Blood eosinophils take centre stage in predicting the response to sublingual immunotherapy (SLIT): a familiar twist

Sublingual immunotherapy (SLIT) represents a safer, more comfortable and more convenient allergen immunotherapy than its subcutaneous counterpart. There is an increasing body of evidence showing that SLIT for house dust mites (HDM), grass, ragweed and/or tree pollen improves allergic symptoms and asthma control.1 It is unclear whether SLIT consistently reduces the occurrence of asthma attacks.1–3 Published in 2016, the MITRA trial was arguably the most robust randomised controlled trial assessing the effect of SLIT (specifically HDM-SLIT) on the prevention of asthma attacks in mild-to-moderate allergic asthma.2 Briefly, the MITRA trial was conducted in 834 people with uncontrolled mild-to-moderate allergic asthma and positive HDM allergen-specific immunoglobulin E (IgE) (≥0.7 kU/L or >3 mm on skin prick—usual cutoffs). After randomisation to HDM-SLIT or placebo, participants were monitored on stable background inhaled corticosteroid (ICS) therapy for 7–12 months, thereafter, reducing their ICS dosing up...
Source: Thorax - Category: Respiratory Medicine Authors: Tags: Thorax Editorial Source Type: research