Does sublingual immunotherapy work with multiallergen mixes?
It is generally accepted—in the United States, at least—that effective subcutaneous injection immunotherapy can be accomplished with mixes of multiple, non–cross-reacting allergen extracts. To date, no study of sublingual immunotherapy (SLIT) with more than two differing allergen extracts has been reported. In the July 2009 issue of The Journal of Allergy and Clinical Immunology, Amar and coworkers address this question. Fifty-three subjects with grass pollen-induced allergic rhinitis received 10 months of SLIT consisting of monotherapy with timothy (30 mcg Phl p 5 daily), the same dose of timothy plus nine nonrelated pollen extracts, or placebo. A very poor pollen season obscured the clinical response. However, those receiving timothy monotherapy showed significant differences from placebo for titrated skin prick tests and nasal challenge, specific IgG4 antibodies, and timothy-stimulated release of IFN-y from peripheral blood mononuclear cells, all indicating a relevant positive respo
