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Sublingual immunotherapy in patients with house dust mite allergic rhinitis: prospective study of clinical outcomes over a two-year period

  • J Y Soh (a1), M Thalayasingam (a2), S Ong (a3), E X L Loo (a4), L P Shek (a1) and S S Chao (a3)...
  • Please note a correction has been issued for this article.



Sublingual immunotherapy in patients with allergic rhinitis sensitised to house dust mites is safe, but its efficacy is controversial and sublingual immunotherapy with Blomia tropicalis has not yet been studied. This study sought to evaluate the efficacy of sublingual immunotherapy with house dust mite extract in children and adults with house dust mite allergic rhinitis over a period of two years.


A prospective observational study was conducted of children and adults diagnosed with house dust mite allergic rhinitis who were treated with sublingual immunotherapy from 2008 to 2012. Total Nasal Symptom Scores, Mini Rhinoconjunctivitis Quality of Life scores and medication usage scores were assessed prospectively.


Thirty-nine patients, comprising 24 children and 15 adults, were studied. Total Nasal Symptom Scores and Mini Rhinoconjunctivitis Quality of Life scores dropped significantly at three months into therapy, and continued to improve. Medication usage scores improved at one year into immunotherapy.


Sublingual immunotherapy with house dust mite extracts, including B tropicalis, is efficacious as a treatment for patients with house dust mite allergic rhinitis.


Corresponding author

Address for correspondence: Dr Lynette Pei-Chi Shek, NUHS Tower Block, Level 12, 1E Kent Ridge Road, Singapore119228 E-mail:


