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Allergen specific sublingual immunotherapy in children with asthma and allergic rhinitis

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Abstract

Background

The incidence of asthma and allergic rhinitis (AR) is significantly increased, especially in younger children. Current treatment for children with asthma and allergic rhinitis include allergen avoidance, standard pharmacotherapy, and immunotherapy. Since standard pharmacotherapy is prescribed for symptoms, immunotherapy at present plays an important role in the treatment of allergic diseases. This article presents insights into the up-to-date understanding of immunotherapy in the treatment of children with allergic rhinitis and asthma.

Data sources

PubMed articles published from 1990 to 2014 were reviewed using the MeSH terms "asthma", "allergic rhinitis", "children", and "immune therapy". Additional articles were identified by hand searching of the references in the initial search.

Results

Numerous studies have shown that sublingual application of allergen specific immunotherapy (SLIT) is an adequate, safe and efficient substitution to subcutaneous route of allergens administration (SCIT) in the treatment of IgE-mediated respiratory tract allergies in children. According to the literature, better clinical efficacy is connected with the duration of treatment and mono sensitized patients.

Conclusions

At least 3 years of treatment and stable asthma before the immunotherapy are positive predictors of good clinical efficacy and tolerability of SLIT. SLIT reduces the symptoms of allergic diseases and the use of medicaments, and improves the quality of life of children with the diseases.

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References

  1. Bousquet J, Lockey R, Malling HJ. Allergen immunotherapy: therapeutic vaccines for allergic diseases. A WHO position paper J Allergy Clin Immunol 1998;102:558–622.

    Article  CAS  PubMed  Google Scholar 

  2. Black JH. The oral administration of pollen: clinical report. J Lab Clin Med 1928;13:709–713.

    Google Scholar 

  3. Moingeon P, Batard T, Fadel R, Frati F, Sieber J, Van Overtvelt L. Immune mechanisms of allergen-specific sublingual immunotherapy. Allergy 2006;61:151–165.

    Article  CAS  PubMed  Google Scholar 

  4. Didier A, Malling HJ, Worm M, Horak F, Jager S, Montagut A, et al. Optimal dose, efficacy, and safety of once-daily sublingual immunotherapy with a 5-grass pollen tablet for seasonal allergic rhinitis. J Allergy Clin Immunol 2007;120:1338–1345.

    Article  CAS  PubMed  Google Scholar 

  5. Dahl R, Kapp A, Colombo G, de Monchy JGR, Rak S, Emminger W, et al. Sublingual grass allergen tablet immunotherapy provides sustained clinical benefit with progressive immunologic changes over 2 years. J Allergy Clin Immunol 2008;121:512–518.

    Article  CAS  PubMed  Google Scholar 

  6. Nouri-Aria KT, Wachholz PA, Francis JN, Jacobson MR, Walker SM, Wilcock LK, et al. Grass pollen immunotherapy induces mucosal and peripheral IL-10 responses and blocking IgG activity. J Immunol 2004;172:3252–3259.

    Article  CAS  PubMed  Google Scholar 

  7. UK Immunotherapy Study Group. Efficacy and safety of specific immunotherapy with SQ allergen extract in treatment-resistant seasonal allergic rhinoconjunctivitis. J Allergy Clin Immunol 2006;117:319–325.

    Article  Google Scholar 

  8. Lue KH, Lin YH, Sun HL, Lu KH, Hsieh JC, Chou MC. Clinical and immunologic effects of sublingual immunotherapy in asthmatic children sensitized to mites: a double-blind, randomized, placebo-controlled study. Pediatr Allergy Immunol 2006;17:408–415.

    Article  PubMed  Google Scholar 

  9. Rolinck-Werninghaus C, Kopp M, Liebke C, Lange J, Wahn U, Niggemann B. Lack of detectable alterations in immune responses during sublingual immunotherapy in children seasonal allergic rhinoconjunctivitis to grass pollen. Int Arch Allergy Immunol 2005;136:134–141.

    Article  CAS  PubMed  Google Scholar 

  10. Pajno GB, Morabito L, Barberio G, Parmiani S. Clinical and immunologic effects of long-term sublingual immunotherapy in asthmatic children sensitized to mites: a double-blind, placebocontrolled study. Allergy 2000;55:842–849.

    Article  CAS  PubMed  Google Scholar 

  11. Bahceciler NN, Arikan C, Taylor A, Akdis M, Blaser K, Barlan IB, et al. Impact of sublingual immunotherapy on specific antibody levels in asthmatic children allergic to house dust mites. Int Arch Allergy Immunol 2005;136:287–294.

