: A Systematic Review.

Previous studies have demonstrated that both subcutaneous (SCIT) and sublingual specific immunotherapy (SLIT) are effective in treating allergic rhinitis (AR). Further studies have evaluated the efficacy of allergen-specific immunotherapy (AIT) on different ear, nose, and throat (ENT) manifestations, in which allergy might have an etiopathogenetic role, such as local allergic rhinitis (LAR), rhinosinusitis (RS), otitis media (OM), and adenotonsillar (AT) disease. Nevertheless, the management of allergy in ENT diseases is still debated. To the best of our knowledge, this is the first systematic review assessing the efficacy of AIT in ENT diseases aside from AR. Literature data confirmed that AIT might be an effective therapeutic option in LAR, although its effect is restricted to studies with short-term follow-up. Furthermore, previous research demonstrated that AIT may improve symptoms and surgical outcomes of chronic rhinosinusitis when used as an adjunctive treatment. Few studies supported the hypothesis that AIT may exert positive therapeutic effects on recurrent upper airway infections as adenotonsillar disease. Finally, some clinical observations suggested that AIT may add some benefits in the management of otitis media with effusion (OME). The results of this systematic review allow us to conclude that the efficacy of AIT in ENT disorders has been only slightly investigated and additional studies are needed.

Effects of Sublingual Duster Mite Drops on Lung Function and Exhaled Nitric Oxide in Children with Multiple and Single Allergic Respiratory Diseases.

Objective To evaluate the efficiency of sublingual immunotherapy with Dermatophagoides Farinae Drops in children with single and multiple respiratory allergic diseases. Methods Seventy-one children with allergic respiratory diseases who had been treated with Dermatophagoides Farinae Drops for one year or more were divided into a single allergic group (12 cases) and multiple allergic group (59 cases). The rhinitis score, daytime and night symptom score of asthma, VAS score, drug score, pulmonary function, and FeNO level before and after treatment were evaluated and compared between the two groups. Results The rhinitis score, night symptom score, VAS score, and drug score in the single allergic group after treatment were significantly lower than those before treatment (p < 0.05), but there was no significant difference in the daytime symptom score before and after treatment (p > 0.05). The rhinitis score, VAS score, and drug score in the multiple allergic group after treatment were significantly lower than those before treatment (p < 0.05), but there was no significant difference in the scores of daytime symptoms and nighttime symptoms before and after treatment (p > 0.05). In both the single allergic group and multiple allergic group, the pulmonary function indexes of the patients were significantly improved after treatment, and the FeNO after treatment was significantly lower than that before treatment (p < 0.05). There was no significant difference in scores, pulmonary function, and FeNO between the two groups (p > 0.05). Conclusion Sublingual specific immunotherapy is effective in treating multiple and single allergic respiratory diseases in children.

Specific sublingual immunotherapy in children with perennial rhinitis: a systemic review and meta-analysis.

Allergic rhinitis (AR) is a major public health problem and is increasing worldwide. AR affects children's learning efficiency, sleep quality, and other major aspects of life. Sublingual immunotherapy (SLIT) is effective and safe for children with seasonal AR, but for children with perennial allergic rhinitis (PAR) caused by house dust mites (HDM), its effectiveness and safety is less convincing. Medical literature databases up to 2019 were searched for published and unpublished pieces of evidence. Studies were individually screened by 2 reviewers against the eligibility criteria. Primary outcomes were total nasal symptoms scores (TNSS) and total medication scores (TMS). The secondary outcomes were total ocular symptoms scores and adverse events (AEs). Random effect models and fixed-effect models were used to calculate the standard mean difference (SMD) and risk ratio (RR), respectively. We identified 3772 abstracts, of which only 16 studies met our established criteria. SLIT significantly reduced TNSS (SMD -1.73; 95% CI, -2.62 to -0.84; p = 0.0001) and TMS (SMD -1.21; 95% CI, -1.75 to -0.67; p < 0.00001). Compared with children taking placebo, children taking SLIT were 1.08 (95% CI, 1 to 1.17; p = 0.05), 1.15 (95% CI, 0.87 to 1.51; p = 0.32), and 1.68 (95% CI, 0.68 to 4.11; p = 0.26) times more likely to develop mild, moderate, and severe AEs, respectively. HDM SLIT can effectively alleviate TNSS and TMS in children with PAR, but care should be taken to avoid harm due to possible adverse drug reactions.

