Sublingual Immunotherapy Research

Many allergists only treat for a small number of local pollens.  However, this fails to fortify you against the full spectrum of allergens in your environment or against new allergens that you may encounter while traveling.  In contrast, the Family Allergy Clinic’s sublingual allergy drops contain a “comprehensive mix” of virtually all common allergens.   This helps ensure broader allergy protection. The comprehensive mix  is paired with the tried-and-true advantages of under-the-tongue drops (also known as sublingual immunotherapy or SLIT) which research has established to be safer than injections as well as highly effective.

The Case for Sublingual Immunotherapy

The Cochrane Collaboration (regarded worldwide as the top standard in health care research) examined 22 studies involving 979 users of sublingual immunotherapy.  It concluded that SLIT is a safe alternative to allergy shots and minimizes symptoms as well as the need for medication in allergic rhinitis sufferers. SLIT is confirmed by the World Health Organization and ARIA directives (Allergic Rhinitis and its Impact on Asthma).  Furthermore, our case studies show that over 80 percent of patients with allergies and over 90 percent of patients with asthma report significant reduction of symptoms in the first several weeks of taking oral drops prescribed through the Family Allergy Clinic. Continue reading for additional research on sublingual allergy drops for pollen and food allergies. Note: Article names link to abstracts unless the complete version is publicly accessible. *SLIT–sublingual immunotherapy (under-the-tongue allergy drops) **SCIT–subcutaneous immunotherapy (allergy injections)

Sublingual Immunotherapy for Environmental Allergies

Allergen-Specific Immunotherapy for Pediatric Asthma and Rhinoconjunctivitis: A Systematic Review
Pediatrics: Official Journal of the American Academy of Pediatrics, 2013

Evidence supports the effectiveness of both SCIT and SLIT for remediation of asthma and hay fever in pediatric patients.

Sublingual Immunotherapy for Allergic Rhinitis and Conjunctivitis
Immunotherapy, 2013

SLIT has shown dependable efficacy in minimizing symptoms and allergy drug usage in allergic rhinitis and likely in concurring asthma for all related antigens. Further, due to the complex mechanism of action, SLIT significantly alters the immune reaction, thus, its effects endure long-term. Additionally, SLIT,* as well as SCIT, ** can lessen the chances for asthma in pediatric allergic rhinitis sufferers. According to this finding, SLIT is affirmed as an operable substitute for SCIT in the remediation of allergic rhinoconjunctivitis, with a very positive safety record and the plausibility of extending its usage to additional diseases.

This study confirms the efficacy of both sublingual immunotherapy and subcutaneous immunotherapy in changing the immune response.

Efficacy of Sublingual Immunotherapy Versus Subcutaneous Injection Immunotherapy in Allergic Patients
Journal of Environmental and Public Health, 2012

These findings indicate that SCIT and SLIT demonstrate similar effectiveness. SLIT empirically betters symptom scores for asthma and hay fever while reducing the need for allergy drugs. With the heightened risks and challenges in treating asthmatic patients and children, these outcomes imply that SLIT should be regarded as the first-line treatment option for these patients, considering allergy shots for low-responders only.

Quality of Life Improvement with Sublingual Immunotherapy: A Prospective Study of Efficacy
Journal of Allergy, 2012

Statistically appreciable relief of symptoms and heightened quality of life are demonstrated during the first four months of sublingual immunotherapy treatment.  Reduced symptom scores sustain or continue to reduce after this time frame.

Allergen Immunotherapy in Allergic Respiratory Disease: From Mechanisms to Meta-Analyses
Chest Journal: Official Publication of the American College of Chest Physicians, 2012

Sublingual immunotherapy is well-accepted by patients with only limited side effects in some patients (slight mouth itching or swelling).  We are aware of just six cases of anaphylactic reaction that have ever occurred in reaction to SLIT.  Additionally, a  financial analysis of SLIT vs. pharmacotherapy for environmental allergens shows SLIT to be cost-efficient.

