1. Here is a study that compares rates of sensitization to new environmental
    Phil Phil United States says:
    November 27, 2012 at 2:02 AM

    Here is a study that compares rates of sensitization to new environmental allergens in the control group vs. the SLIT group.   All control group subjects had at least one new sensitization vs.  an approximate sensitization rate of about 15% in the SLIT group.  Methacholine sensitivity also decreased in the SLIT group.  It did not mention the prevention of asthma in this study.  But to be fair- one small study for SCIT does not really prove anything either.  Yet everyone quotes that study.   So it does appear there is significant immunologic benefit.  

    www.mdconsult.com/.../1.html

    Here is another study that looks at long term remission rates in those on long term SLIT.  There did appear to be successful long term remission after discontinuing SLIT- again supporting long term immune modulation.  It did not comment on preventing asthma.  Unfortunately the studies will take a long time to conduct.  It is not a promise I would make to patients but more of a possibility.  And I think it is a reasonable possibility given the long term impact on new environmental sensitivities and long term remission.  

    I think there is a bias in the information that is reported on SCIT vs. SLIT.  As an example- i don't think there are any real great studies looking at SCIT and polysensitization.  Yet almost every allergist uses large numbers of allergens in their immunotherapy vials.  But not once will you read about academic allergists mentioning that short coming in the SCIT literature.  Yet they are very quick to point that out about SLIT.  So I think we all need to be fair and balanced.  So if you are telling your SCIT patients that IT with multiple allergens has been shown to be clinically effective, that is not really true.  Yet we all know that there is significant clinical benefit when selecting the right patients and using the right dose of IT.  
      Durham SR, Emminger W, Kapp A, et al. SQ-standardized sublingual grass & immunotherapy: confirmation of disease modification 2 years after 3 years of treatment in a randomized trial. J Allergy Clin Immunol 2012; 129:717–
    725.

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