ABSTRACT
The sublingual route has been used for many years to deliver low-molecular-weight drugs to the bloodstream. Immune tolerance predominates in the oral/sublingual mucosa, and the antigen-presenting cells, such as dendritic cells and various T-cell subtypes, serve as key players in oral mucosal tolerance induction. Allergenic extracts available for the preparation of sublingual vaccine administration may be aqueous, glycerinated, or lyophilized. A sublingual mixing protocol should be established and an allergen extract-mixing location selected prior to formulating sublingual immunotherapy (SLIT) vaccines. Allergen extracts used for SLIT originate from different allergen sources. Some companies provide SLIT with different flavors, including strawberry and pineapple. Oral–mucosal reactions, considered as SLIT local reactions, were relatively common, affecting up to 75% of the patients and occurring most frequently in the buildup phase. Physicians preparing SLIT are responsible for establishing the optimal dose for standardized and nonstandardized allergen extracts, based upon the medical literature and clinical experience.
