A Cure For Allergies? (Mind Your Body 4th July 2007)

For the last few years, sublingual immunotherapy has cured hundreds of patients with allergic conditions such as rhinitis and asthma, through a method no more difficult than putting a few drops under the tongue.

“Sublingual immunotherapy came about four or five years ago and allows the individual to be desensitised to allergens such as the dust mite,” says senior consultant ear, nose and throat surgeon Pang Yoke Teen at the Centre for Ear, Nose, Throat, Allergy and Snoring @ HealthSense Specialists in Paragon Medical Suites.

Till it was available, sufferers had to depend on relief from steroid nasal sprays and antihistamines.

While these are good short-term measures, says Dr Pang, sublingual immunotherapy (SLIT) offers a long-term solution.

The treatment is not a drug, he says, but acts more like a vaccine, teaching the body to tolerate allergens.

Just as our senses respond to things we eat, drink or inhale, so do our immune systems. Some people’s immune systems, however, over-react to normally harmless substances, sending out antibodies to get rid of them.

The allergic response has a different name depending on the part of the body that is affected. Symptoms include itching, stinging eyes (conjunctivitis); running nose, blocked nose and sneezing (allergic rhinitis); wheezing, cough and difficulty breathing (asthma); and red, itchy skin (eczema).

In sublingual immunotherapy, tiny water-based amounts of the allergen, which may be extracted from dust mites, grass or pollen, are dropped daily under the tongue, where there are plenty of blood vessels to absorb them. Giving small but increasing amounts of the allergen at regular intervals increases the body’s tolerance to it. On re-exposure to it, symptoms, if any, may be milder.

Though it is not known how many people have had the treatment since it was available, Dr Pang says that anyone who has an allergy to dust mites, grass pollens or venoms such as bee stings should be suitable for it.

He says: “SLIT has been well received by young and old who want to be rid of their symptoms and medications.”

A skin prick test determines the offending allergen. A drop of the extract is injected under the skin on the forearm to see if there is a reaction. Alternatively, a blood test can be done.

“In Singapore, the most common cause of inhalant allergy is the dust mite,” says Dr Pang. For example, 80 per cent of people with allergic rhinitis, one of the most common forms of allergies, react to dust mites. Both adult and children are suitable.

The majority is asthmatics allergic to dust mites and the youngest patient to receive the drops was four years old. It is not age that is the barrier but rather how receptive the child is to having drops placed under his tongue every day. A piece of bread soaked with the drop is recommended for young children.

Says Dr Pang on the benefits of the treatment: “Not only does it prevent you getting sinus infections, it also prevents you from getting or developing new allergies. The other advantage is that it decreases the need for medications.”

The treatment can be stopped when symptom-free.

Book an appointment with HealthSense Specialist Dr. YT Pang to look at your ENT problems and get cured.