Controversie
L’immunoterapia specifica orale: sì o no?
SUBLINGUAL IMMUNOTHERAPY: YES OR NOT?
GIORGIO LONGO
Dipartimento di Scienze della Riproduzione e dello Sviluppo, Centro di Allergologia, Clinica Pediatrica, IRCCS “Burlo Garofolo”, Università di Trieste
Novembre 2001 - pagg. 617 -620
Abstract
Desensitization through the sublingual route is very popular and covers about 50% of the
market. There is general consensus on its biological efficacy but at a more careful scrutiny
its widespread use does not appear totally justified. If costs, limited short-term efficacy and
no long-term efficacy are taken into account, the traditional iv route still seems preferable.
The iv route is more practical, less expensive and, most important, effective also off therapy,
at least for pollens and insect poison.
Classificazione MeSH
Bibliografia
1. Passalacqua G, Bagnasco G, Mariani G, et
al. Local immunotherapy: pharmacokinetics
and efficacy. EEAACI/PTA Symposium
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2. van-Wilsen EJ, van-Hoogstraten IM, Breve J, et al. Dendritic cells of the oral mucosa and the induction of oral tolerance. A local affair. Immunology 1994;83:128-32.
3. Holt PG, Vines J, Britten D. Sublingual allergen administration. I. Selective suppression of IgE production in rats by hight allergen doses. Clin Allergy 1988;18:229-34.
4. Fanta C, Bohle B, Hirt W, et al. Systemic immunological changes induced by administration of grass pollen allergens via the oral mucosa during sublingual immunotherapy. Int Arch Allergy Appl Immunol 1999;120:218- 24.
5. Sabbah A, Hasson S, Le Sellin J. A doubleblind placebo-controlled trial by sublingual route of immunotherapy with a standardized grass pollen extract. Allergy 1994;49:309-13.
6. Pajno GB, Morabito L, Barberio G, et al. Clinical and immunologic effects of long-term sublingual immunotherapy in asthmatic children sensitized to mites: double-blind, placebo- controlled study. Allergy 2000;55: 842-9.
7. Malling H, Abreu-Nogueira J, Alvarez-Cuesta E, et al. Local immunotherapy, Position paper. Allergy 1998;53:933-44.
8. Caffarelli C, Sensi LG, Marcucci F, Cavagni G. Preseasonal local allergoid immunotherapy to grass pollen in children: a doubleblind, placebo-controlled, randomized trial. Allergy 2000;55:1142-7.
9. La Rosa M, Ranno C, André C, et al. Double- blind placebo-controlled evaluation of sublingual- swallow immunotherapy with standardized Parietaria judaica extract in children with allergic rhinoconjunctivitis. J Allergy Clin Immunol 1999;104:425-32.
10. Hirsch Th, Sahm M, Leupold W. Doubleblind placebo-controlled study of sublingual immunotherapy with house dust mite extract (D. pt.) in children. Pediatr Allergy Immunol 1997;8:21-7.
11. Clavel R, Bousquet J, André C. Clinical efficacy of sublingual-swallow immunotherapy: a double-blind, placebo-controlled trial of standardized five-grass pollen extract in rhinitis. Allergy 1998;53:493-8.
12. Passalacqua G, Albano M, Riccio A, et al. Clinical and immunologic effects of a rush sublingual immunotherapy to Parietaria species: A double-blind, placebo-controlled trial. J Allergy Clin Immunol 1999;104:964-8.
13. Adkinson FN, Eggleston PA, Eney D, et al. A controlled trial of immunotherapy for asthma in allergic children. N Engl J Med 1997;336:324-31.
14. Torres Costa JC, Placido JL, Moreira Silva JP, et al. Effects of immunotherapy on symptoms, PEFR, spirometry, and airway responsiveness in patients with allergic asthma to house-dust mites (D. pteronyssinus) on inhaled steroid therapy. Allergy 1996:51:238-44.
15. Longo G, Poli F, Loik F. L’efficacia dell’intervento sull’ambiente (misure antipolvere) nella profilassi dell’asma da dermatofagoidi in pediatria. Folia Allergol Immunol Clin 1980;27:6-9.
