Frontiers in allergy最新文献

{"title":"A sensitive colorimetric ELISA to measure allergen-specific salivary SIgA for monitoring sublingual immunity efficiency in pollinosis SLIT.","authors":"Tetsuro Yamamoto, Fusako Mitsunaga, Atsushi Kotani, Kazuki Tajima, Muneki Hotomi, Shin Nakamura","doi":"10.3389/falgy.2026.1857343","DOIUrl":"https://doi.org/10.3389/falgy.2026.1857343","url":null,"abstract":"<p><strong>Background: </strong>Sublingual immunotherapy (SLIT) is safe and one of the most effective etiological treatment for pollinosis. Allergen-specific salivary secretory immunoglobulin A (SIgA) is a useful marker to objectively evaluate treatment efficacy. However, saliva samples usually exhibit high background noise because of non-specific binding in enzyme-linked immunosorbent assays (ELISAs). We therefore aimed to establish an amplified ELISA to measure allergen-specific salivary SIgA levels to assess the efficacy of SLIT for Japanese cedar pollinosis.</p><p><strong>Methods: </strong>Biotinyl-tyramide (BT-Tyr) was used to amplify the signal in a colorimetric ELISA. The allergen of Japanese cedar pollen, Sugi basic protein (SBP), was biotinylated and used as a reporter to obtain sensitive and specific results with low background. To obtain preliminary observations, we applied this ELISA for measuring anti-SBP SIgA levels in saliva samples from SLIT-treated patients with Japanese cedar pollinosis.</p><p><strong>Results: </strong>The ELISA was highly sensitive and achieved more than 200-fold signal amplification compared with non-amplified conditions. It was also specific for antigens without background noise. The levels of SBP-specific SIgA in saliva increased in patients 9 months after SLIT initiation at the latest.</p><p><strong>Conclusions: </strong>We developed a sensitive colorimetric ELISA to measure SBP-specific SIgA in saliva using BT-Tyr-based amplification and biotinylated antigen as a reporter. We successfully applied this sensitive ELISA to monitor the levels of SBP-specific SIgA in saliva samples from patients with pollinosis receiving SLIT. Increased salivary SBP-specific SIgA levels were observed in these patients.</p>","PeriodicalId":73062,"journal":{"name":"Frontiers in allergy","volume":"7 ","pages":"1857343"},"PeriodicalIF":3.4,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13678487/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149229480","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of two respiratory oscillometers in patients with a broad range of lung function patterns.","authors":"Murphy Binnie, Joyce K Y Wu, Chung-Wai Chow","doi":"10.3389/falgy.2026.1896281","DOIUrl":"https://doi.org/10.3389/falgy.2026.1896281","url":null,"abstract":"<p><strong>Background: </strong>Oscillometry provides a non-invasive assessment of respiratory system mechanics and has shown potential for early detection of lung disease. However, differences in device hardware and signal processing may limit comparisons between devices. The objective of this study was to evaluate agreement between two commercial forced oscillometry devices, Tremoflo C-100 (Thorasys Medical Systems, Canada) and Resmon Pro (Restech srl, Italy) in patients with a spectrum of abnormal lung physiology.</p><p><strong>Methods: </strong>49 patients with chronic lung disease and 27 healthy volunteers completed paired oscillometry using both devices in an alternating order. Measurements of resistance at 5 Hz (R5), resistance between 5 and 19 Hz (R5-19), reactance at 5 Hz (X5), the resonant frequency of the lungs (Fres), and area of reactance (AX) were compared using Wilcoxon signed-rank tests, Bland-Altman analysis, intraclass correlation coefficients (ICC), and effect size calculations.</p><p><strong>Results: </strong>Significant differences were found between devices for all impedance measurements (<i>p</i> ≤ 0.001). The Resmon Pro reported lower R5, R5-19, Fres, and AX, and less negative X5 than the Tremoflo C-100. ICC estimates ranged from 0.59 to 0.85, but Bland-Altman analysis demonstrated systematic bias and wide limits of agreement; for AX, the bias was -4.10 cmH₂O/L with limits of agreement from -14.99 to 6.80 cmH₂O/L.</p><p><strong>Conclusion: </strong>Systematic biases and wide limits of agreement indicate that the devices should not be used interchangeably for longitudinal patient monitoring. Standardization of oscillometry device signal generation and processing is necessary to enable accurate cross-device comparison in both clinical and research applications.