No abstract available.
Immunosuppression*

Allergen specific immunotherapy is a medical treatment aiming at patients suffering from allergies that are insufficiently controlled by symptomatic treatments. Allergen immunotherapy rehabilitates the immune system. Subcutaneous immunotherapy (SCIT) is the historical route of administration and consists of allergen extract injections. SCIT has proven efficacy in allergic rhinitis and asthma, but it requires regular injections at the hospital and carries the risk of potentially serious systemic allergic reactions in response to the treatment itself. Sublingual immunotherapy (SLIT) offers several specific advantages over SCIT. SLIT is more easily administered, avoids cumbersome injections regimens, and carries a much lower risk of anaphylactic shock compared with SCIT. So, this article will discuss the mechanisms of action, advantages, and limitations of SLIT for allergic rhinitis.
Anaphylaxis ; Asthma ; Desensitization, Immunologic ; Humans ; Hypersensitivity ; Immune System ; Immunotherapy ; Rhinitis* ; Sublingual Immunotherapy*

Even though atopic dermatitis (AD) is one of the most common chronic inflammatory skin diseases, its treatment remains a challenge in clinical practice, with most approaches limited to symptomatic, unspecific anti-inflammatory, or immunosuppressive treatments. Many studies have shown AD to have multiple causes that activate complex immunological and inflammatory pathways. However, aeroallergens, and especially the house dust mite (HDM), play a relevant role in the elicitation or exacerbation of eczematous lesions in many AD patients. Accordingly, allergen-specific immunotherapy has been used in AD patients with the aim of redirecting inappropriate immune responses. Here, we report three cases of refractory AD sensitized to HDM who were treated with sublingual immunotherapy.
Dermatitis, Atopic* ; Desensitization, Immunologic* ; Humans ; Immunotherapy ; Pyroglyphidae* ; Skin Diseases ; Sublingual Immunotherapy

Current treatment options for allergic rhinitis (AR) include allergen avoidance and environmental control, pharmacotherapy, nasal surgery and immunotherapy. Among these, immunotherapy is the only therapeutic option that modifies fundamental immunologic mechanism by inducing desensitization. Specific allergen immunotherapy has been used for 1 century since 1911 and subcutaneous immunotherapy (SCIT) has been demonstrated to be effective in asthma and AR. However, SCIT has several disadvantages such as inconvenience, invasiveness and potentially severe systemic reactions. Thus, sublingual immunotherapy (SLIT) has recently received much attention around the world as a treatment for AR and is now widely used to replace the subcutaneous route. SLIT has recently been introduced in Korea and is now available for AR treatment in the Asia-Pacific region. This review offers better understanding of SLIT for AR by summarizing published articles and our previous works regarding proposed mechanisms, indication and efficacy, safety and adverse events, and compliance.
Administration, Sublingual ; Asthma ; Compliance ; Desensitization, Immunologic ; Drug Therapy ; Immunotherapy ; Korea ; Nasal Surgical Procedures ; Rhinitis ; Rhinitis, Allergic ; Sublingual Immunotherapy

OBJECTIVETo compare the difference in the effects of subcutaneous immunotherapy (SCIT) and sublingual immunotherapy (SLIT) on immunological responses in children with asthma.

METHODSA total of 86 children with asthma caused by dust mites were enrolled and divided into a SLIT group (n=29), a SCIT group (n=13), a group receiving complete SCIT course (complete SCIT group; n=14), and a group receiving conventional medication (control group, n=30). Peripheral blood mononuclear cells were isolated and stimulated with house dust mite extract for 48 hours in vitro, and the percentage of regulatory T cells (Treg%) in CD4+ T cells was measured by flow cytometry. Analysis of variance with repeated measures was applied to compare the changes in humoral immunological indices and therapeutic effects in the SCIT and SLIT groups before treatment and after 6 and 12 months of treatment.

RESULTSBefore antigenic stimulation, Treg% in CD4(+) T cells in the SCIT group was significantly higher than that in the SLIT and control groups; after antigenic stimulation was given, Treg% in the four groups decreased significantly. After 6 and 12 months of immunotherapy, the SCIT group had significant changes in serum sIgE and sIgG4 levels, while the SLIT group only showed a significant change in serum sIgE level.

CONCLUSIONSTemporal difference exists in different immunotherapies to cause immunological responses in children with asthma, and immunological responses induced by SCIT may occur earlier.

Adolescent ; Asthma ; immunology ; therapy ; Child ; Child, Preschool ; Desensitization, Immunologic ; Female ; Humans ; Male ; Sublingual Immunotherapy

Dendritic cells (DCs) is known as the most potential and professional antigen presenting cells (APC), it mainly involves in the cellular immunity and T cell dependent humoral immunity, which plays a key role in the immune response and is one of the most hot areas in immunology in recent years. DCs plays a key role in allergic rhinitis (AR) and is one of the most important mechanism of AR treating by sublingual immunotherapy (SLIT). This article reviewed the mechanism of the role of DCs in AR and AR treating by SLIT.
Animals ; Dendritic Cells ; immunology ; Desensitization, Immunologic ; Humans ; Rhinitis, Allergic ; therapy ; Sublingual Immunotherapy

