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Sublingual Immunotherapy (SLIT)

Sublingual Immunotherapy (SLIT). Lt. Col Dimitrios Vourdas M.D. Allergist Director of Allergy and Clinical Immunology Unit 251 Hellenic Air Force Hospital Athens, Hellas. Everything Evolving ……. Evolution in Medicine ……. Evolution in Immunotherapy ……. SLIT. - Severe Adverse Events

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Sublingual Immunotherapy (SLIT)

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  1. Sublingual Immunotherapy (SLIT) Lt. Col DimitriosVourdas M.D. Allergist Director of Allergy and Clinical Immunology Unit 251 Hellenic Air Force Hospital Athens, Hellas

  2. Everything Evolving……

  3. Evolution in Medicine……

  4. Evolution in Immunotherapy…… SLIT

  5. - Severe Adverse Events - Anaphylaxis - Death

  6. The Fear of Injection

  7. Questions who needs Answers

  8. Question 1 Has clarified the Mechanism of Action of Sublingual Immunotherapy or rely on Insufficient or Empirical data?

  9. Mechanism of Action (Ι) (Novak N , Allergy, 66:733-739,2011)

  10. Mechanism of Action (ΙΙ) - Langerhans like DC – The Predominantof the Immune Response inSLIT • Substantial difference between the oral mucosa • counterparts.Expression of FcεRI, MHC class I,II, • costimulatory CD40, CD80, CD86 • Activation of TLR4 leads to productionof IL-10 and • activation of Treg Foxp3. The result is a further • production of IL-10 andTGF-β • SLIT induces mucosal IgA response, which • contributes significantly in immune tolerance • It is important, the adjutants of the formulation • of SLIT, because of them, depends largely, the • induction of the immune tolerance • IgG4 blocking antibodies maintained in high levels • and after 2 years from initiation of treatment (Allam JP , JACI, 121:368E1-374E1,2008)

  11. Question 4 Is SLIT Effective?

  12. Allergy 2005 • Study data until 2003 • 22 randomized, controlled studies • About 1000 patients Allergy 2011 • Study data from 2003 to 2011 • 60 studies (49 for meta-analysis) • About 4000 patients

  13. Question 2 Improves the Quality of Life in SLIT Patients;

  14. Quality of Live (Morris MS , Journal of Allergy, 2012:ID 253879,2012)

  15. Question 3 Is SLIT Safe?

  16. Safety of SLIT (Radulovic S, Allergy, 66:740-752,2011)

  17. Question 5 Is it Equally Effective the SLIT Therapy in Mono-Sensitized and Poly-Sensitized Patients ?

  18. (Malling HJ , Clin Exp Allergy, 39:387-393,2009)

  19. Question 6 There is Dirrect Comparison Between SLIT and SCIT ?

  20. Allergy 2004 Clin Exp Allergy 2010

  21. So, SLIT Validated!!!

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