Oral Pollen Therapy in Ragweed Pollinosis

Feinberg, Samuel M.; Foran, Francis L.; Lichtenstein, M. R.; E, Padnos; Rappaport, Ben Z.; Sheldon, John M.; Zeller, M.

doi:10.1001/jama.1940.02810270025005

Cited by 23 publications

(5 citation statements)

References 8 publications

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“…Oral hyposensitization (OH) in the treatment of allergic disease has been used for more than 80 years (4) and more recent animal studies have demonstrated induction of tolerance in presensitized animals by oral feeding with the antigen in question (2). Several placebo-controlled trials in OH have shown no clinical effect in the treatment of inhalation allergy (3,7,14,17), whereas more optimistic results have been reported from numerous uncontrolled trials (4,11,13,18,19,20,21). Only recently, a beneficial effect has been demonstrated in placebo-controlled studies on the treatment of birch pollinosis in children (10) as well as in adults (15).…”

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High dose grass pollen tablets used for hyposensitization in hay fever patients

Mosbech

Dreborg

Madsen

et al. 1987

Allergy

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Previous, placebo-controlled clinical trials with oral hyposensitization in grass pollinosis have been disappointing. Since the results possibly could be explained by too low doses of ingested allergens, the present study was initiated to evaluate the effect of high doses of allergens. Forty-two adults with symptoms in the grass pollen season and with grass pollen sensitivity demonstrated by skin prick test and conjunctival provocation test were included. Enterosoluble tablets were administered daily for 1 year. Twenty-two patients, who completed the study, received placebo and 17 mixed grass pollen allergens from rye grass, timothy grass, cultivated rye and velvet grass. Evaluated either by self-assessment or by symptom and medicine score before and after treatment, the group receiving pollens did not improve clinically compared the controls. During the study, conjunctival sensitivity decreased equally in the two groups, and changes in specific IgE, allergen-induced histamine release from blood cells and skin prick test were insignificant and with no difference between groups. Five patients, who received pollen allergens, had episodes of urticaria or angioedema, and a further three patients on the same treatment had slight gastrointestinal side effects. In conclusion, enterosoluble grass pollen allergens in contrast to birch pollens did not have any therapeutic effect, even in doses more than 4,000 times higher than those used for subcutaneous hypersensitization. The reason may be degradation of allergens before the immune system is reached.

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High dose grass pollen tablets used for hyposensitization in hay fever patients

Mosbech

Dreborg

Madsen

et al. 1987

Allergy

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“…In 1940, allergists from 3 Chicago medical schools and the University of Michigan conducted a group of loosely related studies of oral immunotherapy with pollen extracts that included comparisons with injection immunotherapy and with placebo. 56 In the 3 largest of these studies, including 141 subjects receiving oral pollen therapy, improvement of a slight or moderate degree was reported by 29.8% of those receiving active treatment, compared with 21.9% receiving placebo. In the studies that included an injection arm, the results with injection were "sharply superior to those of the companion oral groups," despite the fact that in one head-to-head study the total oral dose was 200 times the injected dose.…”

Section: Oral and Sublingual Immunotherapymentioning

confidence: 99%

“…In the studies that included an injection arm, the results with injection were "sharply superior to those of the companion oral groups," despite the fact that in one head-to-head study the total oral dose was 200 times the injected dose. 56 Furthermore, a third of those receiving oral pollen had adverse effects, mostly gastrointestinal, that were sometimes severe enough to cause patients' withdrawal. The conclusion from these studies was that "the therapeutic effectiveness of oral immunotherapy is, at the highest estimate, of a minor grade."…”

Section: Oral and Sublingual Immunotherapymentioning

confidence: 99%

“…The conclusion from these studies was that "the therapeutic effectiveness of oral immunotherapy is, at the highest estimate, of a minor grade." 56 The oral approach has been superseded by sublingual administration. Often, the article by Glenis Scadding and Jonathan Brostoff 57 of the United Kingdom is credited with arousing widespread interest in sublingual allergen administration, although the method had been used by some physicians in private practice earlier.…”

Section: Oral and Sublingual Immunotherapymentioning

confidence: 99%

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The evolution of allergy immunotherapy

Nelson

2021

Annals of Allergy, Asthma & Immunology

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Recognition of hay fever as a distinct entity coincided with the marked increase in the prevalence of allergic diseases in the latter part of the 19th century. This probably reflected the improving levels of hygiene and the trend toward urbanization.Allergy immunotherapy (AIT) was practiced with a high level of enthusiasm for more than 4 decades before randomized, controlled studies scientifically established its efficacy. In the 6 decades since, well-designed studies have established its efficacy in seasonal and perennial allergic rhinitis, asthma, and Hymenoptera venom sensitivity.Studies have also established the principal humoral response to AIT to be the generation of specific immunoglobulin G4, whereas the cellular response is characterized early by the generation of a variety of regulatory T cells and later by an immune deviation from T H 2 to T H 1 response.With the efficacy of AIT established beyond question, including its role as the only disease-modifying treatment for allergic diseases, the onus now is to make AIT safer and more convenient for the patient so that more patients will benefit from this treatment.

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“…In the 1920s and 1930s, too, reports of positive experiences with this method appeared again and again. However, a negative, multicentre comparative study of ragweed pollinosis (4) (in which, interestingly, good results were reported in children!) severely limited the use of OIT in adults in the Anglo‐Saxon countries.…”

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confidence: 99%