Allergen-specific immunotherapy (AIT) is the only curative way that can change the immunologic response to allergens and thus can modify the natural progression of allergic diseases. There are some important criteria which contributes significantly on efficacy of AIT, such as the allergen extract used for treatment, the dose and protocol, patient selection in addition to the severity and control of asthma. The initiation of AIT in allergic asthma should be considered in intermittent, mild and moderate cases which coexisting with other allergic diseases such as allergic rhinitis, and in case of unacceptable adverse effects of medications. Two important impact of AIT; steroid sparing effect and preventing from progression to asthma should be taken into account in pediatric asthma when making a decision on starting of AIT. Uncontrolled asthma remains a significant risk factor for adverse events and asthma should be controlled both before and during administration of AIT. The evidence concerning the efficacy of subcutaneous (SCIT) and sublingual immunotherapy (SLIT) for treatment of pediatric asthma suggested that SCIT decreases asthma symptoms and medication scores, whereas SLIT can ameliorate asthma symptoms. Although the effectiveness of SCIT has been shown for both seasonal and perennial allergens, the data for SLIT is less convincing for perennial allergies in pediatric asthma.
Allergens ; Asthma ; Child ; Desensitization, Immunologic ; Humans ; Hypersensitivity ; Immunotherapy ; Patient Selection ; Rhinitis, Allergic ; Risk Factors ; Seasons ; Sublingual Immunotherapy

OBJECTIVE: To observe the role of the dust mites drops sublingual immunotherapy(SLIT) in pediatric allergic rhiriitis caused by dust mites and compare its efficacy between monosensitized and polysensitized children. METHOD: A total of 77 pediatric allergic rhinitis patients received Dermatophagoides farina extracts sublingual immunotherapy for 2 years were enrolled as desensitization group and were allocated into monosensitized group (41 cases) and polysensitized group (36 cases) according to the number of coexisting allergens. Meanwhile another 33 allergic rhinitis children treated by pharmacotherapy during the period were collected as control group. The total symptom scores (TNSS), total medication scores (TMS) and visual analogue scale(VAS) were assessed at the beginning, six months, 1 year and 2 years of the treatment. SPSS 13. 0 software was used to analyze the data. RESULT: the score of TNSS and VAS in desensitization was slightly higher than the control after six months treatment, but without difference at l year and 2 years; the score of TMS had significantly improved in desensitization compared with the corresponding points in control. All the parameters in monosensitized group were equivalent with polysensitizend group, except the score of TMS was slightly lower than the polysensitizend group at six months. CONCLUSION Dust mite drops sublingual immunotherapy is effective for the allergic rhinitis children caused by mites. And it has similar immunotherapy efficacy between monosensitized and polysensitized children.
Administration, Sublingual ; Allergens ; administration & dosage ; Animals ; Antigens, Dermatophagoides ; administration & dosage ; Child ; Dermatophagoides farinae ; Desensitization, Immunologic ; Humans ; Rhinitis, Allergic ; drug therapy ; Software ; Sublingual Immunotherapy ; Treatment Outcome

Objective:To investigate the compliance of patients with allergic rhinitis（AR） receiving sublingual immunotherapy and its influencing factors. Methods:The clinical data of 291 AR patients who received sublingual immunotherapy for dust mites at the First Hospital of Peking University from January 2016 to January 2018 were retrospectively analyzed, and their outpatient or telephone follow-up was conducted. For patients whose treatment time was less than 2 years, the time and reason for the loss were recorded, and the factors affecting their compliance were discussed from the aspects of gender, age, and education. Results:Among the 291 patients, 245 cases（84.2%） were successfully followed up, and 193 cases（78.8%） fell off midway（treatment time<2 years）. The overall compliance rate was 21.22%（52/245）. The compliance rate of children is higher than that of adults（χ²=21.306, P<0.05）, and gender and education level have no significant effect on the compliance rate. The time period for the largest number of shedding was 6-<12 months after treatment（68 cases, 27.8%）. The main cause of shedding was symptom relief, which was considered cured（16.7%）. Secondly, within 3 months after treatment, a total of 61 patients（24.9%） fell off, of which 34 cases（13.9%） fell off because of troublesome medication, often missed medication, and simply stopped taking the drug. Statistics on the overall reasons for shedding in 193 patients, the top three shedding reasons were: cured after symptom relief（59 cases, 30.6%）, troublesome medication, discontinuation after missed dose（44 cases, 22.8%）, slow onset or ineffectiveness（26 cases, 13.5%）. Conclusion:The overall compliance of sublingual immunotherapy in patients with allergic rhinitis is poor, and the compliance of children is better than that of adults. Clinicians should focus on the reasons for patients to fall off at various times, strengthen patient education, enhance patient confidence in treatment, and improve the compliance of patients.
Adult ; Child ; Animals ; Humans ; Sublingual Immunotherapy ; Retrospective Studies ; Treatment Outcome ; Rhinitis, Allergic/drug therapy* ; Desensitization, Immunologic ; Pyroglyphidae ; Immunotherapy ; Antigens, Dermatophagoides/therapeutic use*

No abstract available.
Humans ; Immunosuppression ; Mycobacterium chelonae*