Immunological changes over three years treatment with Japanese cedar SLIT drops in mono-sensitized and poly-sensitized individuals

[Dear Editor, ] Japanese cedar (JC) pollinosis is the most common seasonal allergy in Japan. It affects more than 40% of the Japanese population and has serious impacts on quality of life and productivity of affected individuals. Treatment of JC pollen allergy has traditionally relied on pharmacotherapy like topical corticosteroids and antihistamines. Although these medications may offer temporary relief, they only address allergic symptoms and not the cause of the disease. In contrast to symptomatic allergy medications, SLIT is an immune modulatory treatment for adults and children that addresses the underlying immune mechanisms of the disease and may lead to persisting clinical effect. SLIT has been demonstrated to be clinically effective towards allergy and asthma caused by a number of different allergens, but due to the complexity of the disease no validated biomarkers for successful allergy immunotherapy (AIT) have yet been identified. In a recent position paper on AIT biomarkers, the relevance of in-vivo and in-vitro markers were discussed.