Limits...
Therapeutic effects and biomarkers in sublingual immunotherapy: a review.

Fujimura T, Okamoto Y, Taniguchi M - J Allergy (Cairo) (2012)

Bottom Line: However, the mechanism of SLIT and associated biomarkers are not fully understood.In this review, we focus on the safety, therapeutic effects, including prolonged effects after treatment, and new methods of SLIT.Finally, we discuss immunological mechanisms of SLIT with a focus on oral dendritic cells and facilitated antigen presentation.

View Article: PubMed Central - PubMed

Affiliation: Research Center for Allergy and Immunology, Yokohama Institute, RIKEN, 1-7-22 Suehiro-cho, Tsurumi-ku, Yokohama, Kanagawa 230-0045, Japan.

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.

No MeSH data available.


Related in: MedlinePlus

Clinical scores in 2-year SLIT and at 1 year after treatment [36]. (a) Average daily SMSs during a 2-year course of SLIT and at 1 year after treatment are plotted for the SLIT and placebo (Plc) groups. *P < 0.05 (unpaired Student t-test). (b) Percentage average SMSs for the SLIT group based on a value of 100% for the placebo group.
© Copyright Policy - open-access
Related In: Results  -  Collection


getmorefigures.php?uid=PMC3303629&req=5

fig1: Clinical scores in 2-year SLIT and at 1 year after treatment [36]. (a) Average daily SMSs during a 2-year course of SLIT and at 1 year after treatment are plotted for the SLIT and placebo (Plc) groups. *P < 0.05 (unpaired Student t-test). (b) Percentage average SMSs for the SLIT group based on a value of 100% for the placebo group.

Mentions: Carry-over effects of SLIT are supported by other studies. DBPC trials of 3-year SLIT for grass pollen allergy showed significantly decreased scores for symptom and the rhinoconjunctivitis quality-of-life questionnaire (RQLQ), and SMS and the medication score tended to decrease with active treatment compared with those for placebo at 1 year after SLIT [34, 35]. Our recent results also suggest a 1-year prolongation of clinical effects after 2-year SLIT for Japanese cedar pollinosis [36]. Analysis of 88 participants (SLIT; N = 51, placebo; N = 37) showed positive therapeutic effects in the second year of SLIT compared with placebo (reduction of SMS by 21%, P = 0.02) and at 1 year after treatment (23%, P = 0.03) (Figure 1). A recent phase III trial performed as a large-scale randomized, DBPC study using a 75,000 SQ-T/2,800 BAU tablet in 257 subjects allergic to grass pollen also has shown that 3-year SLIT significantly decreased the mean rhinoconjunctivitis symptom and medication scores at 1 year after treatment compared with placebo. The results showed reductions of symptom scores of 31%, 36%, 29%, and 26% and reductions of medication scores of 38%, 45%, 40%, and 29% after 1, 2, and 3 years of treatment and after a follow-up year, respectively [37]. Long-lasting effects after 3-, 4-, and 5-year SLIT were evaluated in a 15-year prospective open controlled study in 59 patients with respiratory allergy for mite [38]. A decreased SMS of <50% of the baseline score (at the start of treatment) was found over the following 6 years after 3-year SLIT, and over 8 years after 4- and 5-year SLIT. The SMS after loss of the prolonged therapeutic effects increased to levels comparable with those in the control group. Significant clinical effects were obtained in a second course of SLIT given after the initial effects had vanished.


Therapeutic effects and biomarkers in sublingual immunotherapy: a review.

Fujimura T, Okamoto Y, Taniguchi M - J Allergy (Cairo) (2012)

Clinical scores in 2-year SLIT and at 1 year after treatment [36]. (a) Average daily SMSs during a 2-year course of SLIT and at 1 year after treatment are plotted for the SLIT and placebo (Plc) groups. *P < 0.05 (unpaired Student t-test). (b) Percentage average SMSs for the SLIT group based on a value of 100% for the placebo group.
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3303629&req=5

fig1: Clinical scores in 2-year SLIT and at 1 year after treatment [36]. (a) Average daily SMSs during a 2-year course of SLIT and at 1 year after treatment are plotted for the SLIT and placebo (Plc) groups. *P < 0.05 (unpaired Student t-test). (b) Percentage average SMSs for the SLIT group based on a value of 100% for the placebo group.
Mentions: Carry-over effects of SLIT are supported by other studies. DBPC trials of 3-year SLIT for grass pollen allergy showed significantly decreased scores for symptom and the rhinoconjunctivitis quality-of-life questionnaire (RQLQ), and SMS and the medication score tended to decrease with active treatment compared with those for placebo at 1 year after SLIT [34, 35]. Our recent results also suggest a 1-year prolongation of clinical effects after 2-year SLIT for Japanese cedar pollinosis [36]. Analysis of 88 participants (SLIT; N = 51, placebo; N = 37) showed positive therapeutic effects in the second year of SLIT compared with placebo (reduction of SMS by 21%, P = 0.02) and at 1 year after treatment (23%, P = 0.03) (Figure 1). A recent phase III trial performed as a large-scale randomized, DBPC study using a 75,000 SQ-T/2,800 BAU tablet in 257 subjects allergic to grass pollen also has shown that 3-year SLIT significantly decreased the mean rhinoconjunctivitis symptom and medication scores at 1 year after treatment compared with placebo. The results showed reductions of symptom scores of 31%, 36%, 29%, and 26% and reductions of medication scores of 38%, 45%, 40%, and 29% after 1, 2, and 3 years of treatment and after a follow-up year, respectively [37]. Long-lasting effects after 3-, 4-, and 5-year SLIT were evaluated in a 15-year prospective open controlled study in 59 patients with respiratory allergy for mite [38]. A decreased SMS of <50% of the baseline score (at the start of treatment) was found over the following 6 years after 3-year SLIT, and over 8 years after 4- and 5-year SLIT. The SMS after loss of the prolonged therapeutic effects increased to levels comparable with those in the control group. Significant clinical effects were obtained in a second course of SLIT given after the initial effects had vanished.

Bottom Line: However, the mechanism of SLIT and associated biomarkers are not fully understood.In this review, we focus on the safety, therapeutic effects, including prolonged effects after treatment, and new methods of SLIT.Finally, we discuss immunological mechanisms of SLIT with a focus on oral dendritic cells and facilitated antigen presentation.

View Article: PubMed Central - PubMed

Affiliation: Research Center for Allergy and Immunology, Yokohama Institute, RIKEN, 1-7-22 Suehiro-cho, Tsurumi-ku, Yokohama, Kanagawa 230-0045, Japan.

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.

No MeSH data available.


Related in: MedlinePlus