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World Allergy Organ J. 2014 Mar 28;7(1):6. doi: 10.1186/1939-4551-7-6.

Sublingual immunotherapy: World Allergy Organization position paper 2013 update.

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Respiratory and Allergy Clinic, DIMI-Department of Internal Medicine, University of Genoa, IRCCS Aou San Martino, Largo Rosanna Benzi 10, Genoa 1-16132, Italy.
Department of Medicine, Nova Southeastern University, College of Osteopathic Medicine, Davie Florida, USA.
Division of Allergy, Department of Pediatrics, Nippon Medical School, Tokyo, Japan.
Research Center for Respiratory Medicine (CIMER), Catholic University, Fundación LIBRA, Córdoba, Argentina.
Department of Pediatrics and Medicine, University of Tennessee Health Science Center, Memphis, Tennessee, USA.
Department of Medicine, Second University of Naples, Institute of Translational Pharmacology, Italian National Research Council, Rome, Italy.
Centre Hospitalier Regional Universitaire de Montpellier, Université de Montpellier, Montpellier, France.
Section of Allergy and Clinical Immunology, Imperial College of London, National Heart and Lung Institute, Royal Brompton Hospital, London, UK.
Allergy and Respiratory Diseases Clinic, Department of Internal Medicine, University of Genoa, Genova, Italy.
Allergy and Clinical Immunology, National Heart and Lung Institute, Imperial College of London, London, UK.
Department of Allergology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands.
Allergy Department, Hospital Medica Sur, Mexico City, Mexico.
National Jewish Health, University of Colorado - Denver School of Medicine, Denver, Colorado, USA.
Allergy and Respiratory Diseases, IRCCS San Martino IST, University of Genoa, Genova, Italy.
Center for Rhinology and Allergology Wiesbaden, Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Mannheim, Mannheim, Germany.
Pediatric Allergy and Immunology Division, Hospital de Clínicas, Federal University of Parana, Curitiba, Brazil.
Academic Centre of Primary Care, Division of Applied Health Sciences, University of Aberdeen, Aberdeen, UK.
Children's Mercy Hospital, University of Missouri - Kansas City School of Medicine, Kansas City, Missouri.
Allergy Unit, Department of Dermatology, University Hospital of Zürich, Zürich, Switzerland.
Allergy Unit, Verona General Hospital, Verona, Italy.
Department of Clinical Allergology and Pulmonary Diseases, University of Turku, Finland, and Allergy Clinic, Terveystalo, Turku, Finland.
Department of Paediatrics, University Children's Medical Institute, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
Department of Pediatrics, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand.
Department of Pediatric Pneumology and Immunology, Charité, Humboldt University, Berlin, Germany.
The Allergy and Asthma Institute, Islamabad, Pakistan.
Contributed equally


We have prepared this document, "Sublingual Immunotherapy: World Allergy Organization Position Paper 2013 Update", according to the evidence-based criteria, revising and updating chapters of the originally published paper, "Sublingual Immunotherapy: World Allergy Organization Position Paper 2009", available at Namely, these comprise: "Mechanisms of sublingual immunotherapy;" "Clinical efficacy of sublingual immunotherapy" - reporting all the data of all controlled trials published after 2009; "Safety of sublingual immunotherapy" - with the recently published Grading System for adverse reactions; "Impact of sublingual immunotherapy on the natural history of respiratory allergy" - with the relevant evidences published since 2009; "Efficacy of SLIT in children" - with detailed analysis of all the studies; "Definition of SLIT patient selection" - reporting the criteria for eligibility to sublingual immunotherapy; "The future of immunotherapy in the community care setting"; "Methodology of clinical trials according to the current scientific and regulatory standards"; and "Guideline development: from evidence-based medicine to patients' views" - including the evolution of the methods to make clinical recommendations.Additionally, we have added new chapters to cover a few emerging crucial topics: "Practical aspects of schedules and dosages and counseling for adherence" - which is crucial in clinical practice for all treatments; "Perspectives and new approaches" - including recombinant allergens, adjuvants, modified allergens, and the concept of validity of the single products. Furthermore, "Raising public awareness about sublingual immunotherapy", as a need for our patients, and strategies to increase awareness of allergen immunotherapy (AIT) among patients, the medical community, all healthcare stakeholders, and public opinion, are also reported in detail.

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