Effect of pollen-specific sublingual immunotherapy on oral allergy syndrome an observational study.docVIP

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Effect of pollen-specific sublingual immunotherapy on oral allergy syndrome an observational study.doc

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Effect of pollen-specific sublingual immunotherapy on oral allergy syndrome an observational study

ORIGINALSTUDY EffectofPollen-SpecificSublingualImmunotherapy onOralAllergySyndrome AnObservationalStudy Karl-ChristianBergmann,MD,*HendrikWolf,PhD,**andJo¨rgSchnitker,PhDt U pto70%ofpatientswithpollenallergyalsoexperience oral reactions to food (oral allergy syndrome [OAS]), typicallyfruitandvegetables.1Y3AlthoughmostcasesofOAS Background: Oral allergy syndrome (OAS) triggered by fruit and vegetables often occurs in patients with pollen-induced rhinocon- junctivitisbecauseofcross-reactiveepitopesinpollenandassociated foods.Thisopenobservationalstudyexaminedtheeffectofpollen- specific sublingual immunotherapy ([SLIT] B. U. Pangramin or SLITone involving birch/alder/hazel, grasses/rye, and/or mugwort) on OAS triggered by several foods in patients treated in standard practice.VeryfewstudieshaveexaminedSLITuseinthissituation. Methods:Patients(n=102)hadpollen-inducedrhinoconjunctivitis and OAS and were followed for up to 12 months. Baseline OAS (triggers, symptoms, and symptom severity) was assessed by questionnaire and patient history. Change in OAS was assessed using oral challenge test with 1 or 2 dominant food triggers (and comparedwiththesumscorecalculatedfromtheOASquestionnaire at baseline) and clinician ratings of change. Pollen-induced rhinoconjunctivitis symptoms and medication use were also measured. Results:Intheoralchallengetest,77.0%ofpatientswereconsidered responders(decreaseinsumscoreofQ50%;nodifferenceinpatients receiving B. U. Pangramin or SLITone). At baseline, investigators rated OAS severity as at least moderate in 94.9% of patients comparedwith36.9%after12monthsoftreatment.After12months, OASwasratedasmuchorverymuchimprovedin72.9%ofpatients. Sublingualimmunotherapysignificantlyreducedrhinoconjunctivitis symptoms and medication use. Only 10% of patients experienced adversedrugreactions. resultinmildsymptoms(itchingoflips,mouth,andthroat), more severe (lip and tongue swelling, angioedema of the pharyngeal mucosa) and evenlife-threatening (anaphyl