LifeCare Chiropractic

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Sublingual immunotherapy

Sublingual Immunotherapy Helpful in Mite-Sensitive Asthmatic Kids – (11-12-00)

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Sublingual Immunotherapy Helpful in Mite-Sensitive Asthmatic Kids

Such a simple therapy with almost no side effects, and yet most allergists scoff at doctors using this therapy. This procedure using the concept of oral tolerance, where small dosages of an allergic substance are given, and this teaches the gut to calm down its reaction to the allergen.

Allergy 2000;55:842-849 Sublingual immunotherapy (SLIT) reduces asthma symptoms in children sensitive to house dust-mite allergen, Italian researchers report in the September issue of Allergy. However, the mechanism of the protective effect remains elusive. Dr. Giovanni B. Pajno, of the Universita di Messina, and colleagues conducted a double-blind placebo-controlled trial of SLIT in 24 children ages 8 to 15 years. The children, all of whom had mild to moderate asthma and were sensitive to house dust mite, were randomized to 2 years of SLIT with standardized house dust mite extract or placebo. A total of 21 children completed the study, and those in the active treatment group showed a significant decrease in asthma symptoms and medication use. In addition, asthma scores improved in the treatment group, but not in the placebo group.

7 Ways Drops for Allergies Shine Again: Asthma

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This is not the first time I’ve written about the wonders of drops for allergies for different conditions. But drops for asthma…this is new…

A large chunk of the population deals with the discomfort and limitations of allergies and asthma here in the US.  This allergy season seems to have hit patients particularly hard.  Worse, rarely do I see that commonly used medications like Advair, Allegra and Zyrtec do more than make life a little easier.  Resolution or complete control is not the norm.

While the medications to treat allergies and asthma may be slightly different, I have always lumped them together because the immune system imbalance is the same (Th2 dominance, in case you’re curious).  This also means that the early-life risk factors are similar, such as:

  • Antibiotic use
  • C-section birth
  • Formula feeding instead of breastfeeding
  • Immunizations

When asked what organ plays a critical role in allergies and asthma, few would answer that it is the gut that drives these types of problems.

Why the gut?  Because 2/3 of the immune system is centered around the gut; so designed because the vast majority of foreign material that you are exposed to comes from the stuff you shove in your mouth.

So what if the stuff you were putting into your mouth was very carefully crafted to trick the immune system around your gut into behaving the way it is supposed to?  Sounds pretty cool, right? That is the goal of sublingual immunotherapy, otherwise known as drops for allergies.

This approach to allergies here in the United States, however, lags far behind Europe.  Here in the states, these drops are off-label use because the FDA has not approved its use.  But certainly not for lack of research, as we can see from this particular review.

Researchers looked at the data on drops for allergies and asthma across 63 studies with over 5100 participants total.  What did they find?

  1. Strong evidence supports that sublingual immunotherapy improves asthma symptoms, with 8/13 studies showing 40% improvement.
  2. Moderate evidence supports that drops for allergies decrease rhinitis or rhinoconjunctivitis symptoms, with 9/36 studies showing greater than 40% improvement.
  3. Medication use for asthma and allergies decreased by more than 40% in 16/41 studies.
  4. Moderate evidence found the drops improve conjunctivitis symptoms (13 studies).
  5. Evidence found that drops improved the combined symptom and medication scores (20 studies).
  6. Evidence found that disease-specific quality of life was improved (8 studies).
  7. Local reactions were frequent, but severe allergic reactions were not reported.

Overall, I would have to say that the FDA is WAY behind Europe on this one. Sadly, many allergists dismiss drops for allergies as not having any research to support its use.  You have to be avoiding an awful lot of medical literature to not notice 63 studies IN YOUR FIELD that deal with this approach.

Maybe it’s time to find a new allergist (luckily for those of you in our clinic’s area, we offer drops for allergies).

Drops for Allergies to Peanuts: Start Early

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Peanut allergies can lead to something called anaphalactic shock. Not pleasant when it is your child’s airway that closes up.

Many of these families have to carry around a shot of epinephrine (“epi-pen”) to open up the airway if they are exposed to even the smallest amount of a peanut.  In some cases merely being next to someone eating peanut butter can be enough to trigger a reaction.  Hence the disappearance of peanuts on airline flights.

What if something could be done to derail an allergy this severe?

I’ve written before about using drops for allergies (referred to as subligual immunotherapy, or SLIT).  The process is pretty simple: after some simple in office allergy testing, a solution is prepared that the child would put under his or her tongue daily.  That’s it.

This has been shown to be effective for several problems, including dust mite allergies.

