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Updated: May 11, 2026

Sublingual Immunotherapy as an Alternative to Induce Protection Against Acute Respiratory Infections
Published on: August 30, 2014
Pediatric sublingual immunotherapy efficacy: evidence analysis, 2009-2012
Désirée Larenas-Linnemann1, Michael Blaiss, Hugo P Van Bever
1Hospital Médica Sur, Mexico City, Mexico. Marlar1@prodigy.net.mx
Insights
Sublingual immunotherapy (SLIT) shows growing evidence for treating children's allergies. This review found robust efficacy for grass pollen SLIT and good evidence for house dust mite SLIT in asthma, with no anaphylaxis reported.
Area of Science:
- Pediatric Allergy and Immunology
- Immunotherapy Research
- Clinical Evidence Synthesis
Background:
- Sublingual immunotherapy (SLIT) is an alternative to subcutaneous immunotherapy for allergic diseases.
- Evidence for SLIT's efficacy in pediatric populations requires ongoing evaluation.
- Assessing the quality and scope of recent SLIT research is crucial for clinical practice.
Purpose of the Study:
- To systematically analyze the latest scientific evidence on the clinical efficacy of SLIT in children.
- To evaluate SLIT's effectiveness for various allergic conditions, including respiratory and food allergies.
- To assess the quality of evidence and identify emerging trends in pediatric SLIT research.
Main Methods:
- Comprehensive literature search of PubMed, Embase, and other databases (2009-2012).
- Inclusion of original articles on clinical trials of SLIT in patients under 18 years.
- Quality assessment using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system.
Main Results:
- 29 trials met inclusion criteria, showing robust evidence for grass pollen SLIT in allergic rhinitis.
- High-quality evidence supports house dust mite (HDM) SLIT for medication reduction in pediatric asthma.
- Moderate evidence suggests efficacy for dual grass pollen-HDM SLIT; food SLIT shows less promise than oral immunotherapy.
Conclusions:
- The body of evidence supporting the efficacy of SLIT in children with respiratory and food allergies is expanding.
- SLIT demonstrates potential for managing allergic rhinitis and asthma in pediatric patients.
- Further research is needed to solidify evidence for specific allergens and food allergies.
Objective:
To perform a structured analysis of the latest scientific evidence obtained for the clinical efficacy of sublingual immunotherapy (SLIT) in children.
Data Sources:
PubMed, Embase, reference lists from reviews, and personal databases were reviewed for original articles on clinical trials with SLIT in patients younger than 18 years published from January 1, 2009, through December 31, 2012, using broad search and medical subject heading terms.
Study Selections:
Clinical trials, irrespective of their design, of SLIT in the treatment of respiratory and food allergy in patients 18 years or younger were selected. Clinical outcomes (symptom scores, medication use, provocation tests, pulmonary function tests, skin prick tests, and adverse events) and immunologic changes were tabulated. Quality of each trial and total quality of compounded evidence was analyzed with the Grading of Recommendations Assessment, Development and Evaluation system.
Results:
Of 56 articles, 29 met the inclusion criteria. New evidence is robust for the precoseasonal tablet and drop grass pollen SLIT efficacy in allergic rhinitis and scarce for seasonal asthma. Some evidence for Alternaria SLIT efficacy is appearing. For house dust mite (HDM) SLIT in asthma, there is high-quality evidence for medication reduction while maintaining symptom control; evidence for HDM SLIT efficacy in allergic rhinitis is of moderate-low quality. There is moderate evidence for efficacy of dual grass pollen-HDM SLIT after 12 months of treatment and 1 year after discontinuation. Specific provocation test results (nasal, skin) improve with grass pollen and HDM SLIT but nonspecific bronchial provocation testing does not. Food oral immunotherapy is more promising than food SLIT. Possible new surrogate markers have been reported. No anaphylaxis was found among 2469 treated children.
Conclusion:
Evidence for efficacy of SLIT in children with respiratory or food allergy is growing.
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