SS Asma e Malattie Polmonari, UO Pediatria, Presidio Ospedaliero Macedonio Melloni, Azienda Ospedaliera Fatebenefratelli ed Oftalmico, Milano.
Int J Immunopathol Pharmacol. 2009 Oct-Dec;22(4 Suppl):5-8.
Clinical efficacy of sublingual immunotherapy (SLIT) has been investigated during the last 20 years and results of several meta-analyses are available, showing clinical efficacy of SLIT in children both in allergic asthma and in rhinitis, but strict recommendations are not possible under current evidence. Minimum age for starting SLIT is not clearly defined but several position paper and guidelines indicate a lower limit of 5 years of age. Guidelines on allergic rhinitis suggests SLIT in patients not well controlled with drugs or those who refuse to use drugs. Additional effects are prevention of new sensitizations (evidence IIa) and prevention of asthma in patients with allergic rhinitis (evidence I b). Studies on efficacy of SLIT in asthmatic children are discordant, but the different relevance of allergic and non allergic triggers of symptoms could explain the discordant results obtained in studies on SLIT and asthma, particularly when pooling short and long term studies. Data on efficacy and safety of SLIT are accruing for atopic dermatitis, food allergy and latex allergy, but at the current state of knowledge, SLIT remains an approach reserved to research, and no recommendations can be established. Some studies demonstrate that SLIT is safe in children below 5 years of age, with a lower limit of 3 years.
舌下免疫疗法 (SLIT) 的临床疗效在过去 20 年中得到了研究，并且有几项荟萃分析的结果可用，这些结果表明 SLIT 在儿童过敏性哮喘和鼻炎中均具有临床疗效，但根据现有证据，无法给出严格的建议。开始 SLIT 的最小年龄没有明确界定，但有几份立场文件和指南指出，年龄下限为 5 岁。过敏性鼻炎指南建议在药物治疗效果不佳或拒绝使用药物的患者中使用 SLIT。附加作用是预防新的致敏（证据 IIa）和预防过敏性鼻炎患者的哮喘（证据 Ib）。SLIT 在哮喘儿童中的疗效研究结果不一致，但症状的过敏和非过敏触发因素的不同相关性可以解释 SLIT 和哮喘研究中获得的不一致结果，特别是当将短期和长期研究进行汇总时。有关 SLIT 在特应性皮炎、食物过敏和乳胶过敏中的疗效和安全性的数据正在积累，但在目前的知识状态下，SLIT 仍然是一种保留用于研究的方法，因此无法建立任何建议。一些研究表明，SLIT 在 5 岁以下儿童中是安全的，年龄下限为 3 岁。
