Induction of Tolerance via the Sublingual Route: Mechanisms and Applications

Citations Over TimeTop 10% of 2011 papers

Abstract

The clinical efficacy of sublingual immunotherapy (SLIT) with natural allergen extracts has been established in IgE-dependent respiratory allergies to grass or tree pollens, as well as house dust mites. Sublingual vaccines have an excellent safety record, documented with approximately 2 billion doses administered, as of today, in humans. The oral immune system comprises various antigen-presenting cells, including Langerhans cells, as well as myeloid and plasmacytoid dendritic cells (DCs) with a distinct localisation in the mucosa, along the lamina propria and in subepithelial tissues, respectively. In the absence of danger signals, all these DC subsets are tolerogenic in that they support the differentiation of Th1- and IL10-producing regulatory CD4(+) T cells. Oral tissues contain limited numbers of mast cells and eosinophils, mostly located in submucosal areas, thereby explaining the good safety profile of SLIT. Resident oral Th1, Th2, and Th17 CD4(+) T cells are located along the lamina propria, likely representing a defence mechanism against infectious pathogens. Second-generation sublingual vaccines are being developed, based upon recombinant allergens expressed in a native conformation, possibly formulated with Th1/T reg adjuvants and/or mucoadhesive particulate vector systems specifically designed to target oral dendritic cells.

Related Papers

• Efficacy and safety of sublingual immunotherapy for one year in treatments of patients with allergic rhinitis(2010)
• → A case presented with side effects following initial dose of sublingual immunotherapy for Japanese cedar pollinosis(2016)
• → Update on sublingual immunotherapy in patients with asthma due to house-dust mites(2011)
• → A novel murine model of Japanese cedar pollinosis for characterizing allergen-specific sublingual immunotherapy(2017)
• → Evaluation of severity of allergic rhinoconjunctivitis syptoms and sublingual immunotherapy (SLIT) efficacy in children.(2018)