Sublingual immunotherapeutics

ABSTRACT

Sublingual immunotherapy (SLIT) has been developed to prevent the severe adverse effects and anaphylaxis associated with subcutaneous immunotherapy (SCIT) in the early 1980s in European countries. Allergic Rhinitis and its Impact on Asthma (ARIA) expanded the indications for SLIT to include children in its 2001 guidelines. Many studies have proved that SLIT has therapeutic effects and successful immunologic tolerance in allergic patients, especially those with allergic rhinitis/conjunctivitis and asthma. SLIT is associated with a much lower frequency of anaphylaxis and generalized adverse effects and is easier to use than SCIT. The 2010 ARIA guidelines recommended SLIT for use in adults with seasonal and perennial allergic rhinitis (AR) and children with seasonal, but not perennial, AR. The US Agency for Healthcare Research and Quality states that the superiority of administration between SCIT and SLIT is not known, but moderate grade evidence from 2013 favors SCIT over SLIT for allergic nasal and/or eye symptom control. SLIT is a very safe way to correct Th2-mediated allergic diseases; however, more studies are needed to fully measure its therapeutic effects.