16. Guez S, Vatrinet C, Fadel R, et al. Housedust sublingual-swallow immunotherapy (SLIT) in perennial rhinitis: a double-blind, placebo-controlled study. Allergy 2000; 55:369-75.
17. Durhan SR, Walker SM, Varga EM, et al. Long-term efficacy of grass pollen immunotherapy. N Engl J Med 1999;341:468-75.
18. Passalacqua G, Albano M, Pronzato C, et al. Long-term follow-up immunotherapy to Parietaria: Clinical and immunological effects. Clin Exp Allergy 1997;27:904-8.
19. Di Rienzo V, Puccinelli P, Frati F, et al. Grass pollen specific sublingual/swallow immunotherapy in children: open-controlled comparison smong different treatment protocols. Allergol Immunopathol 1999;27:145-51.
20. Quirino T, Iemoli E, Siciliani E, et al. Sublingual versus injective immunotherapy in grass pollen allergic patients: a double blind (double dummy) study. Clin Exp Allergy 1996;26:1253-61.
21. Malling HJ. Allergen-specific immunotherapy. Present state and directions for the future. Allergy 1999;54:30-3.
22. Des Roches A, Paradis L, Knani J, et al. Immunotherapy with a standardized Dermatophagoides pteronyssinus extract. V. Duration of the efficacy of immunotherapy after its cessation. Allergy 1996;51:430-3.
23. Giovane LA, Bardare M, Passalacqua S, et al. A three-year double-blind placebo-controlled study with specific oral immunotherapy to Dermatophagoides: evidence of safety and efficacy in paediatric patients. Clin Exp Allergy 1994;24:53-9.
24. Antico A, et al. Memorandum SIAIC sulle riniti. Giorn It Allergol Immunol Clin 2000;10:87-145.
25. Andre C, Vatrinet C, Galvain S, et al. Safety of sublingual-swallow immunotherapy in children and adults. Int Arch Allergy Immunol 2000;121:229-34.
26. Businco L, Zannino L, Cantani A, et al. Sistemic reactions to specific immunotherapy in children with respiratory allergy: a prospective study. Pediatr Allergy Immunol 1995;6:44-7.
27. Pichler CE, Helbling A, Pichler WJ. Three years of specific immunotherapy with housedust- mite extracts in patients with rhinitis and asthma: significant improvement of allergen- specific parameters and nonspecific bronchial hyperreactivity. Allergy 2001; 56:301-6.
28. Goldberg A, Confino-Cohen R. Maintenance venom immunotherapy administered at 3-month intervals is both safe and efficacious. J Allergy Clin Immunol 2001;107:902-6.
2. van-Wilsen EJ, van-Hoogstraten IM, Breve J, et al. Dendritic cells of the oral mucosa and the induction of oral tolerance. A local affair. Immunology 1994;83:128-32.
3. Holt PG, Vines J, Britten D. Sublingual allergen administration. I. Selective suppression of IgE production in rats by hight allergen doses. Clin Allergy 1988;18:229-34.
4. Fanta C, Bohle B, Hirt W, et al. Systemic immunological changes induced by administration of grass pollen allergens via the oral mucosa during sublingual immunotherapy. Int Arch Allergy Appl Immunol 1999;120:218- 24.
5. Sabbah A, Hasson S, Le Sellin J. A doubleblind placebo-controlled trial by sublingual route of immunotherapy with a standardized grass pollen extract. Allergy 1994;49:309-13.
6. Pajno GB, Morabito L, Barberio G, et al. Clinical and immunologic effects of long-term sublingual immunotherapy in asthmatic children sensitized to mites: double-blind, placebo- controlled study. Allergy 2000;55: 842-9.
7. Malling H, Abreu-Nogueira J, Alvarez-Cuesta E, et al. Local immunotherapy, Position paper. Allergy 1998;53:933-44.
8. Caffarelli C, Sensi LG, Marcucci F, Cavagni G. Preseasonal local allergoid immunotherapy to grass pollen in children: a doubleblind, placebo-controlled, randomized trial. Allergy 2000;55:1142-7.
