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Updated: Jul 2, 2026
Sublingual Immunotherapy as an Alternative to Induce Protection Against Acute Respiratory Infections
Published on: August 30, 2014
Preventive effects of sublingual immunotherapy in childhood: an open randomized controlled study
Maurizio Marogna1, Dante Tomassetti, Antonella Bernasconi
1Pneumology Unit, Cuasso al Monte, Macchi Hospital Foundation, Varese, Italy.
Insights
Sublingual immunotherapy (SLIT) effectively prevents new allergic sensitizations and mild persistent asthma in children with respiratory allergies. This treatment also reduces clinical symptoms and bronchial hyperreactivity over three years.
Area of Science:
- Pediatric Allergy and Immunology
- Respiratory Medicine
- Immunotherapy Research
Background:
- Sublingual immunotherapy (SLIT) is effective for allergic rhinitis and asthma.
- Limited data exists on SLIT's preventive effects, particularly in pediatric populations.
- Understanding SLIT's role in preventing disease progression is crucial.
Purpose of the Study:
- To evaluate the clinical and preventive effects of SLIT in children with allergic rhinitis.
- To assess the impact of SLIT on new sensitizations and persistent asthma onset.
- To measure changes in clinical symptoms and bronchial hyperreactivity.
Main Methods:
- A 3-year randomized trial involving 216 children with allergic rhinitis.
- Comparison of drugs alone versus drugs plus SLIT.
- Assessment of clinical scores, pulmonary function, methacholine challenge, and skin prick tests.
Main Results:
- SLIT significantly reduced new sensitizations (3.1% vs 34.8%) and mild persistent asthma onset.
- Clinical scores decreased significantly in the SLIT group from year one.
- Bronchial hyperreactivity improved significantly in the SLIT group after three years.
Conclusions:
- SLIT is effective in reducing new sensitizations in children with respiratory allergies.
- SLIT helps prevent the development of mild persistent asthma.
- SLIT improves bronchial hyperreactivity and clinical symptoms in pediatric patients.
Background:
Sublingual immunotherapy (SLIT) has been proved to be effective in allergic rhinitis and asthma, but there are few data on its preventive effects, especially in children.
Objective:
To evaluate the clinical and preventive effects of SLIT in children by assessing onset of persistent asthma and new sensitizations, clinical symptoms, and bronchial hyperreactivity.
Methods:
A total of 216 children with allergic rhinitis, with or without intermittent asthma, were evaluated and then randomized to receive drugs alone or drugs plus SLIT openly for 3 years. The clinical score was assessed yearly during allergen exposure. Pulmonary function testing, methacholine challenge, and skin prick testing were performed at the beginning and end of the study.
Results:
One hundred forty-four children received SLIT and 72 received drugs only. Dropouts were 9.7% in the SLIT group and 8.3% in the controls. New sensitizations appeared in 34.8% of controls and in 3.1% of SLIT patients (odds ratio, 16.85; 95% confidence interval, 5.73-49.13). Mild persistent asthma was less frequent in SLIT patients (odds ratio, 0.04; 95% confidence interval, 0.01-0.17). There was a significant decrease in clinical scores in the SLIT group vs the control group since the first year. The number of children with a positive methacholine challenge result decreased significantly after 3 years only in the SLIT group. Adherence was 80% or higher in 73.8% of patients. Only 1 patient reported systemic itching.
Conclusions:
In everyday clinical practice, SLIT reduced the onset of new sensitizations and mild persistent asthma and decreased bronchial hyperreactivity in children with respiratory allergy.