Effect of sublingual immunotherapy with Dermatophagoides Farinae on the expression of specific IgG4 in patients with allergic rhinitis in Hainan area

Objective:The aim of this study is to investigate the effect of sublingual immunotherapy with Dermatophagoides Farinae on the expression of specific IgG4（sIgG4） in patients with allergic rhinitis （AR） in Hainan area. Method:Seventy-two patients with dust-mite allergic rhinitis, all three generations of whom were local islanders in Hainan, were randomly divided into control group（36 cases） and SLIT group（36 cases）. sIgG4 and sIgE expression levels were detected before treatment, 6 months after treatment, 12 months after treatment, and 18 months after treatment. The patient's symptom score, medication score, VAS score and adverse reactions was also assessed. Finally, through statistical analysis of the relevant data collected at 4 time points in the two groups of patients, the efficacy, safety and changes of sIgG4 antibody expression level in patients with allergic rhinitis receiving sublingual specific immunotherapy in Hainan were observed. Result:Symptoms scores, medication scores and VAS scores were significantly improved in the SLIT group after treatment compared with before treatment（P<0.05）, and serum sIgG4 increased significantly（P<0.01）, serum sIgE showed no significant change（P>0.05）. In the control group, symptom scores, medication scores and VAS scores were also significantly improved compared with before treatment（P<0.05）, while serum sIgG4 and sIgE showed no significant change（P>0.05）. When comparing the two groups, Symptoms scores, medication scores and VAS scores of the SLIT group were significantly lower than those of the control group at 12 months and 18 months after treatment（P<0.05）. sIgG4 expression levels in the SLIT group were significantly higher than those in the control group after 6, 12 and 18 months of treatment（P<0.01）. There was no significant difference in sIgE expression level between the two groups（P>0.05）. No severe systemic adverse reactions occurred in the two groups, and 3 patients showed mild adverse reactions in the SLIT group. Conclusion:Sublingual immunotherapy of Dermatophagoides Farinae was effective and could increase the expression of sIgG4 in patients with Dermatophagoides farinae AR, sIgG4 is expected to be an immunological marker for the objective evaluation of the clinical efficacy of Hapten.

Occupational asthma and rhinitis due to wheat flour: sublingual specific immunotherapy treatment.

Background:There are several potential sensitizers in the bakery environment and wheat flour appears to be the dominant sensitizer in most bakeries. Apart from traditional drug therapy or a change in profession, there are no effective therapies for workers who develop serious respiratory symptoms in the workplace.Objectives:To describe clinical and laboratory findings in workers with asthma and/or rhinitis induced by wheat flour who underwent sublingual specific immunotherapy (SLIT).Methods:Since drug therapy and prevention strategies were not effective, five bakers were elected to undergo SLIT. A three-year study was led by administering a sublingual wheat flour extract. Questionnaires, allergy and respiratory tests were performed before and after SLIT.Results:After SLIT an improvement in symptoms is observed in every patient: Asthma Control Test and a quality-of-life questionnaire show higher scores and as a result, workers have reduced the use of drug therapy. We observed significantly reduced exhaled nitric oxide (FeNO) and eosinophil cationic protein (ECP) levels after SLIT, hypothesizing that these parameters may be used to monitor the effectiveness of immunotherapy. The improvement of FEV1 (forced expiratory volume in 1second) and responsiveness to bronchoprovocative tests with methacholine denotes a possible role of SLIT in treating patients with low-respiratory tract involvement, even though more data are needed.Discussions:This is the first report in the literature on the use of SLIT for baker’s asthma and rhinitis. SLIT for occupational wheat flour allergy should be possible and efficient, saving vocational training, professionalism, and avoiding job loss.

