title: Effects of sublingual immunotherapy for multiple or single allergens in polysensitized patients.
abstract: BACKGROUND
  Sublingual immunotherapy (SLIT) has proven efficacy in treating respiratory allergy.
  
  
  OBJECTIVE
  To compare the clinical and functional effects and the effect on nasal eosinophils of SLIT with either single or combination allergens.
  
  
  METHODS
  We performed an open-labeled, controlled, 4 parallel-group randomized study with 58 patients sensitized to birch and grasses only who had rhinitis and bronchial hyperreactivity in both pollen seasons. Patients were recruited for the study from January 1, 1999, to June 30, 2001. The patients received SLIT for birch, SLIT for grass, SLIT for birch and grass, or drugs only. Symptom and medication scores, forced expiratory volume in 1 second, bronchial hyperreactivity, and nasal eosinophil counts were evaluated in both pollen seasons at baseline and after 2 and 4 years.
  
  
  RESULTS
  Ten patients dropped out and 48 completed the study. No change in all the considered parameters vs baseline was seen in patients treated with drugs only. Those patients receiving SLIT for grass or birch had a significant clinical improvement and nasal eosinophil reduction vs baseline and vs patients who did not receive SLIT in the target season (P < .01) but also in the unrelated pollen season (P < .05). The patients receiving SLIT for grass and birch improved as well, and their improvement in clinical symptoms and inflammation was significantly greater than in patients treated with SLIT for the single allergens. Minor changes were seen in the forced expiratory volume in 1 second, since it remained within the reference range in the whole population.
  
  
  CONCLUSIONS
  In patients sensitized to grass and birch, SLIT with the 2 allergens provided the best clinical results. Nevertheless, SLIT with birch only or grass only also provided a measurable improvement in the grass season and birch season, respectively.
authors: Pneumology Unit, Cuasso al Monte, Macchi Hospital Foundation, Varese, Italy.
authors: Maurizio
authors: M
authors: Marogna
authors: Igino
authors: I
authors: Spadolini
authors: Alessandro
authors: A
authors: Massolo
authors: Pietro
authors: P
authors: Zanon
authors: Daniele
authors: D
authors: Berra
authors: Elena
authors: E
authors: Chiodini
authors: Walter G
authors: WG
authors: Canonica
authors: Giovanni
authors: G
authors: Passalacqua
mesh_terms: D000286:Administration, Sublingual; D000328:Adult; D000485:Allergens / Q000276:immunology* / Q000627:therapeutic use; D052179:Antigens, Plant / Q000276:immunology* / Q000627:therapeutic use; D029662:Betula / Q000276:immunology; D003888:Desensitization, Immunologic / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D006109:Poaceae / Q000276:immunology; D012130:Respiratory Hypersensitivity / Q000276:immunology* / Q000628:therapy*
chemical_list: D000485:Allergens; D052179:Antigens, Plant