</p>","PeriodicalId":73062,"journal":{"name":"Frontiers in allergy","volume":"7 ","pages":"1896281"},"PeriodicalIF":3.4,"publicationDate":"2026-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13658058/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149186577","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Could <i>Dirofilaria immitis</i> contribute to occult allergic sensitization? Serological evidence from allergic patients in a hyperendemic area.","authors":"José Alberto Montoya-Alonso, Alfonso Balmori-de la Puente, Iván Rodríguez-Escolar, Manuel Collado-Cuadrado, Alberto Gil-Abad, Elena Carretón, Rodrigo Morchón","doi":"10.3389/falgy.2026.1943450","DOIUrl":"https://doi.org/10.3389/falgy.2026.1943450","url":null,"abstract":"<p><strong>Introduction: </strong>Although human infection with <i>Dirofilaria immitis</i> is classically linked to benign pulmonary nodules, the immunological impact of repeated exposure to infective larvae in allergic individuals remains poorly understood. This study evaluated serological evidence of exposure and sensitization to <i>D. immitis</i> in human patients with allergic diseases living in Gran Canaria, a hyperendemic area for heartworm disease.</p><p><strong>Methods: </strong>A total of 125 anonymized serum samples from patients diagnosed with allergic conditions were analyzed. Specific Immunoglobulin (Ig) G antibodies against <i>D. immitis</i> and <i>Wolbachia</i> sp., and specific IgE antibodies against D. immitis, were detected by enzyme-linked immunosorbent assay (ELISA). Associations between serological status, epidemiological variables, allergen sensitization, and eosinophilia were explored.</p><p><strong>Results: </strong>Anti-D. immitis IgE positivity was detected in 23.2% of patients, while 6.4% showed simultaneous IgG positivity against <i>D. immitis</i> and <i>Wolbachia</i>. Peripheral eosinophilia was significantly associated with anti-<i>D. immitis</i> IgE seropositivity, with a higher frequency of positives among patients with eosinophilia ≥6%.</p><p><strong>Discussion: </strong>These findings suggest that exposure to <i>D. immitis</i> may have immunological relevance in allergic patients from hyperendemic areas and support further investigation into its potential role in occult allergic sensitization.</p>","PeriodicalId":73062,"journal":{"name":"Frontiers in allergy","volume":"7 ","pages":"1943450"},"PeriodicalIF":3.4,"publicationDate":"2026-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13658081/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149186594","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The ALLPreT panel of legume allergen preparations: characterization of optimized protein extracts for allergen composition, IgE-binding and IgE-crosslinking properties.","authors":"Ana Laura Olivares-Martínez, Sim Ray Yue, Stefanie Randow, Marie Vestergaard Lukassen, Isabela Assugeni, Maria Oliver, Annette Kuehn, Kitty Verhoeckx, Katrine Lindholm Bøgh, Thomas Holzhauser","doi":"10.3389/falgy.2026.1938923","DOIUrl":"10.3389/falgy.2026.1938923","url":null,"abstract":"<p><strong>Introduction: </strong>Allergenicity risk assessment is essential for the authorization of novel foods in accordance with EU Regulation (EU) 2015/2283. Many published studies on the allergenicity assessment of novel foods have been based on study-specific protein preparations with limited comparability across studies. The study aim was to optimize, harmonize and characterize protein extraction from legumes to enable consistent isolation of allergens from relevant protein families in legumes and to be as compatible as possible with <i>in vitro</i> cell assays and <i>in vivo</i> animal models.</p><p><strong>Methods: </strong>Various common (peanut, soybean, lupine, pea, lentil, chickpea, white bean, field bean) and small-seeded (fenugreek, alfalfa, red and white clover) legumes were extracted using 4 different buffers at pH ranging from 7.1 to 9.6. The extracts were prepared using suspension, incubation, centrifugation, filtration, and lyophilization processes. Optimized extracts were characterized for their protein profile (SDS-PAGE), protein composition (mass spectrometry), IgG and IgE-binding properties (Western blot), and functional IgE-crosslinking capacity (RBL-2H3 cell mediator release assay, MRA).</p><p><strong>Results: </strong>Ammonium carbonate buffer (pH 9.0), of which all buffer components fully evaporate during a post-extraction freeze-drying step, resulted in high protein yield with a balanced protein pattern of allergenic proteins within important protein families [11S, 7S, 2S storage proteins; seed albumin, pathogenesis related- 10 (PR-10) protein, profilin, lipid transfer protein, oleosin, defensin, cyclophilin, annexin, seed biotinylated protein, late embryogenesis abundant protein, and others]. All extracts bound IgG from polyclonal peanut or soybean protein antisera, and IgE from legume sensitized subjects. All extracts presented functional IgE-crosslinking properties in legume-specific MRA after passive sensitization with allergen-specific human IgE.