{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T10:08:02Z","timestamp":1789380482396,"version":"build-2803163510"},"reference-count":40,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T00:00:00Z","timestamp":1789344000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Allergy"],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Allergen immunotherapy is the only potentially disease-modifying treatment for IgE-mediated respiratory allergy. Among the available routes, sublingual immunotherapy (SLIT) has gained prominence because of its favorable safety profile and greater patient acceptability.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>This narrative review critically appraises the clinical efficacy, real-world effectiveness, and long-term disease-modifying potential of SLIT for seasonal and perennial respiratory allergies by integrating evidence from randomized controlled trials, large observational cohorts, and meta-analyses, with attention to allergen- and product-specific outcomes and age-related differences.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Robust RCT evidence supports clinically meaningful reductions in symptoms and medication use with grass and HDM SLIT tablets, with sustained benefits observed up to 1\u20132 years after a 3-year treatment course in key trials. Real-world cohorts corroborate these findings and additionally report a reduced risk of new asthma onset and lower long-term medication dispensing after SLIT. Evidence for SLIT in asthma shows reductions in exacerbation risk in some trials, although its effects on day-to-day control are less consistent. Pediatric trials generally mirror adult outcomes, with favorable safety and efficacy, particularly for standardized tablets; however, heterogeneity across trials and historical methodological limitations remain important caveats. Meta-analyses confirm overall efficacy but highlight substantial between-study heterogeneity and the importance of product-specific evaluations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>SLIT could be an effective, well-tolerated, disease-modifying option for respiratory allergic rhinitis and shows promise for selected asthma outcomes. Optimal benefits require standardized, adequately dosed formulations and sustained adherence (\u22653 years). Future research should prioritize product-specific, adequately powered trials with standardized outcomes to refine patient selection and long-term disease-modification endpoints.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/falgy.2026.1940709","type":"journal-article","created":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T09:48:04Z","timestamp":1789379284000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Sublingual allergen immunotherapy: evidence from randomized trials, real-world studies and meta-analyses"],"prefix":"10.3389","volume":"7","author":[{"given":"Giovanni","family":"Paoletti","sequence":"first","affiliation":[{"name":"Department of Biomedical Sciences, Humanitas University","place":["Pieve Emanuele, Italy"]},{"name":"Personalized Medicine, Asthma and Allergy, IRCCS Humanitas Research Hospital","place":["Rozzano, 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Medical Science and Public Health, University of Cagliari","place":["Cagliari, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefano","family":"Del Giacco","sequence":"additional","affiliation":[{"name":"Department Medical Science and Public Health, University of Cagliari","place":["Cagliari, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mattia","family":"Giovannini","sequence":"additional","affiliation":[{"name":"Department of Health Sciences, University of Florence","place":["Florence, Italy"]},{"name":"Allergy Unit, Meyer Children's Hospital IRCCS","place":["Florence, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"Catamer\u00f2","sequence":"additional","affiliation":[{"name":"Department of Health Sciences, University of Florence","place":["Florence, Italy"]},{"name":"Allergy Unit, Meyer Children's Hospital IRCCS","place":["Florence, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesca","family":"Mori","sequence":"additional","affiliation":[{"name":"Allergy Unit, Meyer Children's Hospital IRCCS","place":["Florence, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giuseppe","family":"Guida","sequence":"additional","affiliation":[{"name":"Department of Clinical and Biological Sciences, University of Turin","place":["Turin, Italy"]},{"name":"Severe Asthma, Rare Lung Disease and Respiratory Pathophysiology Unit, San Luigi Gonzaga University Hospital","place":["Orbassano (TO), Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fabio Luigi Massimo","family":"Ricciardolo","sequence":"additional","affiliation":[{"name":"Department of Clinical and Biological Sciences, University of Turin","place":["Turin, Italy"]},{"name":"Severe Asthma, Rare Lung Disease and Respiratory Pathophysiology Unit, San Luigi Gonzaga University Hospital","place":["Orbassano 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