***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: BACKGROUND The efficacy and safety of the 300-index of reactivity ( IR ) dose of 5-grass-pollen sublingual immunotherapy ( SLIT ) tablets ( Stallergènes , Antony , France ) have been demonstrated for the treatment of hay fever in adults . OBJECTIVE We sought to assess the efficacy and safety of this tablet in children and adolescents with grass pollen-related allergic rhinitis . METHODS In this multinational , r and omized , double-blind , placebo-controlled study , 278 children ( 5 - 17 years of age ) with grass pollen-related rhinoconjunctivitis ( confirmed by means of a positive grass pollen skin prick test response and serum-specific IgE measurement ) received once-daily SLIT tablets or placebo . Treatment was initiated 4 months before the estimated pollen season and continued throughout the season . The primary outcome was the rhinoconjunctivitis total symptom score ( RTSS ) , a sum of 6 individual symptom scores : sneezing , runny nose , itchy nose , nasal congestion , watery eyes , and itchy eyes . Secondary end points included rescue medication intake , individual scores , and safety . RESULTS The intent-to-treat population included 266 children ( mean age , 10.9 + /- 3.22 years ) . The RTSS for the 300-IR group was highly significantly different from that of the placebo group ( P = .001 ) . The 300-IR group showed a mean improvement for the RTSS of 28.0 % over that seen with placebo and a median improvement of 39.3 % . Significant differences between the 300-IR and placebo groups were also observed regarding rescue medication score and proportion of days using rescue medication during the pollen season ( P = .0064 and P = .0146 , respectively ) . Adverse events were generally mild or moderate in intensity and expected . No serious side effects were reported . CONCLUSION Five-grass-pollen SLIT tablets ( 300 IR ) reduce both symptom scores and rescue medication use in children and adolescents with grass pollen-related rhinoconjunctivitis BACKGROUND This is an interim analysis of a r and omized , double-blind , placebo-controlled phase III trial with 3 years of daily treatment with grass tablet immunotherapy ( GRAZAX ; ALK-Abelló A/S , Hørsholm , Denmark ) or placebo , followed by 2 years of follow-up to assess the persistent efficacy . OBJECTIVE We sought to evaluate the efficacy and safety of specific immunotherapy with grass allergen tablets compared with placebo after treatment covering 2 consecutive grass pollen seasons . METHODS The interim analyses included 351 adult participants with moderate-to-severe allergic rhinoconjunctivitis caused by grass pollen . Participants were treated with active ( n = 189 ) or placebo ( n = 162 ) tablets for an average of 22 months . All participants were allowed to use symptomatic rescue medication . RESULTS The primary efficacy analysis showed highly significant mean reductions of 36 % in rhinoconjunctivitis symptom score ( P < .0001 ; median reduction , 44 % ) and 46 % in rhinoconjunctivitis medication score ( P < .0001 ; median reduction , 73 % ) in the active group relative to the placebo group . Mean rhinoconjunctivitis quality of life was 33 % better ( P < .0001 ; median , 40 % ) . Clinical improvements were paralleled by significant changes in allergen-specific immunoglobulins . The treatment was well tolerated , and adverse events led to withdrawal in less than 1 % of participants . There were no serious adverse events related to treatment . CONCLUSION Grass allergen tablet immunotherapy showed progressive immunologic changes and highly significant efficacy over 2 years of continued treatment Background : Local application of allergen extracts in specific immunotherapy is accompanied by increased compliance and significantly reduced side effects . However , efficacy of local immunotherapy in children has yet not been sufficiently demonstrated . This study was performed to determine clinical efficacy of high dose sublingual swallow immunotherapy ( SLIT ) by a double‐blind placebo‐controlled study in children with grass pollen allergy using high dose allergen extracts UNLABELLED SAFETY and efficacy of sublingual ( sublingual-swallow ) immunotherapy ( IT ) with house dust mite extract were evaluated in 30 children ( 6 - 15 2/3 years of age ) over the first 12 months of an ongoing study . The cumulative dose