</p><p><strong>Discussion: </strong>The developed procedure harmonizes protein extraction from various legumes. The lyophilized extracts preserve allergenic proteins and, due to lack of buffer components, are compatible for allergenicity testing in both cellular and animal-based models, and diagnostic IgE screening assays. This protocol supports standardization in the allergenicity risk assessment of novel legume foods.</p>","PeriodicalId":73062,"journal":{"name":"Frontiers in allergy","volume":"7 ","pages":"1938923"},"PeriodicalIF":3.4,"publicationDate":"2026-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13654845/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149171884","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploration of miRNAs promoting eosinophilia and type 2 immunity.","authors":"Hiba Sayedali, Jenny Calvén, Emma Boberg, Cecilia Lässer, Frida Dahlberg, Julie Weidner, Carina Malmhäll, Madeleine Rådinger, Kristina Johansson","doi":"10.3389/falgy.2026.1968077","DOIUrl":"https://doi.org/10.3389/falgy.2026.1968077","url":null,"abstract":"<p><strong>Background: </strong>MicroRNAs (miRNAs) are evolutionary conserved, small non-coding RNAs that regulate gene expression and modulate cellular responses. In this study, we profiled miRNAs regulated by interleukin-33 (IL-33), a key inflammatory mediator of allergic responses and type 2 immunity that promotes bone marrow eosinophil development and subsequent airway recruitment.</p><p><strong>Method: </strong>C57BL/6 mice were exposed to recombinant IL-33 intranasally to induce airway eosinophilia. Cellular composition was determined by differential cell counts in bronchoalveolar lavage fluid and bone marrow. RNA profiling was performed using miRNA microarray, NanoString nCounter (miRNA and mRNA), qPCR (miRNA), and PrimeFlow-a method combining flow cytometry with single-cell miRNA detection.</p><p><strong>Result: </strong>IL-33 challenge induced bone marrow eosinophilopoiesis and a significant influx of eosinophils into the airways. IL-33 altered miRNA expression in the lungs, displaying a distinct profile compared to IL-33-responsive miRNAs in the bone marrow. miRNAs previously implicated in regulating eosinophil development (e.g., miR-223-3p and miR-21) and type 2 lymphocyte effector functions (e.g., miR-155-5p, miR-150-5p) were significantly altered. These changes were accompanied by gene expression alterations in mediators associated with eosinophil migration (e.g., <i>Il13ra1</i>, <i>Il4ra</i> and <i>Csf2rb</i>). miR-150-5p was downregulated in the bone marrow of IL-33-challenged mice, and further single-cell analysis via PrimeFlow identified an enrichment of miR-150-5p expression in ILC2s. Furthermore, miR-150-5p targets expressed in ILC2s were modulated by IL-33, which induced high IL-5 production in bone marrow ILC2s.</p><p><strong>Conclusion: </strong>We identify candidate miRNA programs involved in the progression of IL-33-dependent eosinophilic inflammation from bone marrow induction to lung recruitment.</p>","PeriodicalId":73062,"journal":{"name":"Frontiers in allergy","volume":"7 ","pages":"1968077"},"PeriodicalIF":3.4,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13649434/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149167580","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The optimized endolysosomal degradation assay with standardized enzyme activity represents an orthogonal method for predicting protein immunogenicity and T cell epitopes.","authors":"Elif Öztemiz, Christof Regl, Hans Brandstetter, Christian G Huber, Kitty Verhoeckx, Gabriele Gadermaier","doi":"10.3389/falgy.2026.1936335","DOIUrl":"10.3389/falgy.2026.1936335","url":null,"abstract":"<p><strong>Introduction: </strong>The endolysosomal degradation assay mimics endolysosomal processing in antigen-presenting cells in vitro and can be used to evaluate protein immunogenicity and T cell epitopes. As previous endolysosomal degradation results demonstrated significant variability, we developed an optimized protocol to ensure the reproducibility and reliability of the assay.</p><p><strong>Methods: </strong>Different buffers were tested regarding their influence on the assay pH. Cleavage of ZFR-AMC to evaluate cathepsin activity was performed prior to endolysosomal degradation. Allergens from birch pollen (Bet v 1) and horse chestnut (Aes h 1) were degraded by endolysosomal proteins from the murine dendritic cell line JAWSII using an activity-standardized protocol. Long-term storage of endolysosomal proteins was evaluated, the endolysosomal half-life was calculated with a one-phase association model using densitometric gel analyses. Aes h 1 peptides were alkylated and all peptides analyzed by HPLCMS/MS. A browser-based application for visualizing the endolysosomal degradome was developed.