Sublingual Immunotherapy - "Allergy Vaccination" without needles

Spring and summer time: for most people a reason for joy, for the pollen allergy sufferers associated with runny nose, itchy eyes and difficulty breathing. With specific immunotherapy, the causes can be effectively combated, now even with drops instead of syringes.
Hay fever sufferers have a hard time. When others rip their windows and ride their bikes into the countryside, they have to postpone airing at night, wash their hair before going to bed, and - if they have ventured out - leave their clothes in front of the bedroom door.

Many an allergic person relocates his annual holiday to the high mountains in order to avoid the pollen count. Although the symptoms can be alleviated by various means, those affected are always at risk of developing known or new symptoms, including allergic shock. Frequently the allergy gets worse over the years or the symptoms shift from one organ to another. Thus, the allergy to grass or tree pollen can begin as swelling of the nasal mucosa and later develop into asthma of the lungs.

Healing is possible

Currently, the only way to tackle the root of the problem is specific immunotherapy (SIT), also known as hyposensitization or allergy vaccination. With this you start at the origin of the allergy. The organism reacts intensively to harmless substances in allergies, judges them as dangerous and fights them with strong guns. The immune system is particularly immunoglobulin-E antibodies that can be detected in the blood and cause symptoms such as mucosal swelling, sneezing and difficulty breathing.

In the case of hyposensitization, the substance to which it reacts so strongly is now regularly supplied to the body in initially very small and then ever increasing doses. This is how he gets used to, rather than fighting aggressively - 70-80% of those affected a concept that works. Can be treated so especially allergies to pollen and - particularly successful - bee and wasp venom.

Spraying versus spraying

For many years, the specific immunotherapy by means of syringe treatment (subcutaneous immunotherapy = SCIT) performed. Over three years, the patient receives an injection under the skin ("subcutaneously") weekly, later every 2-4 weeks on the upper arm. He then has to stay in the practice for at least 30 minutes, since allergic reactions requiring treatment can occur. A very time-consuming endeavor that requires a lot of discipline and stamina from the victim.

As a gentle alternative, Sublingual Immunotherapy (SLIT) has been known for over ten years now. The allergic person drips a certain number of drops even under the tongue ("sublingual"). Again, the dose is initially increased according to a well-defined plan and treatment is continued for a period of three years. The patient must first regularly every 1-2, and later about every six weeks to introduce the doctor.

In both forms, the doctor determines by various tests, to which substances the affected person reacts before the beginning of the therapy. Treatment should be started in the pollen-free period in the fall and, if possible, before allergies have developed against multiple substances, more severe forms or allergic asthma. Therapy is already possible in childhood.

Advantages and disadvantages

The advantages of sublingual immunotherapy are obvious: the treatment is painless, the patients do not have to visit a doctor or hospital constantly, the time required is lower and the risk of allergic shock and other side effects is extremely small.

On the other hand there are some disadvantages: Not all allergens have experiences and - in contrast to syringe therapy - no long-term experience. There are only a few studies on this treatment (especially in childhood and in direct comparison with SCIT) and the results are partially contradictory. The optimal dose is not yet known, the effect can not be detected in the blood and the costs are higher than with the syringe treatment.

Ultimately, not even the exact operating principle is known. Scientists assume that it is not a "oral vaccine", ie the drops are effective even if they do not enter the gastrointestinal tract. Presumably they cause the cells of the oral mucosa to produce certain substances that inhibit the production of allergenic immune cells. Therefore, sublingual immunotherapy has not yet received the same status as the subcutaneous form. However, the researchers agree that it is a promising alternative.

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