Evaluation of efficacy of 1 year after completing the 2-year specific sublingual immunotherapy treatment course in allergic rhinitis

Objective: To evaluate the efficacy of treatment at 1 year after completing the 2-year specific sublingual immunotherapy in patients with allergic rhinitis (AR). Methods: A retrospective analysis of 124 patients with AR who were allergic to dust mite and treated in the First Affiliated Hospital of Wenzhou Medical University since 2012 was performed. All patients achieved sublingual immunotherapy (SLIT) for 2 years and had a regular follow-up over 1 year. Efficacy evaluation index such as VAS score, total nasal symptom score and total medication score were compared between the time of SLIT for 2 years, and 1 year after termination of SLIT. Paired t test was used for the comparison of scores. Results: Compared with those before treatment, the VAS score, total nasal symptom score and total medication score at the time of SLIT for 2 years were significantly decreased in all patients with AR [(9.40±5.96) vs (24.78±6.36), (4.53±2.06) vs (9.51±2.02), (0.42±0.87) vs (3.02±0.41), t value was 17.627, 24.600, 5.331, respectively, all P<0.01]. Compared with 2 years SLIT treatment, VAS score and total nasal symptom score were significantly increased than 1 year after termination of immunotherapy [(12.52±6.92) vs (9.40±5.96), (5.30±2.36) vs (4.53±2.06), t=5.199, 3.744, respectively, all P<0.01], but the total medication score showed no significant difference [(0.34±0.84) vs (0.42±0.87), t=-1.043, P>0.05]. Conclusions: The symptoms after 2 years SLIT in patients with AR have been well controlled. One year after the termination of SLIT, there is a certain rebound in symptoms, 2 years SLIT may not be the ideal treatment cycle for AR.

Sublingual house dust mite immunotherapy has no impact on decrease of circulating erythrocytes upon airway allergen challenge in allergic rhinitis

House dust mite (HDM) allergy is a predominant cause for perennial allergic rhinitis (AR) in Europe. We recently reported that circulating erythrocyte numbers decrease after airway allergen challenge in a murine asthma model and in grass-pollen sensitized AR subjects. Consequently, we aimed to evaluate these findings in HDM sensitized AR subjects and the influence of preceding allergen immunotherapy. Seventy-seven (age 26.8 ± 7.3 years; 54.5% female) HDM-allergic rhinitis subjects previously enrolled in a randomized, monocentric sublingual immunotherapy (SLIT) trial at the Vienna Challenge Chamber (VCC) were included. Subjects had either received placebo (n = 22), low-dose HDM (n = 29) or high-dose HDM specific sublingual immunotherapy (n = 26) daily for 24 weeks. Blood sampling was performed before and after 6 hours of HDM allergen exposure. Overall, specific airway allergen challenge resulted in a significant decrease in circulating erythrocytes and hematocrit (p < 0.001), and elevation of leukocytes (p < 0.001), particularly segmented neutrophils (p < 0.001). Gender had no significant effect on the observed changes in circulating blood cells. Erythrocytes decreased and neutrophil counts increased significantly after airway allergen challenge regardless of preceding immunotherapy. These findings imply a rapid systemic mobilization of neutrophils occurring within immediate type hypersensitivity response upon a specific allergen challenge, which is possibly inversely linked with the erythrocyte numbers.

