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REVIEW ARTICLE
Year : 2013  |  Volume : 27  |  Issue : 2  |  Page : 102-107

Sublingual swallow immunotherapy


Department of Allergy and Applied Immunology, Bengaluru Allergy Centre, Jayanagar, Bengaluru, Karnataka, India

Correspondence Address:
Komarla Nagendra Prasad
Bengaluru Allergy Centre, #55, Second cross, Gavipuram extension, Banglore - 560 019, Karnataka
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0972-6691.124391

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Allergen Specific Immunotherapy (ASI) in the form of subcutaneous route (SCIT) used over a century and is currently under used for management of IgE mediated allergy disorders. SCIT Meta analysis showed very promising results and sustained effect for a long period from 7 years to 12 years on stopping the therapy. The adverse events are not common and application for day to day practice currently restricted among trained physicians. Allergy prone subjects adherence to SCIT is very less and drop outs are more either due to invasive injections, the long term dosage, cumbersome to wait at the clinic after the injection or due to local and systemic reactions. Alternate route suggested by WAO, ARIA and EAACI is Sublingual (SLIT) for better compliance and to increase the adherence of the therapy. SLIT Meta analysis showed its efficacy is equivalent to SCIT with mild to moderate tolerable adverse events without discontinuation of dosage schedules.SLIT becomes successful in the hands of trained physicians who initiate the effective dose for effective response which is crucial. The quality of standardised allergen extracts and the appropriate dose is to generate clinical response is very important. Selection of allergens for therapy by taking care of proteolysis which degrade in combination of heterogeneous allergens and time of administration is very critical. SLIT is friendly with children less than 6 years, SCIT restricted below 6 years. SLIT in the form of drops, tablets and Stripe is currently used and SLIT kept below the tongue before food for 2 to 5 minutes and swallow. The prescribed tailor made dosage consumed on daily basis at a regular time shows better results. At present the SLIT is a personal Medicine. SLIT is popular among European countries and US FDA is in the process of evaluation of clinical trials.


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