High-Dose Sublingual Immunotherapy with Single-Dose Aqueous Grass Pollen Extract in Children is Effective and Safe: A Double-Blind, Placebo-Controlled Study
Journal of Allergy and Clinical Immunology, 2012

This research affirmed that this usage of sublingual immunotherapy markedly lowered symptoms and medication usage in pediatric patients who had a history of allergies to grass pollen.   SLIT had substantial influence on allergen-specific antibodies, and the therapy was well-tolerated by children. Overall, SLIT appeared to be a viable treatment alternative in children with grass pollen allergies.

A Prospective Study on the Safety of Sublingual Immunotherapy in Pregnancy
Allergy, 2012

SLIT can be safely used in the course of pregnancy.  Additionally, it is safe to start a pregnant woman on SLIT, even if she is using the therapy for the first time.

The Current Role of Sublingual Immunotherapy in the Treatment of Allergic Rhinitis in Adults and Children
Journal of Asthma and Allergy, 2011

SLIT is supported by substantial research affirming its potency and safety.  In some parts of Europe, the treatment is prescribed more frequently than subcutaneous immunotherapy.  In addition to having a more favorable safety profile than SCIT, sublingual immunotherapy has also been shown to have higher compliance rates because it does not need to be taken under medical supervision.  It has also been shown to be more cost-efficient because patients do not have to pay for the administration of shots.

Sublingual Immunotherapy in Allergic Rhinitis
Asia Pacific Allergy, 2011

In Europe, sublingual immunotherapy is frequently used instead of subcutaneous immunotherapy due to several benefits:  it is not as invasive as shots, it does not need to be taken under physician supervision, and it has a higher safety profile.  In 2008, the British Society for Allergy and Clinical Immunology affirmed sublingual immunotherapy  as a safe option for allergic rhinitis and asthma, and in 2009, the World Allergy Organization Position Paper about SLIT highlighted its potency and safety.

Safety of Sublingual Immunotherapy
Journal of Biological Regulators and Homeostatic Agents, 2011

Sublingual immunotherapy is established as an accepted alternative to traditional shot therapy and is broadly used in European healthcare. Sublingual treatment is especially appealing for kids since it is painless.   There are no deaths linked to sublingual immunotherapy, and while two instances of anaphylactic reaction have been linked to it, adverse reactions to SLIT have been classified as mild.

Sublingual Immunotherapy for Allergic Rhinitis
Cochrane Database of Systematic Reviews, 2010

Sublingual immunotherapy is a safe remediation which substantially lessens symptoms and the need for medications in hay fever sufferers.

Sublingual Immunotherapy: Clinical Indications in the WAO-SLIT Position Paper
World Allergy Organization Journal, 2010

Sublingual immunotherapy is indicated in the care of hay fever for both adult and pediatric patients.   In children, SLIT may prevent the onset and progression of asthma. Sublingual immunotherapy is also indicated for asthma that is linked to rhinitis,  whereas it is not the primary treatment option for remediation of isolated asthma. SLIT is deemed to be safe for home administration (though the first dose should be given in a clinical setting).

Undertreatment of Allergy: Exploring the Utility of Sublingual Immunotherapy
Otolaryngology-Head and Neck Surgery, 2009

Traditional subcutaneous immunotherapy (SCIT or allergy shots) is effective but has also been linked to serious negative effects, must be given under medical supervision, and is not recommended for certain groups of people. On the other hand, sublingual immunotherapy is used throughout Europe, offering most of the advantages of immunotherapy and also heightened safety, patient acceptance, and convenience. This overview examines findings from a collection of clinical research and concludes that SLIT may be a fitting choice to help remedy the undertreatment of allergies in the U.S.

Comparison of Sublingual Immunotherapy vs. Inhaled Budesonide in Patients (PDF)
Annals of Allergy, Asthma and Immunology, 2009

This study examines people whose asthma is triggered by grass pollens.  Over time, sublingual immunotherapy was just as effectual as inhaled budesonide in treating asthma symptoms and offered a further advantage in addressing rhinitis and bronchial hyperresponsiveness.

