1. Update on Immune Mechanisms Associated with Sublingual Immunotherapy: Practical Implications for the Clinician 
Philippe Moingeon, PhD 
The Journal of Allergy and Clinical Immunology: In Practice 
Volume 1, Issue 3, Pages (May 2013)
DOI: /j.jaip
Copyright © 2013 American Academy of Allergy, Asthma & Immunology Terms and Conditions

2. Figure 1
Allergen-specific tolerance induction via the sublingual route. The allergen(s) is (are) captured and processed by oral APCs (LCs, MDCs; macrophages) within 15 to 30 minutes. Those APCs loaded with allergen-derived peptides reach cervical lymph nodes within 12 to 24 hours, where they interact with naive CD4+ T cells to induce TH1 and Treg cells with suppressive activity within 2 to 5 days. These CD4+ T cells subsequently migrate into the blood and to tissues, resulting in long-term allergen-specific tolerance.
The Journal of Allergy and Clinical Immunology: In Practice 2013 1, DOI: ( /j.jaip )
Copyright © 2013 American Academy of Allergy, Asthma & Immunology Terms and Conditions

3. Figure 2
Lack of systemic allergen exposure after sublingual administration. Mice received a ragweed pollen extract either intravenously (IV), subcutaneously (SC), or sublingually (SL). The 40 to 45-kDa Amb a 1 allergen was detected in the serum after 1, 5, 10, 20, 60 minutes with the use of a specific polyclonal rabbit antiserum. Sera from naive animals were used as controls (C). This experiment and others performed in dogs with the use of recombinant Bet v 1 confirmed the absence of detectable systemic exposure of proteins/allergens administered sublingually.
The Journal of Allergy and Clinical Immunology: In Practice 2013 1, DOI: ( /j.jaip )
Copyright © 2013 American Academy of Allergy, Asthma & Immunology Terms and Conditions

4. Figure 3
Immune changes induced during SLIT. Immune changes include (1) the polarization of allergen-specific CD4+ T-cell responses, with a switch from TH2 to TH1 and Treg-cell profiles, (2) a progressive decrease in specific IgEs and rapid and sustained induction of IgG4s and IgAs, including potential blocking (ie, anti-inflammatory) antibodies, and (3) molecular alterations at the level of innate cells, including basophils and monocytes/monocyte-derived DCs. Immune mechanisms associated with SLIT and SCIT are thought to be similar, with a critical role of the induction of TH1 (immunodeviation) and Treg-cell responses (immunosuppression).
The Journal of Allergy and Clinical Immunology: In Practice 2013 1, DOI: ( /j.jaip )
Copyright © 2013 American Academy of Allergy, Asthma & Immunology Terms and Conditions