[Sublingual immunotherapy--coming of age?].
BACKGROUND
Immunotherapy is the only therapeutic modality in allergic patients with long lasting effects on the reactivity of the immune system to specific allergen exposure. Classical, subcutaneous, immunotherapy is associated with ubiquitous local and rare but potentially life-threatening systemic side effects. Sublingual immunotherapy is a relatively new modality of treatment, utilizing daily gradually increasing concentrations of allergen that are placed sublingually for a few minutes and swallowed afterwards.


OBJECTIVE
To summarize "state of the art" concepts on sublingual immunotherapy, its mechanisms of action as well as safety and efficacy in the treatment of allergic disease.


METHODS
A Medline search was performed through the PubMed service of the National Library of Medicine, for the period 1985 to December 2004, using "sublingual" and "imm unotherapy" in the title or abstract. The latest Cochrane Library meta-analysis on the subject was extracted as well as the original publications on which the analysis is based.


RESULTS
Sublingual immunotherapy is a safe treatment in patients of all ages with asthma and other allergic diseases. The modality is more effective than placebo in the treatment of allergic rhinitis in adults. Our local experience supports a remarkable safety profile and efficacy.


CONCLUSIONS
Sublingual immunotherapy is a promising treatment for allergic patients. Further study is needed but it seems reasonable to assume that an increasing number of patients will benefit from this modality in the near future.
Kidon
Mona Iancovici
MI
Allergy and Clinical Immunology Unit, Kaplan Medical Centre, Rehovot affiliated to the "Hadassah" School of Medicine, The Hebrew University, Jerusalem. drkidon@bezeqint.net
Nelken
David
D
D000286:Administration, Sublingual; D006801:Humans; D007155:Immunologic Factors / Q000008:administration & dosage* / Q000627:therapeutic use*; D007167:Immunotherapy / Q000379:methods* / Q000639:trends
D007155:Immunologic Factors