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World J Clin Pediatr. Feb 8, 2016; 5(1): 47-56
Published online Feb 8, 2016. doi: 10.5409/wjcp.v5.i1.47
Sublingual immunotherapy for pediatric allergic rhinitis: The clinical evidence
Dimitri Poddighe, Amelia Licari, Silvia Caimmi, Gian Luigi Marseglia
Dimitri Poddighe, Department of Pediatrics, Azienda Ospedaliera di Melegnano, 20070 Milano, Italy
Amelia Licari, Silvia Caimmi, Gian Luigi Marseglia, Department of Pediatrics, Fondazione IRCCS Policlinico San Matteo - Univerista’ degli Studi, 27100 Pavia, Italy
Author contributions: Poddighe D drafted and wrote the manuscript; Licari A and Caimmi S contributed to the analysis of medical literature; Marseglia GL gave substantial intellectual contribution.
Conflict-of-interest statement: The authors report no conflict of interest and have not received any honorarium, grant, or other form of payment to produce it.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Gian Luigi Marseglia, MD, Professor, Department of Pediatrics, Fondazione IRCCS Policlinico San Matteo - Universita’ degli Studi, P.le Golgi 2, 27100 Pavia, Italy. gl.marseglia@smatteo.pv.it
Telephone: +39-0382-502818 Fax: +39-0382-502876
Received: June 14, 2015
Peer-review started: June 17, 2015
First decision: September 30, 2015
Revised: October 21, 2015
Accepted: November 23, 2015
Article in press: November 25, 2015
Published online: February 8, 2016
Processing time: 227 Days and 15.9 Hours
Abstract

Allergic rhinitis is estimated to affect 10%-20% of pediatric population and it is caused by the IgE-sensitization to environmental allergens, most importantly grass pollens and house dust mites. Allergic rhinitis can influence patient’s daily activity severely and may precede the development of asthma, especially if it is not diagnosed and treated correctly. In addition to subcutaneous immunotherapy, sublingual immunotherapy (SLIT) represents the only treatment being potentially able to cure allergic respiratory diseases, by modulating the immune system activity. This review clearly summarizes and analyzes the available randomized, double-blinded, placebo-controlled trials, which aimed at evaluating the effectiveness and the safety of grass pollen and house dust mite SLIT for the specific treatment of pediatric allergic rhinitis. Our analysis demonstrates the good evidence supporting the efficacy of SLIT for allergic rhinitis to grass pollens in children, whereas trials regarding pediatric allergic rhinitis to house dust mites present lower quality, although several studies supported its usefulness.

Keywords: Allergic rhinitis; Grass pollen allergy; House dust mite allergy; Sublingual immunotherapy

Core tip: This manuscript aims at describing objectively the current evidences of sublingual immunotherapy (SLIT) for the treatment of pollen and house dust mite allergic rhinitis in children, based upon the available randomized, double-blinded, placebo-controlled trials. All these studies have been directly analyzed by the authors and have been summarized in this manuscript, in order to be readily available to the reader. We concluded that there is a good evidence of efficacy for grass pollen SLIT, while the benefit seems to be weaker for house dust mite SLIT, in the specific setting of pediatric allergic rhinitis.