Perception and practice of sublingual immunotherapy among practicing allergists in the United States

Sivam, Anita; Tankersley, Mike

doi:10.1016/j.anai.2019.03.023

Cited by 19 publications

(5 citation statements)

References 18 publications

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“…Sublingual routes for IT have been first proposed in 1986 (183) and facilitate the mucosal deposit of the allergen in the form of drops or dissolving tablets/capsules under the tongue. While this route has been tested in clinical trials in the US, only a few SLIT products have yet been approved by the U.S. Food and Drug Administration (FDA) (184). In general, SLIT is associated with a favorable safety profile, lower risks and offers patients the convenience of an at-home and injection-free administration.…”

Section: Allergen-specific Immunotherapymentioning

confidence: 99%

Mechanisms of Particles in Sensitization, Effector Function and Therapy of Allergic Disease

et al. 2020

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Humans have always been in contact with natural airborne particles from many sources including biologic particulate matter (PM) which can exhibit allergenic properties. With industrialization, anthropogenic and combustion-derived particles have become a major fraction. Currently, an ever-growing number of diverse and innovative materials containing engineered nanoparticles (NPs) are being developed with great expectations in technology and medicine. Nanomaterials have entered everyday products including cosmetics, textiles, electronics, sports equipment, as well as food, and food packaging. As part of natural evolution humans have adapted to the exposure to particulate matter, aiming to protect the individual's integrity and health. At the respiratory barrier, complications can arise, when allergic sensitization and pulmonary diseases occur in response to particle exposure. Particulate matter in the form of plant pollen, dust mites feces, animal dander, but also aerosols arising from industrial processes in occupational settings including diverse mixtures thereof can exert such effects. This review article gives an overview of the allergic immune response and addresses specifically the mechanisms of particulates in the context of allergic sensitization, effector function and therapy. In regard of the first theme (i), an overview on exposure to particulates and the functionalities of the relevant immune cells involved in allergic sensitization as well as their interactions in innate and adaptive responses are described. As relevant for human disease, we aim to outline (ii) the potential effector mechanisms that lead to the aggravation of an ongoing immune deviation (such as asthma, chronic obstructive pulmonary disease, etc.) by inhaled particulates, including NPs. Even though adverse effects can be exerted by (nano)particles, leading to allergic sensitization, and the exacerbation of allergic symptoms, promising potential has been shown for their use in (iii) therapeutic approaches of allergic disease, for example as adjuvants. Hence, allergen-specific immunotherapy (AIT) is introduced and the role of adjuvants such as alum as well as the current understanding of their mechanisms of action is reviewed. Finally, future prospects of nanomedicines in allergy treatment are described, which involve modern platform technologies combining immunomodulatory effects at several (immuno-)functional levels.

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Section: Allergen-specific Immunotherapymentioning

confidence: 99%

Mechanisms of Particles in Sensitization, Effector Function and Therapy of Allergic Disease

et al. 2020

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“…With SLIT, the situation is quite different. There are no studies supporting the efficacy of administering more than two allergens by the sublingual route and the majority of US allergists treating with SLIT use single allergen, Food and Drug Administration-approved tablets [29].…”

Section: Discussionmentioning

confidence: 99%

“…The safety and efficacy of administering two liquid allergen extracts was demonstrated in a 4-year open label study [28]. What is lacking is evidence of effectiveness of SLIT employing a liquid extract with more than two distinct allergens despite the fact this is being practiced by a small percentage of US allergists [29]. The only study of multiallergen SLIT compared placebo to timothy grass extract diluted in albumin saline or to the same dose of timothy grass extract diluted in nine other pollen extracts [30].…”

Section: Multiallergen Administration In Sublingual Immunotherapymentioning

confidence: 99%

To mix or not to mix in allergy immunotherapy vaccines

Nelson¹

2021

Current Opinion in Allergy &Amp; Clinical Immunology

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Purpose of reviewEuropean and US allergists generally do not agree on the approach to subcutaneous allergy immunotherapy in patients with multiple allergies. The North American approach is to treat with a mixture that contains all the allergen extracts to which the patient has evident clinical sensitivity, whereas the European approach is to select for treatment the one or at the most two allergens that are clinically most important for the patient. Recent findingsRecent society guidelines continue to recommend these differing practices of treating the polyallergic patient and reviews of prescribing practices indicate these divergent recommendations are followed in Europe and the USA.

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“…During the last decade the use of SLIT-tablets have been increasing as four SLIT-tablets have been approved by the FDA since 2014, however, the use of SLIT-tablets in the US is still limited in comparison to SCIT. 24 More evidence is necessary to understand patients' preferences of SCIT or SLIT-tablets. The objective of this study was to evaluate patients' preferences for SCIT vs SLIT-tablets in the US, in both adults with AR and caregivers of children with AR.…”

Section: Introductionmentioning

confidence: 99%