Long-term clinical effect and safety observation of sublingual dermatophagoides farinae drop in preschool and school-age children with allergic rhinitis

Objective:To evaluate the efficacy of specific sublingual immunotherapy (SLIT) with Dermatophagoides farinae drops on preschool and school age children with allergic rhinitis.Method:Fifty preschool children (≤6 year), and 52 school age children (> 6 year), who suffered from dust mite induced allergic rhinitis, were randomly divided into subingual immunotherapy (SLIT) + drug group and drug group. SLIT + drug group was treated with a standardized subingual immunotherapy drops of Dermatophagoides farinae and combined with symptomatic therapy, drug group was treated with mometasone furoate nasal spray and dseloratdine tablets as symptomatic treatment. These children were followed up for 2 years with one visit in every 3 months. Symptom scores and medication scores were record at each visit. Comprehensive evaluation of symptom, medication, and patients' degree of satisfaction were used.Result:Two years after SLIT finished, symptom scores (SLIT + drug group: 1.13±1.05; drug group: 4.68±3.09), medication scores (SLIT + drug group: 0.07±0.04; drug group: 0.36±0.25) of SLIT+drug group were significantly lower than those in drug group respectively, all P< 0.01. The subjective assessment of patient' symptom, medication, and treatment satisfaction in SLIT+drug group was significantly lower than those in drug group. Subjective assessment symptoms, medication, and treatment satisfaction in preschool group was the same as in school age group. After SLIT ended for 2 years, subjective assessment and treatment satisfaction in the school age group was better than those in preschool group in medication score.Conclusion:SLIT demonstrated clinical improvement in children of different ages during 2 years treatment. the symptom scores, medication scores and subjective satisfaction in school age group are better than those in preschool group.

Efficacy and safety of specific sublingual immunotherapy in children with allergic asthma and rhinitis

Objective:To evaluate the efficacy and safety of specific sublingual immunotherapy (SLIT) with Dermatophagoides farina drops in different courses with allergic asthma and allergic rhinitis.Method:This study retrospectively analyzed the efficacy of SLIT in 158 children with allergic asthma and rhinitis which induced by house dust mites. The children were treated with Dermatophagoides farina drops; clinical observation and follow-up study were conducted. According to the treatment duration, children were divided into 4 groups (1-year, 2-year, 3-year, and 4-year). Symptom scores and medication scores were recorded at each visit. Asthma symptom scores (day and night), the rhinitis symptom scoresand medication scores were evaluated in 4 groups before and after SLIT. The adverse events during the treatment were collected.Result:There were significant differences in asthma symptom scores (day, night), asthma medication scores, rhinitis symptom scores, rhinitis medication scores among children who accepted 1-year, 2-year, 3-year and 4-year SLI treatment as compared with baseline (P< 0.01). As compared with 1-year, 2-year, 3-year groups, the asthma medication scores of 4-year group had obviously decrease (P< 0.05). Rhinitis medication score of SLIT3 years group was significantly lower than 2 years group (P< 0.05). Asthma symptom scores in the day, asthma symptom scores at night, rhinitis symptom scores of four groups children had no statistically significant difference (P>0.05).Conclusion:Different courses of sublingual immunotherapy with Dermatophagoides farina drops had significant effects; the 4-year course of treatment showed the best effect.

Effectiveness of Specific Sublingual Immunotherapy in Korean Patients with Atopic Dermatitis.

BackgroundSublingual immunotherapy (SLIT) with house dust mites (HDM) preparation has recently been proven to be beneficial for treating allergic rhinitis and asthma. However, there has been no report regarding the efficacy and safety of SLIT in Korean patients with atopic dermatitis (AD).ObjectiveWe intended to investigate the efficacy and safety of SLIT in Korean patients with AD.MethodsA total of 34 patients with AD and immunoglobulin E (IgE)-proven HDM sensitization (Class ≥3) were recruited. Eczema area and severity index (EASI) score, total serum IgE level, specific IgE assays to Dermatophagoides pteronyssinus, D. farinae, and adverse effects were recorded during follow-up. "Responder" was defined as a patient with ≥30% improvement in EASI score after SLIT.ResultsTwenty-three patients continued SLIT for 12 months or more, whereas 3 patients (8.8%) dropped out because of exacerbation of dermatitis, and 8 patients (23.5%) were lost to follow-up. The average duration of SLIT treatment was 22.4 months (range, 12~32 months). EASI scores reduced significantly after 6 months of treatment (p<0.05) compared with those at baseline. A total of 18 patients were determined to be responders to SLIT after 6 months. Total and specific IgE serum levels did not significantly reduce after SLIT. No patients experienced serious adverse events, with the exception of two patients who developed transient lip and tongue swelling.ConclusionOur study demonstrated that SLIT with HDM extracts is effective and tolerable in Korean patients with AD. Further controlled long-term trials are required to reinforce the current results.