    Article  PubMed  Google Scholar 

  12. Akdis M, Verhagen J, Taylor A, Karamloo F, Karagiannidis C, Crameri R, et al. Immune responses in healthy and allergic Individuals are characterized by a fine balance between allergen-specific T regulatory 1 and T helper 2 cells. J Exp Med 2004;199:1567–1575.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  13. Mantel PY, Kuipers H, Boyman O, Rhyner C, Ouaked N, Ruckert B, et al. GATA3-driven Th2 responses inhibit TGFbeta1-induced FOXP3 expression and the formation of regulatory T cells. PLoS Biol 2007;5:e329.

    Article  PubMed  PubMed Central  Google Scholar 

  14. Mauri C, Bosma A. Immune regulatory function of B cells. Annu Rev Immunol 2012;30:221–224

    Article  CAS  PubMed  Google Scholar 

  15. Laaksonen K, Junikka M, Lahesmaa R, Terho EO, Savolainen J. In vitro allergen-induced mRNA expression of signaling lymphocytic activation molecule by PBMC of patients with allergic rhinitis is increased during specific pollen immunotherapy. J Allergy Clin Immunol 2003;112:1171–1177.

    Article  CAS  PubMed  Google Scholar 

  16. Gabrielsson S, Soderlund A, Paulie S, van der Pouw Kraan TC, Troye-Blomberg M, Rak S. Specific immunotherapy prevents increased levels of allergen-specific IL-4 and IL-13-producing cells during pollen season. Allergy 2001;56:293–300.

    Article  CAS  PubMed  Google Scholar 

  17. Faith A, Richards DF, Verhoef A, Lamb JR, Lee TH, Hawrylowicz CM. Impaired secretion of interleukin-4 and interleukin-13 by allergen-specific T cells correlates with defective nuclear expression of NF-AT2 and jun B: relevance to immunotherapy. Clin Exp Allergy 2003;33:1209–1215.

    Article  CAS  PubMed  Google Scholar 

  18. Oldfield WL, Larché M, Kay AB. Effect of T-cell peptides derived from Fel d 1 on allergic reactions and cytokine production in patients sensitive to cats: a randomised controlled trial. Lancet 2002;360:47–53.

    Article  CAS  PubMed  Google Scholar 

  19. Ippoliti F, De Santis W, Volterrani A, Lenti L, Canitano N, Lucarelli S, et al. Immunomodulation during sublingual therapy in allergic children. Pediatr Allergy Immunol 2003;14:216–221.

    Article  PubMed  Google Scholar 

  20. Fenoglio D, Puppo F, Cirillo I, Vizzaccaro A, Ferrera A, Tosca MAet al. Sublingual specific immunotherapy reduces PBMC proliferations. Eur Ann Allergy Clin Immunol 2005;37:147–151.

    CAS  PubMed  Google Scholar 

  21. Suárez-Fueyo A, Ramos T, Galán A, Jimeno L, Wurtzen PA, Marin A, et al. Grass tablet sublingual immunotherapy down regulates the TH2 cytokine response followed by regulatory T-cell generation. J Allergy Clin Immunol 2014;133:130–138.

    Article  PubMed  Google Scholar 

  22. Hawrylowicz CM, O’Garra A. Potential role of interleukin-10 secreting regulatory T cells in allergy and asthma. Nature Rev Immunol 2005;5:271–283.

    Article  CAS  Google Scholar 

  23. Taylor A, Verhagen J, Akdis CA, Akdis M. T regulatory cells in allergy and health: a question of allergen specificity and balance. Int Arch Allergy Immunol 2004;135:73–82.

    Article  CAS  PubMed  Google Scholar 

  24. Yazdanbakhsh M, Kremsner PG, Van Ree R. Allergy, parasites and the hygiene hypothesis. Science 2002;296:490–494.

    Article  CAS  PubMed  Google Scholar 

  25. Zhang L, Zhao Y. The regulation of Foxp3 expression in regulatory CD4(1) CD25(1)T cells: multiple pathways on the road. J Cell Physiol 2007;211:590–597.

    Article  CAS  PubMed  Google Scholar 

  26. Mangan PR, Harrington LE, O’Quinn DB, Helms WS, Bullard DC, Elson CO, et al. Transforming growth factor-beta induces development of the T(H)17 lineage. Nature 2006;441:231–234.

