Immunotherapy to Aeroallergens

We are currently initiating Immunotherapy for the 2024 pollen season

  • What is immunotherapy?

Immunotherapy is a treatment used to manage allergic rhinitis, eczema, or asthma symptoms. This treatment involves gradually increasing doses of a specific allergen extract such as pollen, dust mite, mold, or animal dander. Immunotherapy has been in use for nearly a century and is widely practiced worldwide. It's also referred to as "allergy vaccination" or "desensitization." In the past, immunotherapy required a series of injections (known as subcutaneous immunotherapy) over a period of 3 to 5 years. However, with the availability of safe and effective oral products, injection immunotherapy is now rarely used.

  • What is sublingual immunotherapy (SLIT)?

Sublingual immunotherapy involves administering an allergen extract under the tongue, usually in the form of tablets or drops. This method is safe, and injections are not necessary, except in cases of venom allergies. However, SLIT must be taken daily.

  • What are the benefits of sublingual immunotherapy?

Most children who undergo sublingual immunotherapy (SLIT) report a significant improvement in their allergy symptoms such as allergic rhinoconjunctivitis, asthma, and eczema. They may also require less medication after undergoing SLIT treatment. The benefits of SLIT can often be seen within the first year of treatment. Research suggests that SLIT may also help to prevent new allergies from developing and reduce the likelihood of developing other allergic diseases such as asthma.

  • What are the risks?

Numerous large-scale studies conducted on hundreds of children, some as young as two years old, have demonstrated the safety of SLIT as a form of therapy. However, mild side effects such as itchiness and swelling in the mouth after taking the medication are common. To alleviate these symptoms, antihistamines can be taken beforehand or the dosage can be reduced if the symptoms recur. Our experience indicates that the side effects are seldom troublesome enough for a child to discontinue the treatment.

  • How long will the treatment last?

If your child experiences hay fever symptoms during spring or summer, they may be allergic to tree pollen, grass pollen, or both. The type of SLIT product your child will receive depends on their clinical history and allergy test results.

Typically, the treatment will begin a few months before the usual onset of symptoms (if pollen allergic) and continue for a total of 3 years. This cycle of treatment will be repeated over 3 years.

SLIT treatment can be started at any time of the year for non-seasonal allergens.

Improvements in symptoms can be expected from the first year of treatment, and research indicates that this benefit will continue for some years beyond the last course of treatment. It has been demonstrated that three years of treatment (pollen) are more effective than just two years.

  • What are the alternatives?

Immunotherapy is the only treatment that can moderate the underlying cause of an allergy. The alternative is to continue with medicines that suppress the symptoms, such as anti-histamines and steroid-based medicines, but are not curative nor without side effects.

  • Will the treatment completely get rid of my allergy?

Unfortunately, whilst some patients do find they are greatly improved, for many, the improvement is good but not complete. It is, therefore, essential to have realistic expectations. Around 80-85% of patients report significant improvement in their hayfever symptoms in the first year of treatment.

  • How do I use sublingual immunotherapy?

SLIT products come either as a simple spray device, dropper or as tablets. The first dose will be given in Professor Du Toit’s private clinic under close supervision and you will be shown exactly how to use the treatment. Side effects & management will be discussed & written information will be supplied.

  • How old does a patient have to be to commence SLIT?

Most children can comply with the daily regimen of placing the product under the tongue for at least a minute before swallowing from about six years of age.

  • Where can I find more information on SLIT?

Duration each year, repeated over three years, annual follow-up and assessment