Reviews and feature articleSublingual immunotherapy for large local reactions caused by honeybee sting: A double-blind, placebo-controlled trial
Section snippets
Study design
The study was designed as a randomized, double-blind, placebo-controlled, 2-parallel group. The enrolled volunteers, all with HVA caused by honeybee venom with LLRs only, were randomized to receive either SLIT or placebo for 6 months. The extent of LLRs was assessed before randomization and after 6 months by means of a standardized sting challenge. Safety and tolerability were evaluated, and specific IgE and IgG antibodies were measured. The study was approved by the reference ethical
Results
Thirty adult subjects (18 male subjects; mean age, 44.5 years) fulfilling the inclusion criteria were enrolled and signed the informed consent form. None of them had a history of systemic reactions, and all were monosensitized to honeybee venom. The patients were randomized to either SLIT or placebo, and their demographic characteristics were similar at enrollment, as summarized in Table II. Four patients did not complete the study procedures. In fact, 1 subject from the active group and 3
Discussion
Today, SLIT is gaining an increasing approval within the medical community as more and more experimental data are published. The good safety profile and the ease of use of SLIT have prompted the investigation of new indications other than allergic rhinitis and asthma. In fact, in the recent literature some studies proposed the possible use of SLIT in conditions such as atopic dermatitis,14 food allergy,15 or latex allergy.16 Despite this, no attempt has been made thus far to use SLIT in HVA,
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2022, International Journal of Biological MacromoleculesCitation Excerpt :The proof of sublingual delivery of antigens in vivo should be addressed in the future study. SLIT is a highly safe and convenient treatment method and is approved for use worldwide for the treatment of bronchial asthma and bee venom allergies in addition to pollen and mites [9,66–69]. Moreover, sublingual treatments for food allergies, atopic dermatitis, urticaria, and drug allergies are currently under development [70,71].
Venom allergy evaluation, diagnosis, and treatment
2022, Allergic and Immunologic Diseases: A Practical Guide to the Evaluation, Diagnosis and Management of Allergic and Immunologic DiseasesSublingual Immunotherapy for Other Indications: Venom Large Local, Latex, Atopic Dermatitis, and Food
2020, Immunology and Allergy Clinics of North AmericaSublingual immunotherapy: A focused allergen immunotherapy practice parameter update
2017, Annals of Allergy, Asthma and ImmunologySubcutaneous Immunotherapy and Sublingual Immunotherapy: Comparative Efficacy, Current and Potential Indications, and Warnings-United States Versus Europe
2016, Immunology and Allergy Clinics of North AmericaCitation Excerpt :SCIT with Hymenoptera venom4 and whole body extract of imported fire ants19 is well accepted as effective in treating sensitivity to the stings of these insects. There are limited data for treating Hymenoptera venom sensitivity with SLIT and it is currently not recommended.7,8 An attempt was previously made to treat patients with anaphylactic sensitivity to peanuts with injections of peanut extract.
Large Local Reactions to Insect Stings
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The sublingual immunotherapy and matched placebo were kindly provided by Anallergo S.p.A, Florence, Italy.
Disclosure of potential conflict of interest: E. Francescato is employed by Entomon SAS. I. Spadolini owns stock in and is employed by Anallergo. The rest of the authors have declared that they have no conflict of interest.