title: Effects of sublingual immunotherapy on allergic inflammation.
abstract: The clinical expression of the most common allergic diseases reflects allergic inflammation and underlines that inflammation is the main target of anti-allergic therapies. Allergen specific immunotherapy (AIT) has a recognized impact on allergic inflammation, which persists after its discontinuation, and is the only therapy able to modify the natural history of allergic march. The traditional, subcutaneous route of administration is effective in altering the phenotype of allergen-specific T cells, switching from a Th2-type response, characterized by the production of IL-4, IL-5, IL-13, IL-17, and IL-32 cytokines to a Th1-type response. This immune deviation is related to an increased IFN-gamma and IL-2 production as well as to the anergy or tolerance of Th2, the latter related to the generation of allergen-specific T regulatory (Treg) cells, which produce cytokines such as IL-10 and TGF-beta. Anti-inflammatory mechanisms observed during sublingual IT with high allergen doses proved to be similar compared to subcutaneous immunotherapy. Recent data obtained in biopsies clearly indicate that the pathophysiology of the oral mucosa, and in particular mucosal dendritic cells, plays a pivotal role in inducing tolerance to the administered allergen.
authors.affiliation: Allergy/Pulmonary Rehabilitation Unit, ICP Hospital, Milan, Italy. cristoforo.incorvaia@fastwebnet.it
authors.forename: Cristoforo
authors.initials: C
authors.lastname: Incorvaia
authors.forename: Franco
authors.initials: F
authors.lastname: Frati
authors.forename: Paola
authors.initials: P
authors.lastname: Puccinelli
authors.forename: Francesco
authors.initials: F
authors.lastname: Marcucci
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Di Cara
authors.forename: Laura
authors.initials: L
authors.lastname: Sensi
authors.forename: Silvia
authors.initials: S
authors.lastname: Scurati
authors.forename: Mona-Rita
authors.initials: MR
authors.lastname: Yacoub
authors.forename: Philippe
authors.initials: P
authors.lastname: Moingeon
mesh_terms: D000286:Administration, Sublingual; D000485:Allergens / Q000276:immunology* / Q000378:metabolism; D016207:Cytokines / Q000276:immunology* / Q000378:metabolism; D003713:Dendritic Cells / Q000276:immunology / Q000378:metabolism; D003888:Desensitization, Immunologic; D004804:Eosinophils / Q000276:immunology / Q000378:metabolism; D006801:Humans; D006967:Hypersensitivity / Q000276:immunology* / Q000378:metabolism; D007249:Inflammation / Q000276:immunology* / Q000378:metabolism; D008407:Mast Cells / Q000276:immunology / Q000378:metabolism; D050378:T-Lymphocytes, Regulatory / Q000276:immunology / Q000378:metabolism; D018417:Th1 Cells / Q000276:immunology / Q000378:metabolism; D018418:Th2 Cells / Q000276:immunology / Q000378:metabolism
chemical_list: D000485:Allergens; D016207:Cytokines