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How It Works

Allergy symptoms are caused by hypersensitivity of the immune system.

When an allergic body enounters an allergen, type 2 helper T cells (Th2) secrete the cytokines IL-4, IL-5 and IL-10. The Th2 cytokine IL-4 instructs B cells to produce IgE antibodies, which are taken up by basophils and mast cell receptors. Activation of these IgE-sensitized cells results in the release of histamine, leukotrienes and prostaglandins, which produce allergy symptoms.

Allergen immunotherapy is designed to stimulate a more normal immune response. The Th2 dominant response is replaced by the production of IL-10 and TGF-β, which suppress basophils and mast cells, increase the production of allergen-specific IgA and IgG4, and reduce the production of symptom-causing IgE.

Studies show that allergen-specifc IgE gradually decreases over months of immunotherapy; moreover, the “normal” increase in IgE caused by seasonal allergen exposure is blunted following immunotherapy.

SLIT and OIT

Allergen immunotherapy, or desensitization, involves systematically exposing patients to increasingly larger allergen doses to mediate the immune response and reduce symptoms.

In sublingual Immunotherapy (SLIT) or oral immunotherapy (OIT), the allergens are administered orally.

Oral Immunotherapy vs Allergy Shots

There are several advantages of oral or sublinqual immunotherapy over subcutaneous immunotherapy (allergy shots). SLIT and OIT cost less, avoid painful injections, are safer, and can be taken in the comfort of your own home.

Parts Per Million

Sublingual immunotherapy uses allergen extracts that have been serially diluted up to six times before administration, so the allergen material delivered by a dose might only be measured in parts per million.

Select Studies

Randomised controlled trial of homoeopathy versus placebo in perennial allergic rhinitis with overview of four trial series

Taylor MA, Reilly D, Llewellyn-Jones RH, McSharry C, Aitchison TC. Randomised controlled trial of homoeopathy versus placebo in perennial allergic rhinitis with overview of four trial series [published correction appears in BMJ 2000 Sep 23;321(7263):733]. BMJ. 2000;321(7259):471-476. doi:10.1136/bmj.321.7259.471

Sublingual immunotherapy for allergic rhinitis (Cochrane Review)

Wilson DR, Torres, Lima M, Durhum SR. Sublingual immunotherapy for allergic rhinitis (Cochrane Review). In: The Cochrane Library, Issue 4, 2004.

Sublingual immunotherapy: World Allergy Organization position paper 2013 update

Canonica GW, Cox L, Pawankar R, Baena-Cagnani CE, Blaiss M et al.  Sublingual immunotherapy: World Allergy Organization position paper 2013 update. World Allergy Organization Journal 2014; 7:6 (28 March). doi:10.1186/1939-4551-7-6

Allergies: A Route To Resolution – Naturopathic Doctor News And Review

Born, ND, T., 2016. Allergies: A Route To Resolution – Naturopathic Doctor News And Review. [online] Ndnr.com

Allergen immunotherapy: an updated review of safety

James C, Bernstein DI. Allergen immunotherapy: an updated review of safety. Curr Opin Allergy Clin Immunol. 2017;17(1):55-59. doi:10.1097/ACI.0000000000000335

Basic science for the clinician: Mechanisms of sublingual and subcutaneous immunotherapy

Lawrence MG, Steinke JW, Borish L. Basic science for the clinician: Mechanisms of sublingual and subcutaneous immunotherapy. Ann Allergy Asthma Immunol. 2016;117(2):138-142. doi:10.1016/j.anai.2016.06.027

How does sublingual immunotherapy work?

Anthony J. Frew, How does sublingual immunotherapy work?, Journal of Allergy and Clinical Immunology, Volume 120, Issue 3

Sublingual immunotherapy for allergic rhinoconjunctivitis and asthma

Creticos, MD, P., 2019. Sublingual immunotherapy for allergic rhinoconjunctivitis and asthma. [online] Uptodate.com.

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