was 570 micrograms Der p I ( five times that administered with subcutaneous therapy ) . SAFETY One patient on active treatment dropped out after 8 weeks because of a subjective feeling of severe weakness , question ably induced by the therapy . Five patients on active therapy and one patient on placebo reported minor local side effects . EFFICACY Pulmonary symptoms were reduced after 12 months in actively treated asthmatics , but this was not consistent with the lack of improvement in bronchial reactivity , skin sensitivity and specific IgG and IgG4 against D.pt . in this group . In patients with rhinitis  nasal sensitivity was reduced in the placebo group without concomitant improvement in the nasal symptom score . Specific IgE ( D.pt . and D.f . ) increased significantly more in the active treatment group after 3 and 12 months . We conclude that sublingual IT over 12 months with the fivefold Der p 1 dose of subcutaneous IT was well tolerated , but there was no consistent clinical or immunological benefit compared to placebo BACKGROUND Cross-reactivity between the major birch pollen allergen , Bet v 1 , and the apple protein , Mal d 1 , frequently causes food allergy . OBJECTIVE To investigate the effects of successful sublingual immunotherapy ( SLIT ) with birch pollen extract on apple allergy and the immune response to Bet v 1 and Mal d 1 . METHODS Before and after 1 year of SLIT ,  Bet v 1-sensitized patients with oral allergy syndrome to apple underwent nasal challenges with birch pollen and double-blind placebo-controlled food challenges with apple .  Bet v 1-specific and Mal d 1-specific serum antibody levels and proliferation in P BMC s and allergen-specific T-cell lines ( TCLs ) were determined . Bet v 1-specific TCLs were mapped for T-cell epitopes . RESULTS In 9 patients with improved nasal provocation scores to birch pollen , apple-induced oral allergy syndrome was not significantly reduced . Bet v 1-specific IgE and IgG(4 ) levels significantly increased . Bet v 1-specific T-cell responses to all epitopes and those cross-reactive with Mal d 1 significantly decreased . However , neither Mal d 1-specific IgE and IgG(4 ) levels nor Mal d 1-induced T-cell proliferation changed significantly . In contrast , Mal d 1-specific TCLs showed increased responses to Mal d 1 after 1 year of SLIT . CONCLUSION This longitudinal study indicates that pollen SLIT does not efficiently alter the immune response to pollen-related food allergens , which may explain why pollen-associated food allergy is frequently not ameliorated by pollen immunotherapy even if respiratory symptoms significantly improve . CLINICAL IMPLICATION S SLIT with birch pollen may have no clinical effect on associated apple allergy A double-blind , placebo-controlled study of immunotherapy was conducted in 31 patients with allergic rhinitis due to Parietaria pollen to evaluate the efficacy and safety of high doses of allergen via the sublingual route . The patients were assessed before and after a 10-month period of treatment by clinical ( symptom-medication scores and specific nasal reactivity ) and immunological ( total IgE , specific IgE , IgG and IgG4 antibodies ) parameters . High doses of Parietaria extract corresponding to a cumulative dose of 105 BU for each patient were administered with negligible side effects . The actively treated patients had significantly lower medication scores than those on placebo ( p < 0.05 ) when the maximum pollen count was recorded , and at the end of the trial they showed a significant decrease in nasal reactivity ( p < 0.02 ) and a significant increase in serum specific IgG4 ( p = 0.02 ) . No differences were detected in any of these parameters in the placebo group . Possible explanations for the mechanisms of sublingual immunotherapy are proposed OBJECTIVE To evaluate the safety and efficacy of sublingual immunotherapy with ' Dermatophagoides Farinae Drops ' in D. farinae allergic asthma and /or rhinitis patients . METHODS A 25-week double-blind , placebo-controlled , multi-centered trail was conducted in 278 children ( aged 4 - 18 yr ) with mite-induced asthma and /or rhinitis . Patients were r and omly assigned to receive sublingual immunotherapy ( SLIT ) with ' Dermatophagoides Farinae Drops ' ( n = 139 ) or placebo ( n = 139 ) for 25 weeks and the dosage and administration strictly followed the manufacturer 