Mohamed H. Shamji, PhD: Comparing Subcutaneous and Sublingual Immunotherapy

During a segment of his interview with HCPLive, Mohamed H. Shamji, PhD, discussed subcutaneous (SCIT) and sublingual immunotherapies (SLIT) as they pertained to his presentation at the American Academy of Allergy, Asthma & Immunology (AAAAI) 2023 Annual Meeting in San Antonio, TX.

Shamji’s research covers respiratory allergies and disease-modifying treatments affect immunologic responses, and he serves as a professor of immunology and allergy at Imperial College London.

His presentation at AAAAI was titled ‘Biomarkers for the Response to Allergen Immunotherapy’ and it explored patients’ responses to receiving allergen immunotherapy (AIT).

“We conducted an elegant study, here at Imperial College London,” he explained. “It was a single center study, a randomized, double-blind, placebo-controlled trial, of SCIT and SLIT and placebo…And it's perhaps one of the only studies that compared both approaches in one single center study.”

Shamji added that the outcome showed that both immunotherapies were effective at year 1 and year 2 and that the clinical effect was lost at year 3. He noted that this emphasized the fact that treatment should be given for 3 years rather than 2.

“But when it comes to the safety parameters, it's much favored that the sublingual immunotherapy is much safer than SCIT,” Shamji said. “And also, this also applies to when the patient is receiving subcutaneous immunotherapy. They need to go to the clinic, then they need to be there to receive the treatment, and they have to be monitored for a particular time for the severe adverse reactions that may occur.”

Shamji also added that SLIT often has compliance issues when it comes to patient adherence.

He later went on to describe the reason for some of his team’s research focus on airborne allergens as opposed to food allergens.

“Grass pollen is much easier to study,” Shamji explained. “So we can, you know, we can bring our patients before the pollen season and during the pollen season, and so we can understand the disease a little bit more in terms of the immune mechanisms. So we understand more about the changes in, let's say, IgE, before and after the pollen season or during the pollen season… (and) a bit more about the primary effect of the pollen season on immune responses in an allergic individual.”

Shamji later described some of the challenges in studying responses to immunotherapy, particularly due to asthma being a comorbidity with allergic rhinitis. He also compared European versus American guidelines on research.

“The view in Europe is that if you have allergic patients with severe asthma, you control the asthma and then bring in immunotherapy,” he said. “In the US, it's very much, ‘Let's avoid that.’ And perhaps for the right reasons.”

For further information on Shamji’s AAAAI conference presentation, view the full interview segment above.