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SELECTED ARTICLES FROM THE RECENT LITERATURE 2006
9/25/06
Current status of sublingual immunotherapy
Summary
Background - Allergy immunotherapy, traditionally administered by a series of subcutaneous injections (SCIT) has been shown to be effective in several allergic disorders. However, because of the inconvenience of repeated injections and the potential for systemic allergic reactions during SCIT, there has been increasing use of sublingual allergy immunotherapy (SLIT) in Europe.
There is now considerable interest in using SLIT in the USA.
Findings - The current status of SLIT was reviewed by a Task Force representing the AAAAI and the ACAAI. They concluded that SLIT appears to be effective in conditions currently approached with SCIT. However, many questions remain unanswered including effective doses, treatment schedules, and overall duration of treatment. SLIT appears to be generally well tolerated with few associated serious adverse effects.
Studies of SLIT to date have utilized extracts of single allergens with no mixtures of non-cross reacting allergens, as commonly employed in SCIT for the treatment of individuals allergic to several aeroallergens. There are currently no allergen extracts approved by the FDA for SLIT use in the USA.
Reference
J Allergy Clin Immunol 2006;117:1021-35
Editor's Comments
This review by a group of clinicians/investigators with extensive experience in allergy immunotherapy is well worth reading by those interested in undertaking SLIT for their patients. It should be noted that much larger doses of allergenic extract have generally been used in SLIT than in SCIT.Although systemic reactions appear to be very uncommon during SLIT, local itch and sometimes swelling of the oral mucosa occur commonly during the initial dosage build-up in SLIT.
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