To the Editor
Allergen immunotherapy (AIT) is an effective treatment for allergic rhinitis and has been hypothesised as rapidly effective.1 Rush subcutaneous AIT to pollen and mites reduces skin test reactivity to allergens within days, in a dose-dependent and time-independent manner. Venom rush AIT is also effective within days. The tolerance of beekeepers to bee stings fades in some individuals and is also re-installed after a few stings in a dose-dependent and time-independent manner. Finally, desensitisation to drug allergy is effective within hours and there is a refractory period after tolerance. These short-term clinical sequences cannot be explained by an adaptive immune response (immunotherapy) but may be related to rapid and short-lasting cell downregulation responses (desensitisation).
These considerations have prompted the hypothesis that sublingual immunotherapy (SLIT) may induce a rapid relief of allergic symptoms during the pollen season.1 While previous studies have found that SLIT is effective in the same allergy season as when first introduced,7 no study has ever assessed its efficacy on a daily basis...
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