Immunotherapy specific oral

Method of specific immunotherapy with orally applied allergens in drop or tablet form. Good efficacy especially with children. This has been proven in several randomized and non-randomized studies, especially with cow's milk, chicken egg and peanut. S.a.u. SLIT (sublingual immunotherapy).

Remark: The phenomenon of oral immunotolerance has been known for decades. North American Indians have reported that they have been eating the leaves of poison sumac (Poison ivy) for a long time, thus preventing the otherwise massive contact allergies of the outer skin. According to Sampson, the intestinal epithelial cells play a significant role in the process of oral/enteric immunotolerance as "non-professsional" antigen-presenting cells. They mainly take up dissolved antigens and present their immune cells. A prerequisite for the development of an immunotolerance is an intact mucosal barrier. In contrast, immunization dominates in case of defects as well as local inflammations (Jäger L et al. (2001).

Alternatively, specific oral immunotherapy and sublingual immunotherapy ( SLIT) can be combined. After sublingual application in the mouth and defined absorption time, the allergen is swallowed.

In principle, the evidence is of low quality. Data on long-term effects are missing.

1. Bergmann KC (2003) Specific immunotherapy in allergic asthma. Pneumology 57: 84-90
2. Bousquet J (1999) Sublingual-swallow immunotherapy (SLIT) in patients with asthma due to house-dust mites: a double-blind, placebo-controlled study. Allergy 54: 249-260
3. Canonica GW, Passalacqua G (2003) Noninjection routes for immunotherapy. J Allergy Clin Immunol 111: 437-448
4. Fuchs Th, Klimek L (2000) The allergen-specific immunotherapy (hyposensitization) part 2 Oral, sublingual and nasal application. HNO 48: 158-164
5. Jäger L et al (2001) Food allergies and intolerances. Urban & Fischer Publishing House Munich, Jena S 24
6. Morisset M et al (2007) Oral desensitization in children with milk and egg allergies obtains recovery ina
   significant proportion of cases. A randomized study in 60 children with cow's milk allergy and 90 children with egg allergy. Eur Ann Allergy Clin Immunol 39:12-19.
7. Mortemousque B et al (2003) House-dust mite sublingual-swallow immunotherapy in perennial conjunctivitis: a double-blind, placebo-controlled study. Clin Exp Allergy 33: 464-469
8. Nelson HS (2003) Advances in upper airway diseases and allergen immunotherapy. J Allergy Clin Immunol 111(3 Suppl): 793-798
9. Passalacqua G et al (1998) Randomised controlled trial of local allergoid immunotherapy on allergic inflammation in mite-induced rhinoconjunctivitis. Lancet 351: 629-632
10. Varshney P et al (2011) A randomized controlled study of peanut oral immunotherapy: clinicaldesensitization
    and modulation of the allergic response. J Allergy Clin Immunol 127:654-660.
11. Vazquez-Ortiz M et al (2014) Baseline specific IgE levels are useful to predict safety of oral immunotherapy
    in egg-allergic children. Clin Exp Allergy 44:130-141.
12. Woodfolk JA, Platts-Mills TA (2002) The immune response to intrinsic and extrinsic allergens: determinants of allergic disease. Int Arch Allergy Immunol 129: 277-285