Authors:
Holt PG, Sly PD, Sampson HA, Robinson P, Loh R, Lowenstein H, Calatroni A, Sayre P
Authors notes:
Journal of Allergy and Clinical Immunology. 2013:online
Keywords:
Asthma, prevention, sublingual immunotherapy, allergy, sensitisation
Abstract:
A wide body of epidemiologic evidence indicates that in children at high genetic risk of allergic diseases, programming of TH2-polarized immunologic memory associated with progressively increasing IgE antibody production is most commonly initiated during the preschool years, and there is growing interest in ''early intervention'' aimed at arresting this process before it becomes persistent.
These findings collectively provided the basis for an investigator-initiated double-blind placebo-controlled trial to test the hypothesis that enhancing the levels of mucosal exposure of children at high risk of inhalant allergy/asthma prior to the onset of sensitization would reduce the likelihood of subsequent sensitization and/or development of asthma.
It was rationalized that this process would mirror sublingual immunotherapy (SLIT), which is associated with the generation of regulatory T cells directed against the mucosally delivered allergens.
These findings suggest that this modified version of SLIT should be considered for retesting of mucosal-based immunotherapy for atopic asthma prevention.