Allergy Management Technique an Effective Alternative to Injections
People with allergies to dust mites, animal danders, pollens, or molds may experience fewer symptoms by administering drops made from these extracts under the tongue (sublingually), according to a new study in Allergy (2004;59:1205–10).
This new study adds to the growing body of evidence showing sublingual immunotherapy is a safe, effective treatment for allergies. In the new study, 441 participants between ages 15 and 65 with respiratory allergy symptoms or asthma were randomly assigned to receive sublingual immunotherapy (SLIT) plus allergy medication, or allergy medication only for three years. Skin prick tests for allergy to multiple common allergens were performed initially and after three years of treatment. Lung function tests to determine asthma severity were done at the same intervals. Those receiving SLIT were only prescribed the single most clinically relevant extract based on skin testing and the person’s history. Symptom scores for sneezing, runny nose, nasal congestion, itchy nose and eyes, redness of eyes, wheezing, cough, or chest tightness were recorded throughout the study. Use of allergy medications, including nasal cromolyn sodium (Nasalcrom®), oral antihistamines, such as loratadine or cetirizine (Claritin® or Zyrtec®), nasal steroid (beclomethasone), or inhaled albuterol (Ventolin®, Proventil®) were also recorded.
Those receiving SLIT had a significant improvement in allergy symptom scores, compared with those who only took medication. The SLIT group had a respective 50 and 73% improvement in allergy symptom scores after the first and third years of treatment, while no change was observed in the control group. In those under the age of 18, the allergy symptom score reduction was even more pronounced than in those older than 18. This suggests that SLIT may be more effective in teenagers than adults. A 61% decrease in airway hyperreactivity (spasm in the airways leading to difficulty breathing) was observed among those taking SLIT, compared with initial measurements, suggesting SLIT also reduces the risk of having an asthma attack. No one receiving SLIT had any serious adverse effects while undergoing treatment.
Injection immunotherapy has been the standard treatment for various allergies for almost 100 years, but it can cause serious side effects, such as anaphylaxis (a severe reaction that causes swelling in the eyes, face, and throat and may cause difficulty breathing) in a small number of individuals. The World Health Organization has determined that SLIT is a viable, effective alternative to injection immunotherapy for allergic diseases. Several studies have demonstrated that SLIT is effective in treating multiple allergies and have not found that it causes anaphylactic reactions. There are several advantages of SLIT over injection therapy. Some people who have not responded well to injection therapy do better with daily administration of oral drops. It is unknown why this occurs, but some researchers suggest that taking the allergenic substance on a daily basis alters the immune response more favorably than weekly or monthly injections. Oral immunotherapy is more convenient than injections, since the drops are administered at home and no needles are involved. This means fewer office visits are required and no pain occurs, which is particularly important for those who are fearful of getting injections.
Given the excellent safety profile, SLIT may be a reasonable option for people who have previously had an adverse reaction to injection immunotherapy. The author of this article and other physicians have successfully treated thousands of allergic people with SLIT and have not observed any serious adverse effects. Unlike injection immunotherapy that can take years to control allergies, SLIT will often help relieve symptoms in a shorter period of time.
Darin Ingels, ND, MT (ASCP), received his bachelor’s degree from Purdue University and his Doctorate of Naturopathic Medicine from Bastyr University in Kenmore, WA. Dr. Ingels is the author of The Natural Pharmacist: Lowering Cholesterol (Prima, 1999) and Natural Treatments for High Cholesterol (Prima, 2000). He currently is in private practice at New England Family Health Associates located in Southport, CT, where he specializes in environmental medicine and allergies. Dr. Ingels is a regular contributor to Healthnotes and Healthnotes Newswire.
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