</p><p><strong>Results: </strong>The content of the degradation and protein buffers had a significant impact on the assay pH conditions. Measurements using Z-FR-AMC showed varying proteolytic activities of different endolysosomal protein preparations. We therefore defined an endolysosomal constant of 10 μM, which was incorporated into the optimized protocol. After adjusting the endolysosomal protease amount, comparable degradation kinetics and half-lives were observed, providing consistency across different batches. Stable protease activity was observed for 63-day storage of endolysosomal proteins. Bet v 1 exhibited a half-life of one hour and multiple peptide clusters with high peptide signal intensities, some of which harbored validated T cell epitopes, were detected. In comparison, the half-life of Aes h 1 was 16 h, indicating higher proteolytic stability. Notably, alkylation of Aes h 1 endolysosomal peptides enabled superior detection of cysteine-containing fragments. Two prominent peptide clusters were identified, one harboring the region of the homologous Art v 1 T cell epitope. PeptideStudio incorporates visualization of peptide intensities and allows feature modifications to enhance the visualization of endolysomal degradomes.</p><p><strong>Discussion: </strong>The optimized endolysosomal degradation process integrates standardized protease activity and enables verified analyses of cysteine-containing peptides using PeptideStudio. This robust, orthogonal tool can support the prediction of protein immunogenicity, thereby contributing to the safety assessment of novel foods or immunogenic proteins.</p>","PeriodicalId":73062,"journal":{"name":"Frontiers in allergy","volume":"7 ","pages":"1936335"},"PeriodicalIF":3.4,"publicationDate":"2026-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13643861/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149139507","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Case Report: Multisystem response to dupilumab in a child with atopic dermatitis, asthma, eosinophilic esophagitis, and other gastrointestinal manifestations.","authors":"Hua-Jie Yan, Wei Dong, Yu-Nan Yang, Chun-Yun Zeng","doi":"10.3389/falgy.2026.1929466","DOIUrl":"https://doi.org/10.3389/falgy.2026.1929466","url":null,"abstract":"<p><strong>Background: </strong>Atopic dermatitis (AD), asthma, and eosinophilic esophagitis (EoE) may coexist because they share type 2 inflammatory pathways. Evidence for dupilumab in children with EoE and other gastrointestinal manifestations remains limited.</p><p><strong>Case presentation: </strong>A 7-year-old girl had poorly controlled AD, recurrent asthma, EoE (>100 eosinophils/high-power field), and lower-density eosinophilic infiltration in gastric, ileal, and colonic biopsies. These extraesophageal findings did not uniformly satisfy proposed thresholds for definite non-EoE eosinophilic gastrointestinal disease. Severe AD despite topical therapy was the primary indication for dupilumab; the coexisting type 2 inflammatory disorders supported selection of a pathway-directed systemic treatment. Dupilumab was administered as a 600-mg loading dose followed by 300 mg subcutaneously every 4 weeks. Over 48 weeks, pruritus resolved, skin lesions markedly improved, wheezing did not recur, inhaled salmeterol/fluticasone was reduced, appetite improved, and vomiting ceased. Follow-up endoscopy showed a smooth esophagus and no obvious duodenal abnormality, although gastric inflammation and small ulcers persisted and repeat histology was unavailable. Total IgE decreased from >2,000 to 211.2 IU/mL; peripheral eosinophils decreased from 0.64 to 0.30 × 10⁹/L. No treatment-related adverse events occurred.</p><p><strong>Conclusion: </strong>This case suggests that IL-4/IL-13 blockade may provide coordinated clinical benefit across multiple type 2 inflammatory organs. The gastrointestinal findings should be interpreted cautiously because symptom improvement was not confirmed by repeat biopsy.</p>","PeriodicalId":73062,"journal":{"name":"Frontiers in allergy","volume":"7 ","pages":"1929466"},"PeriodicalIF":3.4,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13630664/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149119507","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Editorial: Allergens and allergic sensitization in Asia and the tropics-volume II.","authors":"Kyoung Yong Jeong, Alain Jacquet, Ting Fan Leung, Philip Hei Li","doi":"10.3389/falgy.2026.1973136","DOIUrl":"https://doi.org/10.3389/falgy.2026.1973136","url":null,"abstract":"","PeriodicalId":73062,"journal":{"name":"Frontiers in allergy","volume":"7 ","pages":"1973136"},"PeriodicalIF":3.4,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13632487/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149119436","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Are we there yet? understanding interactions between respiratory viral infections, atopy, and the microbiome.","authors":"Megan E Hanna, Navya Kartha, Andriana LaMantia, Mitchell H Grayson, Syed-Rehan A Hussain","doi":"10.3389/falgy.2026.1952677","DOIUrl":"https://doi.org/10.3389/falgy.2026.1952677","url":null,"abstract":"<p><p>Atopic