Immune system network in allergic diseases during sublingual immunotherapy: The role of oral mucosal tissue

Specific sublingual immunotherapy (SLIT) represents an approach currently available to redirect inappropriate immune response in atopic patients. Since oral mucosal tissue displays high affinity for allergens, it is conceivable that the sublingual administration route might induce immunological tolerance towards allergens involving cells and mediators specific of oral and intestinal mucosa. The presence in oral mucosa of dendritic cells (DCs) which express the high-affinity receptor for immunoglobulin (Ig)E (FceRI) seems to suggest that the generation of T regulatory cells in periphery is orchestrated by a particular subset of DCs. It seems that repeated stimulation of naive CD4 T cells with allogenic immature DCs induce Tr1 cell maturation. Nevertheless, other cells are involved in this process, such as Toll Like Receptors (TLR), Major Histocompatibility Complex I and II (MHC I and II) and costimulatory molecules, such as CD40, CD 80/B7.1 and CD 86/B7.2. An increase of serum IgG4 and IgA, a reduced number of inflammatory cells infiltrating target organs, as well as a reduction of eosinophilic cationic protein and a T cell suppression in the peripheral blood also occur with SLIT. All these molecules orchestrate the immune network within the regional immune system, recreating a favourable environment for the induction of tolerance operated by SLIT.

Allergen specific sublingual immunotherapy in children with asthma and allergic rhinitis.

The incidence of asthma and allergic rhinitis (AR) is significantly increased, especially in younger children. Current treatment for children with asthma and allergic rhinitis include allergen avoidance, standard pharmacotherapy, and immunotherapy. Since standard pharmacotherapy is prescribed for symptoms, immunotherapy at present plays an important role in the treatment of allergic diseases. This article presents insights into the up-to-date understanding of immunotherapy in the treatment of children with allergic rhinitis and asthma. PubMed articles published from 1990 to 2014 were reviewed using the MeSH terms "asthma", "allergic rhinitis", "children", and "immune therapy". Additional articles were identified by hand searching of the references in the initial search. Numerous studies have shown that sublingual application of allergen specific immunotherapy (SLIT) is an adequate, safe and efficient substitution to subcutaneous route of allergens administration (SCIT) in the treatment of IgE-mediated respiratory tract allergies in children. According to the literature, better clinical efficacy is connected with the duration of treatment and mono sensitized patients. At least 3 years of treatment and stable asthma before the immunotherapy are positive predictors of good clinical efficacy and tolerability of SLIT. SLIT reduces the symptoms of allergic diseases and the use of medicaments, and improves the quality of life of children with the diseases.

Effect of Japanese cedar–specific sublingual immunotherapy on allergen-specific TH2 cell counts in blood

BackgroundThe contribution of antigen-specific TH cells in peripheral blood to immunologic mechanisms underlying sublingual immunotherapy (SLIT) remains unclear, partly because of the lack of a standardized method for the analysis of this rare lymphocyte subset. ObjectiveTo clarify the role of antigen-specific TH cells during SLIT using a sensitive method analyzing activation marker CD154-positive TH cells with multicolor flow cytometry. MethodsWe assessed antigen-specific TH cells using multicolor flow cytometry based on the expression of the activation marker CD154 and intracellular cytokines in patients with Japanese cedar pollinosis receiving SLIT at baseline and during the first pollen season after the initiation of SLIT. ResultsA total of 18 patients between 12 and 44 years of age were enrolled in the present study. Of these, 8 patients received SLIT (SLIT group) and 10 patients received symptomatic treatment only (control group). Although seasonal pollen exposure significantly increased the number of Japanese cedar–specific interleukin 5– and interleukin 4–producing TH cells in the control group (P < .01 for both), SLIT ameliorated this increase in the SLIT group (P = .64 and P = .84, respectively). ConclusionThe present study indicates that allergen-specific TH2 cells in peripheral blood are involved in mechanisms underlying SLIT. The analysis of antigen-specific TH cells using multicolor flow cytometry based on the expression of the activation marker CD154 represents a sensitive and relatively simple, standardized method for monitoring peripheral antigen-specific TH cells during allergen-specific immunotherapy.