    Article  CAS  PubMed  Google Scholar 

  27. Gambineri E, Torgerson T, Ochs H. Immune dysregulation, polyendocrinopathy, enteropathy, and X-linked inheritance (IPEX), a syndrome of systemic autoimmunity caused by mutations of Foxp3, a critical regulator of T cell homeostasis. Curr Opin Rhumatol 2003;15:430–435.

    Article  CAS  Google Scholar 

  28. Gentile D, Schreiber R, Howe-Adams J, Trecki J, Patel A, Angelini B, et al. Diminished dendritic cell interleukin 10 production in atopic children. Ann Allergy Asthma Immunol 2004;92:538–544.

    Article  PubMed  Google Scholar 

  29. Ling EM. Relation of CD4+CD25+ regulatory T-cell suppression of allergen-driven T-cell activation to atopic status and expression of allergic disease. Lancet 2004;363:608–615.

    Article  CAS  PubMed  Google Scholar 

  30. Akdis C, Joss A, Akdis M, Blaser K. Mechanisms of IL10 induced T cell inactivation in allergic inflammation and normal response to allergens. Int Arch Allergy Immunol 2001;124:180–182.

    Article  CAS  PubMed  Google Scholar 

  31. Akdis M, Akdis C. Mechanisms of allergen-specific immunotherapy: Multiple suppressor factors at work in immune tolerance to allergens. J Allergy Clin Immunol 2014;133:621–631.

    Article  CAS  PubMed  Google Scholar 

  32. Tari G. Efficacy of sublingual immunotherapy in patients with rhinitis and asthma due to house dust mite. A doubleblind study. Allergol Immunopathol (Madr) 1990;18:277–284.

    CAS  Google Scholar 

  33. Hirsch T, Sahn M, Leupold W. Double-blind placebo-controlled study of sublingual immunotherapy with house dust mite extract (D. pt. ) in children. Pediatr Allergy Immunol 1997;8:21–27.

    Article  CAS  PubMed  Google Scholar 

  34. Vourdas D, Syrigou E, Potamianou P, Carat F, Batard T, André C, et al. Double blind, placebo-controlled evaluation of sublingual immunotherapy with standardized olive pollen extract in pediatric patients with allergic rhinoconjunctivitis and mild asthma due to olive pollen sensitization. Allergy 1998;53:662–672.

    Article  CAS  PubMed  Google Scholar 

  35. La Rosa M, Ranno C, André C, Carat F, Tosca MA, Canonica GW. Double-blind placebo-controlled evaluation of sublingual swallow immunotherapy with standardized Parietaria judaica extract in children with allergic rhinoconjunctivitis. J Allergy Clin Immunol 1999;104:425–432.

    Article  PubMed  Google Scholar 

  36. Caffarelli C, Sensi LG, Marcucci F, Cavagni C. Preseasonal local allergoid immunotherapy to grass pollen in children: a double-blind, placebo-controlled, randomized trial. Allergy 2000;55:1142–1147.

    Article  CAS  PubMed  Google Scholar 

  37. Yuksel H, Tanac R, Gousseinov A, Demir E. Sublingual immunotherapy and influence on urinary leukotrienes in seasonal pediatric allergy. J Investig Allergol Clin Immunol 1999;9:305–313.

    CAS  PubMed  Google Scholar 

  38. Bahceciler NN, Isik U, Barlan IB, Basaran MM. Efficacy of sublingual immunotherapy in children with asthma and rhinitis: a double-blind, placebo-controlled study. Pediatr Pulmonol 2001;32:49–55.

    Article  CAS  PubMed  Google Scholar 

  39. Pajno GB, Vita D, Parmiani S, Caminiti L, La Grutta S, Barberio G. Impact of sublingual immunotherapy on seasonal asthma and skin reactivity in children allergic to Parietaria pollen treated with inhaled fluticasone propionate. Clin Exp Allergy 2003;33:1641–1647.

    Article  CAS  PubMed  Google Scholar 

  40. Wuthrich B, Bucher Ch, Jorg W, Bircher A, Eng P, Schneider Y, et al. Double-blind, placebo-controlled study with sublingual immunotherapy in children with seasonal allergic rhinitis to grass pollen. J Investig Allergol Clin Immunol 2003;13:145–148.

