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Nothing to Sneeze At
So long to shots for allergy sufferers?


Sinusitis and allergy specialist Sandra Lin evokes smiles from needle-squeamish patients.

For decades, people with allergy-related conditions have been rolling up a sleeve once a week at the doctor’s office to receive injections of allergens.

Now Sandra Lin, a specialist in sinusitis and allergy here, is offering an alternative treatment that eschews injections altogether. Known as sublingual immunotherapy, the approach involves a daily regimen of placing a few drops of an allergen solution under the tongue and holding it there for several minutes. The potion, a custom blend of extracts proven through allergy skin testing to cause reactions, is given in consecutively stronger doses for about four months and then levels off. As with injections, it must be taken for three to five years in order to maximize long-lasting effects.

“Sublingual immunotherapy has been shown to improve allergy symptoms, decrease the need for medicine, decrease asthma attacks, and decrease the chance of developing asthma in allergic children. And because patients can take it at home, they should be more compliant,” Lin says. The approach could expand access to those in rural areas, and make treating children (typically terrified of allergy shots) easier, she adds.

Widely used in Europe and endorsed by the World Health Organization, sublingual immunotherapy is not now prevalent in the United States (in part because it is not covered by insurance), nor is it approved by the FDA. What’s needed to clear that hurdle and make the approach available to millions of allergy sufferers: more research to define its molecular and cellular mechanisms, and clinical trials to determine ideal dosing strength and schedule.  


—Anne Bennett Swingler



Johns Hopkins Medicine

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