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1Asher, MI, Montefort, S, Björkstén, B, Lai, CK, Strachan, DP, Weiland, SK et al. ; ISAAC Phase Three Study Group. Worldwide time trends in the prevalence of symptoms of asthma, allergic rhinoconjunctivitis, and eczema in childhood: ISAAC phases one and three repeat multicountry cross-sectional surveys. Lancet 2006;368:733–43
2Bousquet, J, Khaltaev, N, Cruz, AA, Denburg, J, Fokkens, WJ, Togias, A et al. Allergic Rhinitis and its Impact on Asthma (ARIA) 2008 update (in collaboration with the World Health Organization, GA(2)LEN, and AllerGen). Allergy 2008;63:8160
3Canonica, GW, Bousquet, J, Mullol, J, Scadding, GK, Virchow, JC. A survey of the burden of allergic rhinitis in Europe. Allergy 2007;62:1725
4Wahn, U. What drives the allergic march? Allergy 2000;55:591–9
5Gelfand, EW. Pediatric allergic rhinitis: factors affecting treatment choice. Ear Nose Throat J 2005;84:163–8
6Bousquet, PJ, Bachert, C, Canonica, GW, Casale, TB, Mullol, J, Klossek, JM et al. Uncontrolled allergic rhinitis during treatment and its impact on quality of life: a cluster randomized trial. J Allergy Clin Immunol 2010;126:666–8
7Craig, TJ, Sherkat, A, Safaee, S. Congestion and sleep impairment in allergic rhinitis. Curr Allergy Asthma Rep 2010;10:113–21
8Bousquet, J, Lockey, R, Malling, HJ. Allergen immunotherapy: therapeutic vaccines for allergic diseases. WHO position paper. J Allergy Clin Immunol 1998;102:558–62
9Passalacqua, G, Guerra, L, Pasquali, M, Lombardi, C, Canonica, GW. Efficacy and safety of sublingual immunotherapy. Ann Allergy Asthma Immunol 2004;93:312
10Bousquet, J. Sublingual immunotherapy: validated! Allergy 2006;61:56
11Roder, E, Berger, MY, de Groot, H, van Wijk, RG. Immunotherapy in children and adolescents with allergic rhinoconjunctivitis: a systematic review. Pediatr Allergy Immunol 2008;19:197207
12Penagos, M, Compalati, E, Tarantini, F, Baena-Cagnani, R, Huerta, J, Passalacqua, G et al. Efficacy of sublingual immunotherapy in the treatment of allergic rhinitis in pediatric patients 3 to 18 years of age: a meta-analysis of randomized, placebo-controlled, double-blind trials. Ann Allergy Asthma Immunol 2006;97:141–8
13Wilson, DR, Lima, MT, Durham, SR. Sublingual immunotherapy for allergic rhinitis: systematic review and meta-analysis. Allergy 2005;60:412
14Arlian, LG, Vyszenski-Moher, DL, Fernandez-Caldas, E. Allergenicity of the mite, Blomia tropicalis. J Allergy Clin Immunol 1993;91:1042–50
15Caraballo, L, Puerta, L, Martínez, B, Moreno, L. Identification of allergens from the mite Blomia tropicalis. Clin Exp Allergy 1994;24:1056–60
16Fernández-Caldas, E, Puerta, L, Caraballo, L. Mites and allergy. Chem Immunol Allergy 2014;100:234–42
17Juniper, EF, Guyatt, GH, Andersson, B, Ferrie, PJ. Comparison of powder and aerosolized budesonide in perennial rhinitis: validation of rhinitis quality of life questionnaire. Ann Allergy 1993;70:225–30
18Juniper, EF, Thompson, AK, Ferrie, PJ, Roberts, JN. Development and validation of the Mini Rhinoconjunctivitis Quality of Life Questionnaire. Clin Exp Allergy 2000;30:132–40
19Lee, JE, Choi, YS, Kim, MS, Han, DH, Rhee, CS, Lee, CH et al. Efficacy of sublingual immunotherapy with house dust mite extract in polyallergen sensitized patients with allergic rhinitis. Ann Allergy Asthma Immunol 2011;107:7984
20Wise, SK, Woody, J, Koepp, S, Schlosser, RJ. Quality of life outcomes after sublingual immunotherapy. Am J Otolaryngol 2009;30:305–11
21Kim, ST, Han, DH, Moon, IJ, Lee, CH, Min, YG, Rhee, CS. Clinical and immunologic effects of sublingual immunotherapy on patients with allergic rhinitis to house-dust mites: 1-year follow-up results. Am J Rhinol Allergy 2010;24:271–5
22Yonekura, S, Okamoto, Y, Sakurai, D, Horiguchi, S, Hanazawa, T, Nakano, A et al. Sublingual immunotherapy with house dust extract for house dust-mite allergic rhinitis in children. Allergol Int 2010;59:381–8
23Ferrés, J, Justicia, JL, García, MP, Muñoz-Tudurí, M, Alvà, V. Efficacy of high-dose sublingual immunotherapy in children allergic to house dustmites in real-life clinical practice. Allergol Immunopathol (Madr) 2011;39:122–7
24Park, IH, Hong, SM, Lee, HM. Efficacy and safety of sublingual immunotherapy in Asian children. Int J Pediatr Otorhinolaryngol 2012;76:1761–6
25Wang, DH, Chen, L, Cheng, L, Li, KN, Yuan, H, Lu, JH et al. Fast onset of action of sublingual immunotherapy in house dust mite-induced allergic rhinitis: a multicenter, randomized, double-blind, placebo-controlled trial. Laryngoscope 2013;123:1334–40
26Kim, SH, Mun, SJ, Han, DH, Kim, JW, Kim, DY, Rhee, CS. Three-year follow-up results of sublingual immunotherapy in patients with allergic rhinitis sensitized to house dust mites. Allergy Asthma Immunol Res 2015;7:118–23
27de Bot, CM, Moed, H, Berger, MY, Röder, E, Hop, WC, de Groot, H et al. Sublingual immunotherapy not effective in house dust mite-allergic children in primary care. Pediatr Allergy Immunol 2012;23:151–9
28Hirsch, T, Sahn, M, Leupold, W. Double-blind placebo-controlled study of sublingual immunotherapy with house dust mite extract ( in children. Pediatr Allergy Immunol 1997;8:21–7
29Aydogan, M, Eifan, AO, Keles, S, Akkoc, T, Nursoy, MA, Bahceciler, NN et al. Sublingual immunotherapy in children with allergic rhinoconjunctivitis mono-sensitized to house-dust-mites: a double-blind-placebo-controlled randomized trial. Respir Med 2013;107:1322–9
30Tahamiler, R, Saritzali, G, Canakcioglu, S. Long-term efficacy of sublingual immunotherapy in patients with perennial rhinitis. Laryngoscope 2007;117:965–9
31Marcucci, F, Sensi, L, Di Cara, G, Salvatori, S, Bernini, M, Pecora, S et al. Three-year follow-up of clinical and inflammation parameters in children monosensitized to mites undergoing sub-lingual immunotherapy. Pediatr Allergy Immunol 2005;16:519–26
32Marogna, M, Spadolini, I, Massolo, A, Canonica, GW, Passalacqua, G. Long-lasting effects of sublingual immunotherapy according to its duration: a 15-year prospective study. J Allergy Clin Immunol 2010;126:969–75



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