's instructions . At the beginning of the 2nd , 3rd , 4th , 6th , 10th , 14th , 18th , 22nd week of the treatment , the patients were asked to accept follow-up visit , during the clinical trial all patients and parents were asked to keep a daily record of their asthma symptom scores , rescue medicine use , rhinitis symptom scores , morning and evening peak expiratory flow . Asthma symptom scores , reduction in use of rescue medicine , rhinitis symptom scores , lung function tests , skin sensitivity to mite , mite-specific immunoglobulin ( Ig ) E and IgG4 , and quality of life and adverse effect were assessed during the study . RESULT ( 1 ) Of the 278 children , 27 dropped out before the study completion . ( 2 ) After 25 weeks of treatment , the median variability of PEFR was -1.38 for SLIT group and -0.90 for the placebo ( P < 0.05 ) . ( 3 ) Besides , the mean variability of medicine score of asthma was -0.08 for SLIT group and 0.52 for the plcebo ( P < 0.05 ) . ( 4 ) The median variability of rhinitis symptom score was -1.96 for SLIT group and -1.03 for the placebo ( P < 0.01 ) . ( 5 ) The rescue medicine usage of SLIT reduced but did not show significant differences between SLIT and placebo . ( 6 ) After 25 weeks treatment , the increase of D. farinae specific IgE antibody of two groups were similar , while specific IgG4 increased significantly in SLIT compared to the patients in control one ( P < 0.01 ) ; ( 7 ) No severe adverse events happened in the trial and the most-likely adverse events were mild asthma and local rash . CONCLUSION Dermatophagoides Farinae Drops is safe and effective in treating allergic asthma and atopic rhinitis BACKGROUND Allergen immunotherapy ( desensitization ) by injection is effective for seasonal allergic rhinitis and has been shown to induce long-term disease remission . The sublingual route also has potential , although definitive evidence from large r and omized controlled trials has been lacking . OBJECTIVE The aim was to confirm the efficacy of a rapidly dissolving grass allergen tablet ( GRAZAX , ALK-Abelló , Hørsholm , Denmark ) compared with placebo in patients with seasonal rhinoconjunctivitis . METHODS A longitudinal , double-blind , placebo-controlled , parallel-group study that included 51 centers from 8 countries . Subjects were r and omized ( 1:1 ) to receive a grass allergen tablet or placebo once daily . A total of 634 subjects with a history of grass pollen-induced rhinoconjunctivitis for at least 2 years and confirmation of IgE sensitivity ( positive skin prick test and serum-specific IgE ) were included in the study . Subjects commenced treatment at least 16 weeks before the grass pollen season , and treatment was continued throughout the entire season . RESULTS The primary efficacy analysis showed a reduction of 30 % in rhinoconjunctivitis symptom score ( P < .0001 ) and a reduction of 38 % in rhinoconjunctivitis medication score ( P < .0001 ) compared with placebo . Side effects mainly comprised mild itching and swelling in the mouth that was in general well tolerated and led to treatment withdrawal in less than 4 % of participants . There were no serious local side effects and no severe systemic adverse events . CONCLUSION Sublingual immunotherapy with grass allergen tablets was effective in grass pollen-induced rhinoconjunctivitis . The tablet was well tolerated with minor local side effects . CLINICAL IMPLICATION S The grass allergen tablet represents a safe alternative to injection immunotherapy suitable for home use BACKGROUND Sublingual immunotherapy ( SLIT ) is accepted as a safe and effective route for the treatment of grass pollen allergy , but clarification of its clinical and biological efficacy requires more study . OBJECTIVE To evaluate the efficacy , safety , and compliance of SLIT with a st and ardized 3-grass pollen extract in patients with grass pollen seasonal allergic rhinoconjunctivitis , with or without mild asthma . METHODS This multicenter , r and omized , double-blind study included 127 patients ( aged 12 - 41 years ; mean age , 24.9 years ) with grass pollen seasonal allergic rhinoconjunctivitis , with or without mild asthma . They received either SLIT with a high-dose , st and ardized , 3 
    Output:
    
Overall , SLIT is moderately effective in reducing total and individual ocular symptom scores in participants with ARC and AC .