| Sublingual allergen immunotherapy: mode of action and its relationship with the safety profile. | |
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MedLine Citation:
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PMID: 22150126 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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To cite this article: Calderón MA, Simons FER, Malling H-J, Lockey RF, Moingeon P, Demoly P. Sublingual allergen immunotherapy: mode of action and its relationship with the safety profile. Allergy 2011; DOI: 10.1111/j.1398-9995.2011.02761.x ABSTRACT: Allergen immunotherapy reorients inappropriate immune responses in allergic patients. Sublingual allergen immunotherapy (SLIT) has been approved, notably in the European Union, as an effective alternative to subcutaneous allergen immunotherapy (SCIT) for allergic rhinitis patients. Compared with SCIT, SLIT has a better safety profile. This is possibly because oral antigen-presenting cells (mostly Langerhans and myeloid dendritic cells) exhibit a tolerogenic phenotype, despite constant exposure to danger signals from food and microbes. This reduces the induction of pro-inflammatory immune responses leading to systemic allergic reactions. Oral tissues contain relatively few mast cells and eosinophils (mostly located in submucosal areas) and, in comparison with subcutaneous tissue, are less likely to give rise to anaphylactic reactions. SLIT-associated immune responses include the induction of circulating, allergen-specific Th1 and regulatory CD4+ T cells, leading to clinical tolerance. Although 40-75% of patients receiving SLIT experience mild, transient local reactions in the oral mucosa, these primary reactions rarely necessitate dose reduction or treatment interruption. We discuss 11 published case reports of anaphylaxis (all nonfatal) diagnosed according to the World Allergy Organization criteria and relate this figure to the approximately 1 billion SLIT doses administered worldwide since 2000. Anaphylaxis risk factors associated with SCIT and/or SLIT should be characterized further. |
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Authors:
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M A Calderón; F E R Simons; H-J Malling; R F Lockey; P Moingeon; P Demoly |
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Publication Detail:
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Type: JOURNAL ARTICLE Date: 2011-12-12 |
Journal Detail:
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Title: Allergy Volume: - ISSN: 1398-9995 ISO Abbreviation: - Publication Date: 2011 Dec |
Date Detail:
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Created Date: 2011-12-13 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 7804028 Medline TA: Allergy Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Copyright Information:
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© 2011 John Wiley & Sons A/S. |
Affiliation:
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Section of Allergy and Clinical Immunology, Imperial College-NHLI, Royal Brompton Hospital, London, UK Department of Pediatrics & Child Health, Department of Immunology, University of Manitoba, Winnipeg, Canada Allergy Clinic, Copenhagen University Hospital, Copenhagen, Denmark Division of Allergy & Immunology, University of South Florida College of Medicine, Tampa, FL, USA Research & Development Department, Stallergenes SA, Antony, France Allergy Division, Pneumology Department, INSERM U657, Hôpital Arnaud de Villeneuve, University Hospital of Montpellier, France. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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