disease has become an increasingly prevalent condition worldwide and a significant health concern. Similarly, due to concerns about morbidity associated with respiratory viral illness in early childhood, there has been increased exploration of the relationship between atopy and viral illnesses. Historically, studies have focused on early-life respiratory infections driving the development of atopy or post-viral airway disease, with respiratory syncytial virus (RSV) infection driving post-viral disease in those without atopy, while human rhinovirus (hRV) leading to asthma in those with pre-existing atopy. The impact of atopy on the antiviral immune response remains debated, with some studies suggesting it provides a protective role, while others suggest it impairs the immune response. Beyond the respiratory tract, the gut microbiome increasingly is recognized as a potential modulator of both local and distant immune responses, a relationship associated with lung function termed the gut-lung axis. As we continue to elucidate the biochemical mechanisms underlying these pathways in mouse models, it will be important to identify analogous human pathways. This review explores what is currently known about the relationship between atopy and respiratory viral infections focusing on knowledge about how viral infections drive atopy and, reciprocally, how atopy modulates respiratory viral induced disease. Moreover, we review published information on analogous human pathways. Utilizing this information will help us with better disease management and potential development of targeted therapeutics.</p>","PeriodicalId":73062,"journal":{"name":"Frontiers in allergy","volume":"7 ","pages":"1952677"},"PeriodicalIF":3.4,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13631494/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149119491","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sublingual allergen immunotherapy: evidence from randomized trials, real-world studies and meta-analyses.","authors":"Giovanni Paoletti, Nicolò Valli, Danilo Di Bona, Giulia Anna Maria Luigia Costanzo, Andrea Giovanni Ledda, Stefano Del Giacco, Mattia Giovannini, Francesco Catamerò, Francesca Mori, Giuseppe Guida, Fabio Luigi Massimo Ricciardolo, Francesca Bertolini, Remo Poto, Corrado Pelaia, Gilda Varricchi, Giorgio Walter Canonica, Enrico Heffler","doi":"10.3389/falgy.2026.1940709","DOIUrl":"10.3389/falgy.2026.1940709","url":null,"abstract":"<p><strong>Background: </strong>Allergen immunotherapy is the only potentially disease-modifying treatment for IgE-mediated respiratory allergy. Among the available routes, sublingual immunotherapy (SLIT) has gained prominence because of its favorable safety profile and greater patient acceptability.</p><p><strong>Objectives: </strong>This narrative review critically appraises the clinical efficacy, real-world effectiveness, and long-term disease-modifying potential of SLIT for seasonal and perennial respiratory allergies by integrating evidence from randomized controlled trials, large observational cohorts, and meta-analyses, with attention to allergen- and product-specific outcomes and age-related differences.</p><p><strong>Results: </strong>Robust RCT evidence supports clinically meaningful reductions in symptoms and medication use with grass and HDM SLIT tablets, with sustained benefits observed up to 1-2 years after a 3-year treatment course in key trials. Real-world cohorts corroborate these findings and additionally report a reduced risk of new asthma onset and lower long-term medication dispensing after SLIT. Evidence for SLIT in asthma shows reductions in exacerbation risk in some trials, although its effects on day-to-day control are less consistent. Pediatric trials generally mirror adult outcomes, with favorable safety and efficacy, particularly for standardized tablets; however, heterogeneity across trials and historical methodological limitations remain important caveats. Meta-analyses confirm overall efficacy but highlight substantial between-study heterogeneity and the importance of product-specific evaluations.</p><p><strong>Conclusions: </strong>SLIT could be an effective, well-tolerated, disease-modifying option for respiratory allergic rhinitis and shows promise for selected asthma outcomes. Optimal benefits require standardized, adequately dosed formulations and sustained adherence (≥3 years). Future research should prioritize product-specific, adequately powered trials with standardized outcomes to refine patient selection and long-term disease-modification endpoints.</p>","PeriodicalId":73062,"journal":{"name":"Frontiers in allergy","volume":"7 ","pages":"1940709"},"PeriodicalIF":3.4,"publicationDate":"2026-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13617367/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149076768","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}