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Review
. 2022 Nov 9;11(11):1313.
doi: 10.3390/pathogens11111313.

Sublingual Immunotherapy for Japanese Cedar Pollinosis: Current Clinical and Research Status

Daiju Sakurai  1 , Hiroki Ishii  1 , Ayumi Shimamura  1 , Daisuke Watanabe  1 , Takaaki Yonaga  1 , Tomokazu Matsuoka  1
Affiliations
Review

Sublingual Immunotherapy for Japanese Cedar Pollinosis: Current Clinical and Research Status

Daiju Sakurai et al. Pathogens. .

Abstract

The incidence of Japanese cedar pollinosis is increasing significantly in Japan, and a recent survey suggested that about 40% of the population will develop this disease. However, spontaneous remission is rare. The increased incident rate of Japanese cedar pollinosis is a huge issue in Japan. Allergen immunotherapy is the only fundamental treatment that modifies the natural course of allergic rhinitis and provides long-term remission that cannot be induced by general drug therapy. Sublingual immunotherapy for Japanese cedar pollinosis has been developed and has been covered by health insurance since 2014 in Japan. The indication for children was expanded in 2018. Clinical trials of sublingual immunotherapy for Japanese cedar pollinosis have demonstrated its long-term efficacy and safety. It is recommended for patients who wish to undergo fundamental treatment regardless of the severity of the practical guidelines for the management of allergic rhinitis in Japan. For sublingual immunotherapy, a long-term treatment period of 3 years or longer is recommended to obtain stable therapeutic effects. In recent years, evidence based on basic research and clinical trials has demonstrated sublingual immunotherapy-induced immunological changes and efficacy in patients; however, biomarkers that objectively predict and judge these therapeutic effects need to be established.

Keywords: Japanese cedar pollen; allergen immunotherapy; allergic rhinitis; pollinosis; sublingual immunotherapy.

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Conflict of interest statement

D.S. received lecture fees from Torii Pharmaceutical, SHIONOGI, and research funding from Torii Pharmaceutical. The other authors have no conflict of interest to declare.

Figures

Figure 1
Figure 1
Photomicrograph image of Japanese cedar pollen collected on the rooftop of the University of Yamanashi.
Figure 2
Figure 2
The amount of JC pollen and cypress pollen scattered. The number (grains/cm2) of JC pollen (solid line) and cypress pollen (dotted line) scattered as assessed by the Durham method at the University of Yamanashi, School of Medicine (Yamanashi Prefecture) from February to April 2021.
Figure 3
Figure 3
Immunological alterations induced by SLIT and putative mechanisms. DC: dendritic cell, ILC2: type 2 innate lymphoid cell, Treg: regulatory T cell, MC mast cell, sIgE: specific IgE, sIgG4: specific IgG4.
See this image and copyright information in PMC

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