9. La Rosa M, Ranno C, André C, et al. Double- blind placebo-controlled evaluation of sublingual- swallow immunotherapy with standardized Parietaria judaica extract in children with allergic rhinoconjunctivitis. J Allergy Clin Immunol 1999;104:425-32.
10. Hirsch Th, Sahm M, Leupold W. Doubleblind placebo-controlled study of sublingual immunotherapy with house dust mite extract (D. pt.) in children. Pediatr Allergy Immunol 1997;8:21-7.
11. Clavel R, Bousquet J, André C. Clinical efficacy of sublingual-swallow immunotherapy: a double-blind, placebo-controlled trial of standardized five-grass pollen extract in rhinitis. Allergy 1998;53:493-8.
12. Passalacqua G, Albano M, Riccio A, et al. Clinical and immunologic effects of a rush sublingual immunotherapy to Parietaria species: A double-blind, placebo-controlled trial. J Allergy Clin Immunol 1999;104:964-8.
13. Adkinson FN, Eggleston PA, Eney D, et al. A controlled trial of immunotherapy for asthma in allergic children. N Engl J Med 1997;336:324-31.
14. Torres Costa JC, Placido JL, Moreira Silva JP, et al. Effects of immunotherapy on symptoms, PEFR, spirometry, and airway responsiveness in patients with allergic asthma to house-dust mites (D. pteronyssinus) on inhaled steroid therapy. Allergy 1996:51:238-44.
15. Longo G, Poli F, Loik F. L’efficacia dell’intervento sull’ambiente (misure antipolvere) nella profilassi dell’asma da dermatofagoidi in pediatria. Folia Allergol Immunol Clin 1980;27:6-9.
16. Guez S, Vatrinet C, Fadel R, et al. Housedust sublingual-swallow immunotherapy (SLIT) in perennial rhinitis: a double-blind, placebo-controlled study. Allergy 2000; 55:369-75.
17. Durhan SR, Walker SM, Varga EM, et al. Long-term efficacy of grass pollen immunotherapy. N Engl J Med 1999;341:468-75.
18. Passalacqua G, Albano M, Pronzato C, et al. Long-term follow-up immunotherapy to Parietaria: Clinical and immunological effects. Clin Exp Allergy 1997;27:904-8.
19. Di Rienzo V, Puccinelli P, Frati F, et al. Grass pollen specific sublingual/swallow immunotherapy in children: open-controlled comparison smong different treatment protocols. Allergol Immunopathol 1999;27:145-51.
20. Quirino T, Iemoli E, Siciliani E, et al. Sublingual versus injective immunotherapy in grass pollen allergic patients: a double blind (double dummy) study. Clin Exp Allergy 1996;26:1253-61.
21. Malling HJ. Allergen-specific immunotherapy. Present state and directions for the future. Allergy 1999;54:30-3.
22. Des Roches A, Paradis L, Knani J, et al. Immunotherapy with a standardized Dermatophagoides pteronyssinus extract. V. Duration of the efficacy of immunotherapy after its cessation. Allergy 1996;51:430-3.
23. Giovane LA, Bardare M, Passalacqua S, et al. A three-year double-blind placebo-controlled study with specific oral immunotherapy to Dermatophagoides: evidence of safety and efficacy in paediatric patients. Clin Exp Allergy 1994;24:53-9.
24. Antico A, et al. Memorandum SIAIC sulle riniti. Giorn It Allergol Immunol Clin 2000;10:87-145.
25. Andre C, Vatrinet C, Galvain S, et al. Safety of sublingual-swallow immunotherapy in children and adults. Int Arch Allergy Immunol 2000;121:229-34.
26. Businco L, Zannino L, Cantani A, et al. Sistemic reactions to specific immunotherapy in children with respiratory allergy: a prospective study. Pediatr Allergy Immunol 1995;6:44-7.
27. Pichler CE, Helbling A, Pichler WJ. Three years of specific immunotherapy with housedust- mite extracts in patients with rhinitis and asthma: significant improvement of allergen- specific parameters and nonspecific bronchial hyperreactivity. Allergy 2001; 56:301-6.
28. Goldberg A, Confino-Cohen R. Maintenance venom immunotherapy administered at 3-month intervals is both safe and efficacious. J Allergy Clin Immunol 2001;107:902-6.