This particular study tackles the use of drops for allergies for those with peanut allergies.  More importantly, this is one of the first studies to evaluate the effectiveness of allergy drops in toddlers.  Here’s the details:

  • The study was done on 41 children aged 16- to 37-months-old, with treatment lasting up to 3 years
  • In the first 12 children who were able to tolerate 5 grams of peanut protein, subsequent blinded oral challenges 1 month apart were successful in all 12
  • Allergic reactions using the sub-lingual drops for allergies were cut 44%.

A couple things to consider.

First, this was not published in a peer reviewed journal because it is the early stages of the study.  Rather, this was a presentation at an annual conference (American Academy of Allergy, Asthma, and Immunology, 2013) by one of the study authors.

Despite this, these results are consistent with other studies done in non-toddler populations on the use of drops for allergies.  Given the major impact of potential anaphalactic reactions and the safety of sublingual immunotherapy, the future for natural allergy relief like this is bright.

Dust Mite Allergy? Drops for Allergies Shines Again

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With food allergies, you can avoid offending foods. What about environmental allergies? Kind of hard to live in a bubble. Good thing there are drops for allergies.

This is not the first time I have addressed this option for allergy sufferers.  Basically, the use of drops under the tongue (sublingual) has been shown to be consistently effective at helping to manage allergies.  I have addressed this in detail in a previous post that can be read by clicking here.

However, there has been a major weakness in many of previous studies that I have reviewed.

They are designed as a one-allergen type of approach.  Basically, in setting up the studies, researchers picked a single allergen (such as peanuts) and provided the treatment using the sublingual drops for allergies focused on a single allergen.  In real life, people are rarely allergic to one single thing.  Once the immune system gets pissed off, it starts firing off at multiple allergens.  Rarely is it a single allergen.

Despite this, the results of these studies have been pretty solid.  So what happens when a research study is set up to treat for more than one allergen?  Turns out we have an answer in this particular study.

Researchers treated for not one, but TWO types of dust mites with sublingual drops for allergies in a group of seniors aged 60-75.  Here’s the specifics:

  • The trial lasted 3 years.
  • The total nasal symptom score decreased by 44% in the active group and 6% in the placebo group (Tweet this).
  • In the group that got the drops for allergies, the total medication score dropped 51%.
  • There were no systemic adverse reactions during the study.

These are pretty good results for an approach as simple as sublingual immunotherapy with no real incidence of adverse reactions.  While I highlighted the fact that this study used 2 different allergens, there are practitioners out there using sublingual immunotherapy that treat for many more allergens in the drops for allergies.  The more that are used, the greater the chance of toning down the entire immune response and really helping to make the patient feel better.

Have you tried sublingual immunotherapy before or currently?  If so, how does the response compared to other methods you have tried in the past?

Sublingual immunotherapy is safe, inexpensive and has no side effects – (04-22-04)

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Allergic rhinitis due to house dust mites: evaluation of the efficacy of specific sublingual immunotherapy

Sublingual immunotherapy, which I classify under the oral tolerance category, has been around for many years. Essentially, the clinician evaluates what the patient is allergic to and then gives the patient small vials with minute amounts of the allergen to be taken under the tongue. This is believed to work by de-activating the GALT cells of the GI tract (the immune system that surrounds the GI tract) against that antigen. The GALT then sends the same “safe” signal out to the rest of the body, thus reducing or eliminating the reaction against the allergen. Very safe, very inexpenisve, no side effects.

Read entire article here

STUDY THE SUBLINGUAL IMMUNOTHERAPY FOR RESPIRATORY ALLERGY – (10-13-04)

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Randomized controlled open study of sublingual immunotherapy for respiratory allergy in real-life: clinical efficacy and more

While we’re on the subject…another safe approach to respiratory problems is sublingual immunotherapy. This concept works by inducing oral tolerance via the immune system in the GI tract–the immune system cells lining the GI tract identify the compound being given sublingually, and then send a signal out to the rest of the body that this compound is NOT an invader, thereby lowering the immune response all throughout the body, including the respiratory tract. Randomized controlled open study of sublingual immunotherapy for respiratory allergy in real-life: clinical efficacy and more.

Read entire article here

SUBLINGUAL IMMUNOTHERAPY IS HIGHLY SAFE AND BENEFICIAL – (02-27-06)

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Immune mechanisms of allergen-specific sublingual immunotherapy

While still not well accepted by many physicians in this country, the research behind sublingual immunotherapy is growing. It’s safety is very high, and every study I’ve come across finds a benefit. Basically, the patient’s allergies are identified, and they are given a vial of liquid that they put under their tongue.

Most likely, this route gets down to the immune cells surrounding the gut (the GALT). The GALT then evaluates this small amount of allergen, kind of twisting it around in it’s little white blood cell hands, sees nothing threatening, and sends the signal of “no problem” to the rest of the immune system.

This works to tone down the allergic response to that particular substance. It is truly working on fixing the problem.

Read entire article here