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| |  Combined Subcutaneous, Sublingual Immunotherapy More Effective Than Either Approach Alone for Cross-Reactive Food Allergy: Presented at EAACI By Judith Moser, MD WARSAW, Poland -- June 10, 2009 -- In a study presented at the 28th Congress of the European Academy of Allergy and Clinical Immunology (EAACI), combined subcutaneous and sublingual immunotherapy was more effective in patients with seasonal allergic rhinitis and cross-reactive food allergy than either approach alone. A study investigated the clinical and immune changes in reaction to subcutaneous allergen-specific immunotherapy (SCIT), sublingual allergen-specific immunotherapy (SLIT), and a combination of both treatments in patients with seasonal allergic rhinitis, who also have cross-reactive food allergy, typically displaying clinically as oral allergy syndrome in the majority of patients. Liliya Romaniuk, MD, Department of Allergy, Kiev Municipal Hospital Nr. 8, Kiev, Ukraine, presented the findings here at a poster presentation on June 8. The rationale for the study was the assumed increase of the immunomodulatory impact by combining SCIT and SLIT. The study cohort was divided into 4 groups; in each of the first 3 groups, 30 patients received immunotherapy with either SCIT (group 1), SCIT and SLIT (group 2), or SLIT alone (group 3). The fourth group comprised 30 healthy subjects as controls. Levels of serum allergen-specific immunoglobulin E (IgE), salivary secretory immunoglobulin A (IgA), circulating immune complexes, and autoantibodies to pancreatic tissue were assessed by enzyme-linked immunosorbent assay. The assessments showed that 82% of patients had abnormal humoral and cellular immune parameters including decreased secretory IgA in saliva, high levels of allergen-specific IgE, high levels of circulating immune complexes, and high levels of autoantibodies to pancreatic tissue. After treatment, the allergen-specific IgE levels remained elevated in each group. Secretory IgA levels normalised in group 1 and group 2. The levels of circulating immune complexes decreased slightly in all groups. Autoantibodies to pancreatic tissue decreased more in group 1 and group 2. During exacerbations of allergic disease, disorders in cellular and humoral immunity occurred in all 3 groups, but in group 2 the deviations in immune response were less pronounced. "This finding indicates that the best treatment of these patients is combined SCIT and SLIT," Dr. Romaniuk concluded. As she pointed out, the different mechanisms that are involved in the combination treatment result in a synergism. "The sublingual administration maximally stimulates local immune responses in the oral mucosa and gastrointestinal tract, while subcutaneous administration influences nonmucosal immune responses." Presentation title: Assessment of the Efficacy of Subcutaneous (SCIT), Sublingual (SLIT) and Combined SCIT and SLIT Allergen Immunotherapy in Patients With Pollen Allergy and Cross-Reacting Food Allergen Sensitization. Abstract 929
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