Therapeutic Effects and Biomarkers in Sublingual Immunotherapy: A Review

Abstract

Immunotherapy is considered to be the only curative treatment for allergic diseases such as pollinosis, perennial rhinitis, asthma, and food allergy. The sublingual route is widely applied for immunotherapy for allergy, instead of the conventional administration by subcutaneous route. A recent meta-analysis of sublingual immunotherapy (SLIT) has shown that this approach is safe, has positive clinical effects, and provides prolonged therapeutic effects after discontinuation of treatment. However, the mechanism of SLIT and associated biomarkers are not fully understood. Biomarkers that change after or during SLIT have been reported and may be useful for response monitoring or as prognostic indicators for SLIT. In this review, we focus on the safety, therapeutic effects, including prolonged effects after treatment, and new methods of SLIT. We also discuss response monitoring and prognostic biomarkers for SLIT. Finally, we discuss immunological mechanisms of SLIT with a focus on oral dendritic cells and facilitated antigen presentation.

Fast onset of action of sublingual immunotherapy in house dust mite‐induced allergic rhinitis: A multicenter, randomized, double‐blind, placebo‐controlled trial

“…and basophils); 3) T cells and cytokines (Th1, Th2, and regulatory T cells, e.g., CD41, CD81, CD251, and Foxp31/ CD127lo cells), and their related cytokines (e.g., IL3, IL4, IL5, IL9, IL10, IL13, IL17, IL18, IFN-c), and the signaling lymphocytic activation molecule (SLAM). 7,22,24 In our study, we did not see a significant change in serum sIgE antibody to D.f. and D.p.…”

“…In the literature, however, other biomarkers have been reported in association with SLIT, such as: 1) specific antibodies (IgE, CD23, IgA, IgG4, and IgG); 2) effector cells (eosinophils, neutrophils, mast cells. and basophils); 3) T cells and cytokines (Th1, Th2, and regulatory T cells, e.g., CD4+, CD8+, CD25+, and Foxp3+/CD127lo cells), and their related cytokines (e.g., IL3, IL4, IL5, IL9, IL10, IL13, IL17, IL18, IFN‐γ), and the signaling lymphocytic activation molecule (SLAM) …”

Differential Plasma-cell evolution is linked with Dermatophagoides pteronyssinus immunotherapy response

“…During AIT there are high levels of allergen-specific IgG1, IgG4 and IgA that can block the binding of the allergen-IgE complex at the surface of effector cells 15 16 . Specific IgG levels have been used as a biomarker to monitor AIT response 17 18 19 , although their utility for predicting treatment outcome has not been proven.…”

Spectrum of allergens for Japanese cedar pollinosis and impact of component-resolved diagnosis on allergen-specific immunotherapy

“…54 Over the last two decades, sublingual SIT (SLIT) has become recognized as a preferable form of immunotherapy compared with conventional subcutaneous SIT (SCIT) in terms of safety, feasibility, and convenience for patients. 55 Crude extracts from natural allergen sources have been used as SIT vaccines widely in the clinics. The World Allergy Organization recommends that standardized vaccines should be used for SIT if they are available.…”