Immunologic response and safety in birch pollen sublingual versus oral vestibule immunotherapy: A pilot study

Allam, Jean‐Pierre; Wuestenberg, Eike G.; Wolf, Hendrik; Klimek, Ludger; Decot, Elke; Horn, Andreas; Schnitker, J; Bieber, Thomas; Novak, Natalija

doi:10.1016/j.jaci.2014.03.026

Cited by 9 publications

(3 citation statements)

References 9 publications

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“…In fact, in an elegant study, Allam et al ., observed that the oral mucosa is rich in LCs expressing FcεRI 17 and they showed that allergen contact of LCs enhances their migratory properties 18 . However, unlike epicutaneous administration, sublingual and oral vestibule allergen contact strongly increased (almost 3-fold) allergen-specific IgE levels 19 . The induction of allergen-specific IgG after oral allergen contact was as low as observed by us for the epicutaneous route.…”

Section: Discussionmentioning

confidence: 88%

Epicutaneous allergen application preferentially boosts specific T cell responses in sensitized patients

Campana

Moritz

Neubauer

et al. 2017

Sci Rep

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The effects of epicutaneous allergen administration on systemic immune responses in allergic and non-allergic individuals has not been investigated with defined allergen molecules. We studied the effects of epicutaneous administration of rBet v 1 and rBet v 1 fragments on systemic immune responses in allergic and non-allergic subjects. We conducted a clinical trial in which rBet v 1 and two hypoallergenic rBet v 1 fragments were applied epicutaneously by atopy patch testing (APT) to 15 birch pollen (bp) allergic patients suffering from atopic dermatitis, 5 bp-allergic patients suffering from rhinoconjunctivitis only, 5 patients with respiratory allergy without bp allergy and 5 non-allergic individuals. Epicutaneous administration of rBet v 1 and rBet v 1 fragments led to strong and significant increases of allergen-specific T cell proliferation (CLA+ and CCR4+T cell responses) only in bp-allergic patients with a positive APT reaction. There were no relevant changes of Bet v 1-specific IgE and IgG responses. No changes were noted in allergic subjects without bp allergy and in non-allergic subjects. Epicutaneous allergen application boosts specific T cell but not antibody responses mainly in allergic, APT-positive patients suggesting IgE-facilitated allergen presentation as mechanism for its effects on systemic allergen-specific immune responses.

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Section: Discussionmentioning

confidence: 88%

Epicutaneous allergen application preferentially boosts specific T cell responses in sensitized patients

Campana

Moritz

Neubauer

et al. 2017

Sci Rep

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“…19 Data obtained in this study with tablet administration to the sublingual versus vestibular region differs from a previous study conducted with AIT-drops, in which a tendency for less LAR in the group of patients with vestibular administration was observed. 15 Whether this difference is explained by the AIT formulation used (drops vs.…”

Section: Discussionmentioning

confidence: 99%

“…Vestibular application is occasionally used in practice as an alternative site when subjects experience severe or persistent local application site reactions 14 . One clinical trial previously studied the immunologic response and safety of vestibular administration of birch SLIT‐drops, showing noninferiority of the immunologic response with vestibular administration compared with the sublingual route and no significant difference in the safety profiles between the two groups 15 . No clinical trial has formally assessed the vestibular tolerability of AIT‐tablets.…”

Section: Introductionmentioning

confidence: 99%

Tolerability of sublingual versus vestibular allergy immunotherapy tablet administration: A randomized pilot study

Simard,

Novak,

Drolet

et al. 2023

Clin Experimental Allergy

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BackgroundLocal application site reactions are common with sublingual allergy immunotherapy (AIT)‐tablets for the treatment of allergic rhinitis/conjunctivitis (AR/C) and occasionally lead to treatment discontinuation. Because of the lower mast cell density in the vestibular mucosa than the sublingual area, vestibular AIT‐tablet administration may result in fewer adverse events (AEs). This pilot study evaluated the tolerability of the vestibular administration route of AIT‐tablets compared with the sublingual route in adult subjects with AR/C.MethodsAdults (n = 164) aged 18–65 years with AR/C treated with daily birch pollen, grass pollen, ragweed pollen or house dust mite AIT in tablet form were randomized 1:1 to vestibular or sublingual administration for 28 days, followed by 28 days of sublingual administration only. The primary endpoint was the severity (mild, moderate, severe) of local treatment‐related adverse events (TRAEs) during the first 28 days of treatment.ResultsDuring the first 28 days, the percentage of subjects in the vestibular and sublingual groups reporting mild TRAEs were 55.6% versus 50.6%, respectively; moderate TRAEs were 27.2% versus 30.1%; and severe TRAEs were 12.3% versus 6.0% (p = .16). In the vestibular group, 95.1% of the subjects experienced at least one TRAE during the first period versus 81.9% in the sublingual group (p = .01) and discontinuation rates due to AEs were higher (12.3% vs. 3.6%).ConclusionThe frequencies of subjects experiencing severe TRAEs, at least one TRAE, and discontinuations due to AEs at the initiation of AIT‐tablets were numerically higher with vestibular administration than sublingual administration. Sublingual administration should remain the standard of care for subjects treated with AIT‐tablets for AR/C.

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Coadministration of Sublingual Immunotherapy Tablets and Management of Potential Adverse Effects: Austrian, German, and Swiss Expert Recommendations

Sturm

Vogelberg

Marchon³

et al. 2019

Clinical Therapeutics

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Immunologic response and safety in birch pollen sublingual versus oral vestibule immunotherapy: A pilot study

Cited by 9 publications

References 9 publications

Epicutaneous allergen application preferentially boosts specific T cell responses in sensitized patients

Epicutaneous allergen application preferentially boosts specific T cell responses in sensitized patients

Tolerability of sublingual versus vestibular allergy immunotherapy tablet administration: A randomized pilot study

Coadministration of Sublingual Immunotherapy Tablets and Management of Potential Adverse Effects: Austrian, German, and Swiss Expert Recommendations

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