    CAS  PubMed  Google Scholar 

  41. Bufe A, Ziegler-Kirbach E, Stoeckmann E, Heidemann P, Gehlhar K, Klimek L, et al. Efficacy of sublingual swallow immunotherapy in children with severe grass pollen allergic symptoms: a double-blind placebo-controlled study. Allergy 2004;59:498–504.

    Article  CAS  PubMed  Google Scholar 

  42. Niu CK, Chen WY, Huang JL, Lue KH, Wang JY. Efficacy of sublingual immunotherapy with high-dose mite extracts in asthma: a multicenter, double-blind, randomized, and placebocontrolled study in Taiwan. Respir Med 2006;100:1374–1383.

    Article  PubMed  Google Scholar 

  43. Valovirta E, Jacobsen L, Ljorring C, Koivikko A, Savolainen J. Clinical efficacy and safety of sublingual immunotherapy with tree pollen extract in children. Allergy 2006;61:1177–1183.

    Article  CAS  PubMed  Google Scholar 

  44. Pham-Thi N, Scheinmann P, Fadel R, Combebias A, Andre C. Assessment of sublingual immunotherapy efficacy in children with house dust miteinduced allergic asthma optimally controlled by pharmacologic treatment and mite-avoidance measures. Pediatr Allergy Immunol 2007;18:47–57.

    Article  PubMed  Google Scholar 

  45. Roder E, Berger MY, Hop WC, Bernsen RM, de Groot H, Gerth van Wijk R. Sublingual immunotherapy with grass pollen is not effective in symptomatic youngsters in primary care. J Allergy Clin Immunol 2007;119:892–898.

    Article  PubMed  Google Scholar 

  46. Wahn U, Tabar A, Kuna P, Halken S, Montagut A, De Beaumont O. Efficacy and safety of 5 grass pollen subllingualimmunotherapy in pediatric allergic rhinoconjunctivitis. J Allergy Clin Immunol 2009;123:160–166.

    Article  CAS  PubMed  Google Scholar 

  47. Bufe A, Eberle P, Franke-Beckmann E, Funck J, Kimmig M, Klimek L, et al. Safety anefficacy in children of an SQstandardized grass allergen tablet for sublingual immunotherapy. J Allergy Clin Immunol 2009;123:167–173.

    Article  CAS  PubMed  Google Scholar 

  48. Stelmach I, Kaczmarek-Wozniak J, Majak P, Olszowiec-Chlebna M, Jerzynska J. Efficacy and safety of high-doses sublingual immunotherapy in ultra-rush scheme in children allergic to grass pollen. Clin Exp Allergy 2009;39:401–408.

    Article  CAS  PubMed  Google Scholar 

  49. Marcucci F, Sensi L, Di Cara G, Incorvaia C, Frati F. Dose dependence of immunological response to sublingual immunotherapy Allergy 2005;60:952–956.

    Article  CAS  PubMed  Google Scholar 

  50. Larenas-Linnemann D, Blaiss M, Van Bever HP, Compalati E, Baena-Cagnani CE Pediatric sublingual immunotherapy efficacy: evidence analysis, 2009-2012. Ann Allergy Asthma Immunol 2013;110:402–415.

    Article  PubMed  Google Scholar 

  51. Hedlin G, van HM. The role of immuntherapy in the managment of childhood asthma. Ther Adv Respir Dis 2012;127:30–38.

    Google Scholar 

  52. Tabar AI, Arroabarren E, Echechipía S, García BE, Martin S, Alvarez-Puebla MJ. Three years of specific immunotherapy may be sufficient in house dust mite respiratory allergy. J Allergy Clin Immunol 2011;127:57–63.

    Article  PubMed  Google Scholar 

  53. Ozdemir C, Yazi D, Gocmen I, Yesil O, Aydogan M, Semic-Jusufagic A, et al. Efficacy of long-term sublingual immunotherapy as an adjunct to pharmacotherapy in house dust mite-allergic children with asthma. Pediatr Allergy Immunol 2007;18:508–515.

    Article  PubMed  Google Scholar 

  54. Zielen S, Kardos P, Madonini E. Steroid-sparing effects with allergen specific immunotherapy in childrem with asthma: a randomized controled trial. J Allergy Clin Immunol 2010;126:942–956.

    Article  CAS  PubMed  Google Scholar 

  55. Lin SY, Erekosima N, Kim JM, Ramanathan M, Suarez-Cuervo C, Chelladurai Y, et al. Sublingual immunotherapy for the treatment of allergic rhinoconjuntivits and asthma. JAMA 2013;309:1278–1288.

