Sublingual Versus Subcutaneous Immunotherapy for Allergic Rhinitis: What Are the Important Therapeutic and Real-World Considerations?

Field, Kelsey; Blaiss, Michael S.

doi:10.1007/s11882-020-00934-4

Cited by 12 publications

(8 citation statements)

References 54 publications

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“…For that reason, it is important that information on patients' preferences for administration is conveyed to healthcare providers and considered for inclusion in available AIT shared decision-making tools. [33][34][35] Results showed that the majority of the adults and children in this study were polyallergic (>65%), a…”

mentioning

confidence: 73%

Preference for Immunotherapy with Tablets by People with Allergic Rhinitis

Tankersley¹,

Winders²,

Aagren³

et al. 2021

PPA

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mentioning

confidence: 73%

Preference for Immunotherapy with Tablets by People with Allergic Rhinitis

Tankersley¹,

Winders²,

Aagren³

et al. 2021

PPA

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“…Some studies have shown an indirect comparison favoring SLIT over SCIT treatment based on tolerability and safety. SCIT can be associated with allergic reactions ( 24 , 35 ). In addition, compared with SCIT, SLIT is easy to operate and can be safely self-administered, which results in a high number of local adverse effects of SLIT, such as oral itching, swelling, and throat irritation ( 7 ).…”

Section: Discussionmentioning

confidence: 99%

Efficacy and safety of sublingual immunotherapy for allergic rhinitis: A network meta-analysis

Jiang

2023

Front. Immunol.

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BackgroundTo systematically evaluate the clinical efficacy and safety of sublingual immunotherapy for allergic rhinitis (AR) and provide evidence for clinical treatment.MethodsA literature search was performed on the China National Knowledge Infrastructure (CNKI), Wanfang database, PubMed, Web of Science, Cochrane Library, and Embase database. Data from randomized controlled trials (RCTs) of sublingual immunotherapy for AR were screened and extracted from the establishment of those databases to November 2022. Subsequently, a network meta-analysis was performed using a statistical software R 4.2.ResultsTotally 22 RCTs that met the inclusion and exclusion criteria and screened from 1,164 literature were included. A total of 4,941 AR patients were involved in the 22 trials, as well as five interventions including placebo, pharmacotherapy, subcutaneous immunotherapy_dust mite, sublingual immunotherapy_dust mite, and sublingual immunotherapy_ grass mix plus pollen extract. The results of network meta-analysis showed that, based on symptom scores after different interventions for AR, the most effective treatments for AR were in order as follows: sublingual immunotherapy_dust mite, subcutaneous immunotherapy_dust mite, sublingual immunotherapy_ grass mix plus pollen extract, placebo, and pharmacotherapy. Importantly, sublingual immunotherapy had fewer adverse reactions and higher safety.ConclusionSublingual immunotherapy_dust mite for AR has the best efficacy, whereas traditional medicine has the worst. More high-quality studies with a large sample and multiple centers are needed to verify this conclusion in the future, so as to further provide more reliable evidence-based medical evidence for the clinical treatment options of AR patients.

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“…Despite the growing number of studies on the contribution of AIT in the management of allergic diseases [ 26 ], the relevant literature on the SLIT in the context of ARDs is still scarce. The SLIT aims to induce mucosal immunity against airway allergic reactions through administration of allergen extract as drops or dissolvable tablet under the tongue [ 27 , 28 ]. While the allergen can arrive in local lymph nodes as unbound via free diffusion, it can also be delivered by oral DCs which can migrate to the proximal lymph nodes for the activation of both allergen-specific T- and B-cells upon engulfment of the foreign particle [ 29 ].…”

Section: Slit On Immune Cell Functions During Ardsmentioning

confidence: 99%

“…Characteristic inflammation pattern in the patients with allergic diseases involves the IgE production by B-cells under the influence of type 2 cytokines [ 61 ]. Data obtained from numerous studies investigating the efficiency of AIT also provided insights on the IgE production dynamics; similar to SCIT which causes a transient increase followed by a decrease in serum IgE production [ 27 ], SLIT was able to elevate the allergen-specific IgE levels within the initial few months [ 62–66 ], while unaltered or reduced IgE levels were detected after at least a year of treatment in relative to the basal values [ 49 , 50 , 67–77 ]. However, elevated IgE levels after long-time treatment were also demonstrated by some studies which could be due to differences in the treatment protocol (e.g.…”

Section: Slit On Immune Cell Functions During Ardsmentioning

confidence: 99%

Immune mechanisms induced by sublingual immunotherapy in allergic respiratory diseases

Gazi

Bahceciler

2022

Clinical and Experimental Immunology

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Allergic respiratory diseases (ARDs) are still a major burden on global public health. Sublingual immunotherapy (SLIT) is a mode of allergen immunotherapy (AIT) which involves administration of the allergen under the tongue, and benefits from tolerogenic properties of the oral mucosa. Studies revealed reduced levels of eosinophilia and eosinophil-dominated inflammation in airways of both animals and humans after SLIT. SLIT was also suggested to lower basophil responsiveness and innate lymphoid cell-2 function in blood samples collected from ARD patients. Moreover, apart from shifting pathogenic type 2 (TH2) to a type 1 (TH1) and protective regulatory (Treg) polarization of helper T-cell immune response, antibody isotype switch from IgE to IgG1, IgG2, IgG4 and IgA was also reported in ARD patients receiving SLIT. Today, the literature on SLIT-mediated activities is still scarce and more studies are required to further enlighten the mechanisms utilized by SLIT for the induction of tolerance. The aim of this review is to summarize the current knowledge about the immune-regulatory mechanisms induced by SLIT against ARDs.

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Sublingual Versus Subcutaneous Immunotherapy for Allergic Rhinitis: What Are the Important Therapeutic and Real-World Considerations?

Cited by 12 publications

References 54 publications

Preference for Immunotherapy with Tablets by People with Allergic Rhinitis

Preference for Immunotherapy with Tablets by People with Allergic Rhinitis

Efficacy and safety of sublingual immunotherapy for allergic rhinitis: A network meta-analysis

Immune mechanisms induced by sublingual immunotherapy in allergic respiratory diseases

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