Relationship between Saliva and Sublingual Immunotherapy

The demand for allergen specific immunotherapy (AIT), especially sublingual immunotherapy (SLIT), is increasing because of its efficacy in inducing clinical remission of allergic diseases and its low risk of side effects. Since not all patients that undergo SLIT demonstrate an improvement in allergic symptoms, the development of biomarkers to predict the outcome and adjuvants for SLIT is desired. Saliva is the first target with which tablets used in SLIT come into contact, and salivary pH, chemical properties or microbiome composition are reported to possibly be associated with the outcome of SLIT. Antibodies such as IgG4 and IgA not only in the serum but also in the saliva are increased after SLIT and may also be associated with the efficacy of SLIT. The development of the metagenomic sequencing technique makes it possible to determine the microbiome composition and ratio of each bacterium, and researchers can investigate the relationships between specific bacteria and the immune response. Some bacteria are reported to improve the SLIT outcome and have the potential to be used as biomarkers for the selection of patients and as adjuvants in SLIT. Here, we introduce biomarkers for SLIT and present recent findings regarding the relationship between saliva and SLIT.

Automated summary

Research suggests that factors such as saliva pH, chemical properties, and microbiome composition may influence the efficacy of sublingual immunotherapy (SLIT), with certain antibodies increasing post-SLIT potentially contributing to treatment effectiveness. The advancement of metagenomic sequencing technology allows for the identification of microbiome composition and exploration of relationships between specific bacteria and immune responses. Such bacteria may have the potential to be utilized as biomarkers for patient selection and as adjuvants in SLIT.