    Article  CAS  PubMed  Google Scholar 

  56. Bachert C, Canonica GW, Bufe A. SIT: efficacy depends on product, not on route of application. Pediatr Allergy Immunol 2012;23:401.

    Article  PubMed  Google Scholar 

  57. Yoselin A, Kendirli SG, Yilmaz M, Altintas DU, Karakoc GB. et al. Effect of one-year subcutaneous and sublingual immunotherapy on clinical and laboratory parameters in children with rhinitis and asthma: a randomized, placebo-controlled, double-blind, double-dummy study. Int Arch Allergy Immunol 2012;157:288–298.

    Google Scholar 

  58. Aydogan 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 randomised trial. Respir Med 2013;107:1322–1329.

    Article  PubMed  Google Scholar 

  59. Blaiss M, Maloney J, Nolte H, Gawchik S, Yao R, Skoner DP. Efficacy and safety of timothy grass allergy immunotherapy tablets in North American children and adolescents. J Allergy Clin Immunol 2011;127:64–71, 71. e1-4.

    Article  CAS  PubMed  Google Scholar 

  60. Rodriguez-Perez N, Ambriz-Moreno AJ, Canonica GW, Penagos M. Frequency of acute systemic reactions in patients with allergic rhinitis and asthma treated with sublingual immunotherapy. Ann Allergy Asthma Immunol 2008;101:304–310.

    Article  CAS  PubMed  Google Scholar 

  61. Antico A, Pagani M, Crema A. Anaphylaxis by latex sublingual immunotherapy. Allergy 2006;61:1236–1237.

    Article  CAS  PubMed  Google Scholar 

  62. Blazowski L. Anaphylactic shock because of sublingual immunotherapy overdose during third year of maintenance dose. Allergy 2008;63:374.

    Article  CAS  PubMed  Google Scholar 

  63. de Groot H, Bijl A. Anaphylactic reaction after the first dose of sublingual immuno-therapy with grass pollen tablet. Allergy 2009;64:963–964.

    Article  PubMed  Google Scholar 

  64. Di Rienzo V, Pagani A, Parmiani S, Passalacqua G, Canonica GW. Postmarketing surveillance study on the safety of sublingual immunotherapy in children. Allergy 1999;54:1110–1113.

    Article  PubMed  Google Scholar 

  65. Drachenberg KJ, Urban E, Proll S, Woroniecki SR. Sublingual specific immunotherapy for adults and children: a post marketing survey. Allergol Immunopathol 2004;32:76–81.

    Article  CAS  Google Scholar 

  66. Agostinis F, Tellarini L, Canonica GW, Falagiani P, Passalacqua G. Safety of sublingual immunotherapy with a monomeric allergoid in very young children. Allergy 2005;60:133.

    Article  CAS  PubMed  Google Scholar 

  67. Rienzo VD, Minelli M, Musarra A, Sambugaro R, Pecora S, Canonica WG, et al. Post marketing survey on the safety of sublingual immunotherapy in children below the age of 5 years. Clin Exp Allergy 2005;35:560–564.

    Article  PubMed  Google Scholar 

  68. Fiocchi A, Pajno G, La Grutta S, Pezzuto F, Incorvaia C, Sensi L, et al. Safety of SLIT in children aged 3 to 7 years. Ann Allergy Asthma Immunol 2005;95:254–258.

    Article  PubMed  Google Scholar 

  69. Agostinis F, Foglia C, Landi M, Cottini M, Lombardi C, Canonica GW, et al. The safety of sublingual immunotherapy with one or multiple pollen allergens in children. Allergy 2008;63:1637–1639.

    Article  CAS  PubMed  Google Scholar 

  70. De Castro G, Zicari AM, Indinnimeo L, Tancredi G, di Coste A, Occasi F, et al. Efficacy of sublilngual immunotherapy on allergic asthma in children’s real life. Eur Rev Med Pharmacol Sci 2013;17:2225–2231.

    PubMed  Google Scholar 

  71. Caminati M, Dama A, Schiappoli M, Senna G. Balancing efficacy against safety in sublingual immunotherapy with inhalant allergens: what is the best approach? Expert Rev Clin Immunol 2013;9:937–947.

    Article  CAS  PubMed  Google Scholar 

  72. Calderón MA, Simons FE, Malling HJ, Lockey RF, Moingeon P, Demoly P. Sublingual allergen immunotherapy: mode of action and its relationship with the safety profile. Allergy 2012;67:302–311.