Meta-analysis of the Efficacy of Sublingual Immunotherapy in the Treatment of Allergic Asthma in Pediatric Patients
Chest Journal: Official Publication of the American College of Chest Physicians, 2008

Sublingual immunotherapy with standardized allergenic extracts decreases symptoms as well as drug requirements in pediatric patients  allergy-related asthma.

The Safety of Sublingual Immunotherapy with one or Multiple Pollen Allergens in Children
Allergy, 2008

The use of an increased number of antigens for sublingual immunotherapy does not increase side effects in children.

Preventive Effects of Sublingual Immunotherapy in Childhood
Annals of Allergy, Asthma and Immunology, 2008

In daily medical practice, sublingual immunotherapy decreased the development of sensitivities to new antigens and mild asthma and reduced bronchial hyperreactivity in pediatric patients who exhibited respiratory allergies.

Sublingual Immunotherapy: What Have We Learned From the ‘Big Trials’?
Current Opinion in Allergy and Clinical Immunology, 2008

SLIT is an effective and favorably-tolerated therapy for adult seasonal hay fever sufferers. Current clinical research and examination of lasting effects will shape its continuing role in allergy remediation.

Effects of Sublingual Immunotherapy on Allergic Inflammation
Inflammation and Allergy Drug Targets, 2008

Allergen specific immunotherapy (AIT) has a marked effect on tissue inflammation resulting from allergies that endures after the treatment’s end. Further, AIT is the only treatment capable of changing the course of allergic progression. Anti-inflammatory mechanisms observed with use of high antigen doses proved to be equitable between SLIT (allergy drops) and SCIT (allergy shotes).  Biopsy results show that the pathophysiology of the oral mucosa, and in particular mucosal dendritic cells, plays a key part in helping patients build up immunity to the antigens being treated for.

Sublingual Immunotherapy: Past, Present, Paradigm for the future? A Review of the Literature
Otolaryngology-Head and Neck Surgery, 2007

Americans are becoming increasingly interested in sublingual immunotherapy. The benefits of SLIT include a highly favorable safety profile as well as a high degree of patient acceptance/tolerability, easier and better access to immunotherapy, and a more child-friendly administration route.

Post-Marketing Survey on the Safety of Sublingual Immunotherapy in Children Below the Age of 5 Years
Clinical and Experimental Allergy, 2005

Sublingual immunotherapy has been found to be safe in pediatric patients 5 years old and younger.

Position Papers

Allergic Rhinitis and Its Impact on Asthma (ARIA) Guidelines: 2010 Revision World Allergy Organization Position Paper on Sublingual Immunotherapy 2009

Sublingual Immunotherapy for Food Allergies

Sublingual Immunotherapy for Peanut Allergy: A Randomized, Double-Blind, Placebo-Controlled Multicenter Trial The Journal of Allergy and Clinical Immunology, 2013 Sublingual immunotherapy for peanut allergies was shown to safely instigate a modicum of desensitization in most trial participants.  Prolonged treatment with sublingual immunotherapy showed marked improvements in the successfully consumed doses. Sublingual vs. Oral Immunotherapy for Food Allergy: Identifying the Right Approach Drugs, 2012 Allergen immunotherapy is being examined in remediation of IgE-mediated food allergy to the most frequently eaten foods, i.e. peanut, tree nut, dairy, etc. Both oral immunotherapy and sublingual immunotherapy have shown highly favorable results in desensitizing study participants to the food allergens, though the two therapies have key variations in terms of dosing, length of therapy, safety, and convenience.  OIT and SLIT show significant promise, and a widely-available remediation for food allergies may be imminent. Can a Radical New Treatment Save Children With Severe Food Allergies? The New York Times, 2013Research at Stanford University School of Medicine is being conducted into desensitizing patients with allergies to numerous food items. Sublingual Immunotherapy for Peanut Allergy: Clinical and Immunologic Evidence of Desensitization The Journal of Allergy and Clinical Immunology, 2010 Sublingual immunotherapy has been shown to safely desensitize pediatric patients to peanut allergens.  Resulting immunologic changes point to a notable change in the way patients react to previously troublesome allergens. Continuing study can help assess SLIT’s ability to bring about long-range immune acceptance.

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