Allergy Immunotherapy:
SLIT or SCIT
SCIT (subcutaneous immunotherapy) injection of allergens has been
practiced for almost 100 years.
SLIT (sublingual immunotherapy) is a method of allergy treatment
using allergen solution as drops deposited under the tongue and holding it
there for a few minutes before swallowing.
Since 1969 SLIT was used for treating foods allergy and since 1970
for treating inhalants allergens.
In 1998 the World Health Organization concluded that SLIT was a
viable alternative to the injections.
After numerous control trials SLIT is gaining support from Allergists
and Otolaryngologists.
SLIT worked differently than SCIT: once the antigens are placed
under the tongue, dentritic cells take up the antigens, migrate to cervical
lymphatic nodes and have an effect on T-regulatory cells, which then cause a
systemic response.
SLIT had a very good safety tract, is given at home to adults and
children:
- Allergic Food sensitivities and Asthma in young children.
- Allergic Rhinitis and Asthma in older children and Adults.
Patients can be treated with a large number of antigens using drops
(SLIT) compared to the shots (SCIT).
With (SLIT) there are so few reactions that up to 20 antigens can be
mixed in a single bottle.
ACAA: American College of Allergy, Asthma and Immunology
_ SLIT may be beneficial for Adults with mild Allergic Rhinitis
caused by grass and trees.
- SCIT was better than SLIT for perennial Allergic Rhinitis due to
house dust and mites.
SLIT is administered at home with no direct supervision, the
physician will need to provide specific instructions to patients how to
manage adverse reactions, unplanned treatment interruptions, dosing
adjustments.
SLIT desensitizes you to your own allergies, over time, this shifts
your immune system to tolerate instead of react allergically to pollen,
dander, dust, mites and molds.
Drops contain the same antigens as shots. Dosage will be gradually
increased as your treatment progresses.
SLIT can be given before a pollen season, during a pollen season,
both or year round.
SLIT doesn’t hurt. Allergy sufferers, especially children are afraid of
shots, they don't like needles.
Patients visit the Dr. only 2-3 times per year for drop strength
adjustment vs. weekly or monthly for 3-5 years when using SCIT.
95-97% of patients stay on therapy for SLIT vs. 50 % of patients on
SCIT stop the therapy too soon.
_Unlike shots, dops are safe for children under 6y, the age when
allergy immunotherapy can be most effective at preventing asthma and new
allergies. Allerdrops are safe, even for pregnant women.
SLIT is safer, no anaphylactic or life threatening side effects have
ever been reported.
Around 1986 injections for allergy immunotherapy were practically
banned in England because of some deaths were linked to the therapy. The
law requested the injections to be done in a hospital.
Shots caused serious reactions in about 5%: generalized urticaria,
severe pruritus, anaphylactic reaction with airway edema.
_ Side Effects in SLIT are usually benign and very rare: 1/12000
doses.
* itchy mouth.
* lip, mouth, tongue, irritation.
* nausea, vomiting, abdominal cramping and diarrhea.
* sneezing, nasal congestion.
* asthma symptoms.
* urticaria, angioedema.
At the present time SLIT is widely used in England, Europe and South
America.
In the USA, most Allergists and Otolaryngologists still give allergy
shots, U.S. may be several years away from a significant acceptance of
SLIT.
For a list of Drs who use SLIT visit: www.allergy choices.com/find
doct
Tra T. Nguyen