Sublingual Immunotherapy: Past, present, paradigm for the future?A review of the literature

Abstract

Since the early 1900s, allergen immunotherapy has been recognized as an effective treatment option for patients with inhalant allergies. Subcutaneous injection has traditionally been the main route of antigen delivery for immunotherapy in the United States. Over the past 15 years, sublingual administration of allergen extract has become a widely used method of immunotherapy in other countries, particularly in Europe. Although sublingual immunotherapy (SLIT) has been used by some physicians in the United States, this technique has not found widespread utilization. A growing interest in SLIT use in this country is developing. SLIT offers several potential advantages, including excellent safety and tolerability, increased access to immunotherapy, and improved method of antigen delivery to children. This paper reviews the basic and clinical science data available in the literature concerning the immunology, efficacy, and safety of SLIT. It is written to serve as a springboard for future discussions and clinical investigations regarding the potential expanded use of SLIT in the United States.

Sublingual Immunotherapy for Asthma: Affects T-Cells but Does not Impact Basophil Activation

“…4,8,[13][14][15] To date, there are many publications regarding the clinical efficacy of SLIT, although very few consider laboratory analyses of SLIT action. [16][17][18][19][20] Most of these concern the evaluation of inflammatory mediators and cytokine concentrations in bronchoalveolar lavage fluid and in serum obtained from asthmatic subjects treated with SLIT. 13,[17][18][19] The influence of SLIT on basophil surface antigens as activation markers is limited.…”

CCR7-CCL19/CCL21-Regulated Dendritic Cells Are Responsible for Effectiveness of Sublingual Vaccination

“…The s.l. route is also effective and efficient for allergen-specific immunotherapy (7,8). Recently, we demonstrated that s.l.…”

The Role of Cytokine Interleukin-2, Transcription Factor of FoxP3 in the Immunological Regulation of Allergic Rhinitis

“…Tolerance occurs as a result of an increase from a specific allergen suppressor T cell, and Treg after immunotherapy [33]. A new perspective of the therapeutic approach focuses on administering IL-2 to inflamed tissue in autoimmune and allergic-induced inflammatory cases.…”