    Article  PubMed  Google Scholar 

  73. Passalacqua G, Canonica GW. Specific immunotherapy in asthma: efficacy and safety. Clin Exp Allergy 2011;41:1247–1255.

    Article  CAS  PubMed  Google Scholar 

  74. Medical Dictionary for Regulatory Activities (MedDRA). Maintenance support services and organization. http://www.meddra.com (Accessed October 1, 2014).

  75. Senna G, Ridolo E, Calderon M, Lombardi C, Canonica GW, Passalacqua G. Evidence of adherence to immunotherapy. Curr Opin Allergy Clin Immunol 2009;9:544–548.

    Article  CAS  PubMed  Google Scholar 

  76. Pajno GB, Caminiti L, Crisafulli G, Barberi S, Landi M, Aversa T, et al. Adherence to sublingual immunotherapy in preschool children. Pediatr Allergy Immunol 2012;23:688–689.

    Article  PubMed  Google Scholar 

  77. Senna G, Caminati M, Canonica GW. Safety and tolerability of sublingual immunotherapy in clinical trials and real life. Curr Opin Allergy Clin Immunol 2013;13:656–662.

    Article  CAS  PubMed  Google Scholar 

  78. Passalacqua G, Baena-Cagnani CE, Bousquet J, Canonica GW, Casale TB, Cox L, et al. Grading local side effects of sublingual immunotherapy for respiratory allergy: speaking the same language. J Allergy Clin Immunol 2013;132:93–98.

    Article  PubMed  Google Scholar 

  79. Juniper EF, Guyatt GH. Development and testing of a new measure of health status for clinical trias in rhinoconjunctivitis. Clin Exp Allergy 1991;21:77–83.

    Article  CAS  PubMed  Google Scholar 

  80. Ciprandi G, Cadario G, Valle C, Ridolo E, Verini M, Di Gioacchino M, et al. Sublingual immunotherapy in polysensitized patients: effect on quality of life. J Investig Allergol Clin Immunol 2010;20:274–279.

    CAS  PubMed  Google Scholar 

  81. Bousquet J, Scheinmann P, Guinnepain MT, Perrin-Fayolle M, Sauvaget J, Tonnel AB, et al. Sublingual swallow immunotherapy (SLIT) in patients with asthma due to house dust mites; a double blind placebo controlled study. Allergy 1999;54:249–260.

    Article  CAS  PubMed  Google Scholar 

  82. Khinchi MS, Poulsen LK, Carat F, André C, Hansen AB, Malling HJ. Clinical efficacy of sublingual and subcutaneous birch pollen allergen-specific immunotherapy: a randomized, placebo-controlled, double-blind, double-dummy study. Allergy 2004;59:45–53.

    Article  CAS  PubMed  Google Scholar 

  83. Kahlert H, Grage-Griebenow E, Stüwe HT, Cromwell O, Fiebig H. T cell reactivity with allergoids: influence of the type of APC. J Immunol 2000;165:1807–1815.

    Article  CAS  PubMed  Google Scholar 

  84. Ulrich JT1, Myers KR. Monophosphoryl lipid A as an adjuvant. Past experiences and new directions. Pharm Biotechnol 1995;6:495–524.

    Article  CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. Faculty of Medical Science Kragujevac, Department of Immunology, Svetozara Markovica 69, Kragujevac, 34000, Serbia

    Ivana Đurić-Filipović

  2. Unita di Allergologia Centro Regionale di riferimento per la prevenzione, la diagnosi e la terapia delle malattie allergiche Ospedale Universitario Borgo Trento, Piazzale Stefani 1, Verona, Italy

    Marco Caminati

  3. Children’s Hospital, Clinical Centre Kragujevac, Zmaj Jovina 30, 34000, Kragujevac, Serbia

    Gordana Kostić

  4. Institution for Emergency Medical Care, Bulevar Franša Depera 5, 11000, Belgrade, Serbia

    Đorđe Filipović

  5. Children’s Hospital for Lung Diseases and Tuberculosis, Medical Center “Dr Dragisa Misovic”, Heroja Mihajla Tepića 1, 11000, Belgrade, Serbia

    Zorica Živković

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  1. Ivana Đurić-Filipović
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Đurić-Filipović, I., Caminati, M., Kostić, G. et al. Allergen specific sublingual immunotherapy in children with asthma and allergic rhinitis. World J Pediatr 12, 283–290 (2016). https://doi.org/10.1007/s12519-016-0022-1

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