Clinical and Immunological Assessment of Efficacy Specific Sublingual Immunotherapy in Respiratory Allergy Patients

Clinical and Immunological Assessment of Efficacy Specific Sublingual Immunotherapy in Respiratory Allergy Patients

Grass pollen sublingual immunotherapy: a double-blind, placebo-controlled study in elderly patients with seasonal allergic rhinitis.

This study evaluates the safety and efficacy of specific sublingual immunotherapy (SLIT) against grass pollen allergens in patients >60 years of age with seasonal allergic rhinitis (SAR) and/or asthma. This study sought to assess nasal symptoms during the grass pollen season, reduce medication use, and monitor adverse reactions during immunotherapy. Seventy-eight 60- to 70-year-old patients with SAR and a confirmed grass pollen allergy according to skin-prick tests, nasal provocation, and measurement of serum IgE were included in the study. The patients were individually randomized to the active or placebo groups using a double-blind method. A total of 41 subjects in the SLIT group (5 grass pollen mixture) and 37 subjects in the placebo group were monitored for 3 years. The patients were required to record each use of an antiallergy medication on a diary card. Thirty-eight patients completed 3 years (preseasonal) of SLIT, and 34 subjects finished the placebo treatment in the same time period. The total nasal symptom score decreased by 64% in the active group and 7% in the placebo group after SLIT. This difference was only significant in the active group (p < 0.05). At the end of therapy, the total medication score of the active group decreased significantly by a maximum of 51% (p < 0.05), whereas the total medication score of the placebo group had an insignificant decrease. None of the study participants had systemic adverse reactions during the study period. SLIT in elderly patients with a grass pollen allergy generated a significant clinical improvement in the active group compared with the placebo group for grass pollen season. This therapy was well tolerated.

Efficacy of sublingual immunotherapy for allergic asthma: retrospective meta‐analysis of randomized, double‐blind and placebo‐controlled trials

Allergen-specific immunotherapy (SIT) is the only available curative choice with a disease-modifying effect against respiratory allergies. The efficacy of SIT via the sublingual route was demonstrated by a number of clinical trials. This meta-analysis was performed to investigate the clinical efficacy and safety of sublingual-specific immunotherapy (SLIT) for allergic asthma. PubMed, EMBASE and the Cochrane Central Register of Controlled Trials were searched for randomized, double-blind and placebo-controlled (DBPC) trials evaluating the efficacy and safety of SLIT on allergic asthma. Subgroup analyses were performed according to age, type of allergen and duration of SLIT treatment. Sixteen randomized DBPC trials comprising 794 patients in total met the inclusion criteria. The results suggest that SLIT significantly reduces both symptom [standardized mean difference (SMD), -0.74; P=0.006] and medication scores (SMD, -0.78; P=0.02) compared with placebo. SLIT offers a better clinical response in mite sensitive asthmatics but without confirmed proof from subgroup analyses. Prolonged duration of treatment for more than 12 months brings no additive effects. Improvement in the skin prick test was also observed following immunotherapy. There was no consistent effect on forced expiratory volume in 1 s, serum levels of antigen-specific immunoglobulin G4 and immunoglobulin E in the treated group. The risk of adverse effects was relative risk 2.23 (P=0.01). SLIT is safe and clinically effective in reducing symptoms and medication use for allergic asthma. Our subgroup analyses failed to identify a disproportionate benefit of SLIT in any specific group of asthmatics, but some possible trends did emerge.