Sublingual immunotherapy in spray a new way of dispensing allergy vaccins

摘要

Immunotherapy is the only allergy treatment directed to the cause of the disease. Immunotherapy is used for more than 100 years empirically for a long time, but its effect is now explained by molecular biology (1, 2, 10, 12, 13).The end points for immunotherapy are the relief of symptoms, improvement of quality of life and "in vivo" and "in vitro" evidence of benefits.Nowadays is generally agreed that allergen immunotherapy is the only treatment that can modify the immune response to allergen and alter the cause of allergic disease (1, 2, 10, 13). Proposed mechanisms of immunotherapy are a early desensitization of basophils a decrease of specific IgE, increase on IgG antibodies the "old" blocking antibodies a shift from TH2 to TH1 cells, activation of Treg cells with production of IL-10 and TGF Beta and a decrease of inflammatory molecules and cellules with T-cell anergy (1, 2, 11, 14). During the immune response to immunotherapy allergen can be taken up by dendritic cells namely in buccal mucosal and the allergen be presented to T-cells in presence of IL-12 causing a TH1 shift with activation of TReg CD4+CD25 cells releasing IL-10 and blocking TH2 response leading to decreased recruitment of pro-inflammatory cells. An increase of IL-10 after immunotherapy has been clearly shown in the last few years (1, 10).