Development of an allergen extract for sublingual immunotherapy--evaluation of Staloral.
BACKGROUND
Specific immunotherapy (IT) is an effective treatment for rhinitis and asthma caused by aeroallergens sensitization. Sublingual IT (SLIT) was introduced to solve the problem of systemic reactions to subcutaneous IT (SCIT) and developed to represent an actual treatment option. It is now generally accepted that allergen doses much higher than those administered by SCIT must be used to achieve clinical efficacy on allergic symptoms.


OBJECTIVE
To evaluate the characteristics of Staloral, an allergen extract produced by Stallergenes (Antony, France) in terms of practical administration, efficacy, safety and mechanism of action.


METHODS
Data were obtained from 20 double-blind, placebo-controlled studies using Staloral in patients sensitized to pollens and house-dust mites, and also from open studies concerning practical administration and the mechanism of action.


CONCLUSIONS
Efficacy and safety of Staloral, as demonstrated by the revision of the studies, which used doses up to 1125 times those administered with SCIT, are very satisfactory and confer to this allergen extract optimal characteristics for treating patients with seasonal allergies due to pollens or with perennial symptoms induced by dust mites. The main mechanism of action is the interaction with dendritic cells of the oral mucosa and the subsequent tolerance induced in T cells.
Frati
Franco
F
Scientific and Medical Department, Stallergenes Italia, Milan, Italy. frati.f@stallergenes.it
Scurati
Silvia
S
Puccinelli
Paola
P
Justicia
José Luis
JL
Adamec
Thomas
T
Sieber
Hans Jochen
HJ
Ras
Lisbeth
L
David
Marie
M
Marcucci
Francesco
F
Incorvaia
Cristoforo
C
D000485:Allergens / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D003888:Desensitization, Immunologic / Q000379:methods*; D006801:Humans; D007167:Immunotherapy; D014059:Tongue
D000485:Allergens