Clinical and immunological response to sublingual allergen-specific immunotherapy: cumulative dose-response relationship

Abstract

Background: Initial studies on sublingual allergen-specific immunotherapy (SLIT) used low doses, but it soon became clear that cumulative dosages higher than the doses used in subcutaneous immunotherapy (SCIT) were required to guarantee clinical efficacy. Objective: This study aimed to evaluate the cumulative dose-dependent clinical and immunological responses to SLIT. Methodology: Patients with allergic airway diseases were included in the study. Patients underwent a skin prick test (SPT) and then received sublingual allergen-specific immunotherapy. Clinical and immunological response variables were recorded at 0, 3, and 6 months intervals of the SLIT schedule (with progressively increasing doses). Results: The study included 74 patients with allergic airway diseases. Symptom and medication scores significantly decreased from baseline (P <0.0001). Hay-specific IgE levels did not decrease significantly, but mite-specific IgE levels decreased by 146%. Hay-specific IgG4 levels increased by 44. 44% after six months of immunotherapy (P<0.01). Eosinophil cationic protein (ECP) levels decreased significantly in patients who underwent six months of sublingual-swallow immunotherapy. Conclusion: There is a clinical cumulative dose-response relationship after SLIT. However, apart from ECP, the immunological cumulative dose-response relationship varies between the allergens.