0.829
IF
20
MNiSW
166.26
ICV
REVIEW PAPER
 
 

Sublingual immunotherapy (SLIT) – indications, mechanism, and efficacy Position paper prepared by the Section of Immunotherapy, Polish Society of Allergy

Marek Jutel 1,  
 
1
Wroclaw Medical University, Wrocław, Poland
2
Chair of Clinical Immunology, Department of Clinical Immunology, University of Medicine, Lublin, Poland
3
Department of Pneumonology, Allergology and Clinical Immunology, Poznan University of Medical Sciences, Poland
4
Chair of Pediatrics, Department of Pediatrics, Jagiellonian University Medical College, Krakow, Poland
5
Department of Lung Diseases and Rheumatology, University of Medicine, Lublin, Poland
6
Chair and Department of Internal Medicine, Allergy, Clinical Immunology, Medical University of Silesia, Katowice, Poland
7
I Department of Pediatrics, Allergy and Pulmonology, Szczecin, Poland
8
Icahn School of Medicine at Mount Sinai Hospital, New York, US
9
Department of Prevention of Envinronmental Hazards and Allergology, Medical University, Warszawa, Poland
10
PTA
Ann Agric Environ Med 2016;23(1):44–53
KEYWORDS:
ABSTRACT:
SLIT ([i]sublingual immunotherapy[/i],) induces allergen-specific immune tolerance by sublingual administration of a gradually increasing dose of an allergen. The mechanism of SLIT is comparable to those during SCIT (subcutaneous immunotherapy), with the exception of local oral dendritic cells, pre-programmed to elicit tolerance. In the SLIT dose, to achieve the same efficacy as in SCIT, it should be 50–100 times higher with better safety profile. The highest quality evidence supporting the efficacy of SLIT lasting 1 – 3 years has been provided by the large scale double-blind, placebo-controlled (DBPC) trials for grass pollen extracts, both in children and adults with allergic rhinitis. Current indications for SLIT are allergic rhinitis (and conjunctivitis) in both children and adults sensitized to pollen allergens (trees, grass, [i]Parietaria[/i]), house dust mites ([i]Dermatophagoides pteronyssinus, Dermatophagoides farinae[/i]), cat fur, as well as mild to moderate controlled atopic asthma in children sensitized to house dust mites. There are positive findings for both asthma and new sensitization prevention. Severe adverse events, including anaphylaxis, are very rare, and no fatalities have been reported. Local adverse reactions develop in up to 70 – 80% of patients. Risk factors for SLIT adverse events have not been clearly identified. Risk factors of non-adherence to treatment might be dependent on the patient, disease treatment, physician-patient relationship, and variables in the health care system organization.
eISSN:1898-2263
ISSN:1232-1966