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II.
Allergic and Immunologic Disorders
A.
Allergy
1.
Immunology
2.
New diagnostics
3.
Treatment of allergic rhinitis
a.
SLIT/SCIT
Lin SY, Erekosima N, Kim JM, et al. Sublingual immunotherapy for the treatment of
allergic rhinoconjunctivitis and asthma: a systematic review.
JAMA
. 2013;
309(12):1278-1288. EBM level 1a.........................................................................183-193
Summary
: Sublingual immunotherapy (SLIT) provides a moderate-grade level of evidence to
support effectiveness for the treatment of allergic rhinitis and asthma when combined. In the
asthma group, the evidence was high in support of SLIT for improving symptoms. In the rhinitis
group, the evidence was rated moderate in support of SLIT for rhinitis symptoms.
b.
Pharmaceuticals
Li JT, Bernstein DI, Calderon MA, et al. Sublingual grass and ragweed immunotherapy:
clinical considerations-a PRACTALL consensus report.
J Allergy Clin Immunol
. 2016;
137(2):369-376. EBM level 1a...............................................................................194-201
Summary
: Sublingual allergen immunotherapy has been widely used and studied throughout
Europe. Sublingual grass and ragweed immunotherapy tablets, used for allergic rhinitis, have
proven efficacy studied through large multi-institutional trials. Sublingual immunotherapy
(SLIT) is indicated for IgE atopy confirmed by positive skin test or
in vitro
testing. Most SLIT-
induced local reactions occur soon after the beginning of treatment and cease within 2 weeks
without intervention. SLIT is extremely safe. Based on the European experience, no SLIT
related fatalities have occurred.
B.
Asthma
1.
Unified airway
Mener DJ, Lin SY. Improvement and prevention of asthma with concomitant treatment of
allergic rhinitis and allergen-specific therapy.
Int Forum Allergy Rhinol
. 2015; 5 Suppl
1:S45-S50. EBM level 4................................................................................................202-207
Summary
: This article is an expert review on the impact of management of allergic rhinitis on asthma
treatment and prevention.
Stachler RJ. Comorbidities of asthma and the unified airway.
Int Forum Allergy Rhinol
.
2015; 5 Suppl 1:S17-S22. EBM level 4.........................................................................208-213
Summary
: This article is a review of the current literature, studying asthma as a comorbidity of
respiratory diseases such as allergic rhinitis.