Allergic diseases are rarely found alone. In cases of poorly treated and inadequately treated areas; some other disorders like-wise asthma, otitis media, rhinosinusitis, lymphoid hypertrophy, sleep apnea etc. may occur. 
At present, allergen-specific immunotherapy is the only treatment which has the potential to stop the development of asthma from allergic rhinitis. 
Immunotherapy is a safe treatment. 
Several studies have demonstrated that subcutaneous immunotherapy is clinically effective in the treatment of allergic diseases. [2,3,4]
Symptom and medication scores, visual analogue score, nasal provocation and skin prick test results were improved in rhinitis patients who have received house dust mite immunotherapy. 
The earliest improvement in symptom and drug use scores was seen with subcutaneous immunotherapy. 
The patients were followed for the next seven years after treatment, and at the end of this study, immunotherapy was still clinically effective in the group receiving specific immunotherapy, additionally asthma development was found to be minimal. 
Specific allergen immunotherapy is an effective treatment on children with moderate or severe allergic rhinitis who do not respond to environmental control and optimal drug use. 
Subcutaneous immunotherapy has been demonstrated in studies that can be performed safely in children under five years of age. [9,10,11]
In patients receiving subcutaneous immunotherapy, allergy syndromes were reduced by up to 95%. 
Immunospecific therapy reduces the symptoms of illness in children and adults without serious side effects. 
1. Tuncer, Ayfer, and Hasan Yüksel. Allerjik Rinit Tanı Ve Tedavi Rehberi. Ankara: Bilimsel Tıp Yayınevi, 2012.
2. Can D, Tanaç R, Demir E, Gülen F, Veral A. Efficacy of pollen immunotherapy in seasonal allergic rhinitis. Pediatr Int 2007;49:64-9.
3. Keskin O, Tuncer A, Adalioglu G, Sekerel BE, Sackesen C, Kalayci O. The effects of grass pollen allergoid immunotherapy on clinical and immunological parameters in children with allergic rhinitis. Pediatr Allergy Immunol 2006;17:396-407.
4. Sahin E, Taş E, Dagtekin Ergur EN, Cuhali BD, Gürsel AO. The results of specific immunotherapy for house dust mites in patients with allergic rhinitis. Kulak Bu-run Bogaz Ihtis Derg 2008;18:79-84.
5. Ewan PW, Alexander MM, Snape C, Ind PW, Agrell B, Dreborg S. Effective hyposensitization in allergic rhinitis using a potent partially purified extract of house dust mite. Clin Allergy 1988;18:501-8.
6. Keles S, Karakoc-Aydiner E, Ozen A, et al. A novel approach in allergen-specific immunotherapy: combination of sublingual and subcutaneous routes. J Allergy Clin Immunol 2011;128:808-15.
7. Jacobsen L, Niggemann B, Dreborg S, et al. Specific immunotherapy has long-term preventive effect of seasonal and perennial asthma: 10-year follow-up on the PAT study. Allergy 2007;62:943-8.
8. Bacharier LB, Boner A, Carlsen KH, et al. Diagnosis and treatment of asthma in childhood: a PRACTALL consensus report. Allergy 2008;63:5-34.
9. Ibanez MD, Kaiser F, Knecht R, et al. Safety of specific sublingual immunotherapy with SQ standardized grass allergen tablets in children. Pediatr Allergy Immunol 2007;18:516-22.
10. Finegold I. Immunotherapy: when to initiate treatment in children. Allergy Asthma Proc 2007;28:698705.
11. Rienzo VD, Minelli M, Musarra A, et al. Postmarketing survey on the safety of sublingual immunotherapy in children below the age of 5 years. Clin Exp Allergy 2005;35:560-4.
12. Asero R. Effects of birch pollen-speciﬁc immunotherapy on apple allergy in birch pollen-hypersensitive patients. Clin Exp Allergy 1998;28:1368-73.
13. J Allergy Clin Immunol 2011;127:502-8.
Itching and irritation in the mouth are frequently reported side effects during sublingual immunotherapy. [1,2,3] These side effects are often reproducible after application. 
There is little literature on the effect of sublingual immunotherapy on specific antibody responses. 
The effectiveness of sublingual immunotherapy is still in the research phase. 
A severe systemic reaction has been reported in the patient during sublingual immunotherapy. 
• Within the first few minutes of sublingual immunotherapy on the third day of treatment, there was widespread itching in the body, angioedema in the hands and feet, dyspnea, wheezing and dizziness. 
Generally itching, redness, urticaria, wheezing and hypotension develop within five minutes of receiving a sublingual house dust mite allergen. 
After one year of treatment, subcutaneous immunotherapy group showed significant improvement in asthma and rhinitis scores, however only rhinitis symptoms in sublingual immunotherapy group were improved. 
A group of patients who received sublingual immunotherapy for two years were compared to those receiving subcutaneous immunotherapy and there was more improvement in rhinitic scores in the subcutaneous immunotherapy group. 
Immunological parameters such as skin reactivity, IgG and specific IgG improved only in the subcutaneous immunotherapy group. [11th]
1. Didier A, Malling HJ, Worm M, et al. Optimal dose, efficacy, and safety of once-daily sublinguaal immunotherapy with a 5-grass pollen tablet for seasonal allergic rhinitis. Allergy Clin Immunol 2007;120:1338-45.
2. Torres Lima M, Wilson D, Pitkin L, et al. Grass pollen sublingual immunotherapy for seasonal rhinoconjunctivitis: a randomized controlled trial. Clin Exp Allergy 2002;32:507-14.
3. Alvarez-Cuesta E, Berges-Gimeno P, Mancebo EG, et al. Sublingual immunotherapy with a standardized cat dander extract: evaluation of efficacy in a double blind placebo controlled study. Allergy 2007;62:8107.
4. Bousquet PJ, Cox LS, Durham SR, et al. Sub-lingual immunotherapy: World Allergy Organization position paper 2009. Allergy 2009;64(Suppl 91):S1-S59.
5. Tuncer, Ayfer, and Hasan Yüksel. Allerjik Rinit Tanı Ve Tedavi Rehberi. Ankara: Bilimsel Tıp Yayınevi, 2012.
6. Dunsky EH, Goldstein MF, Dvorin DJ, Belecanech GA. Anaphylaxis to sublingual immunotherapy. Allergy 2006;61:1235.
7. Eifan AO, Keles S, Bahceciler NN, Barlan IB. Anaphylaxis to multiple pollen allergen sublingual immunotherapy. Allergy 2007;62:567-8
8. Blazowski L. Anaphylactic shock because of sublingual immunotherapy over-dose during third year of maintenance dose. Allergy 2008;63:374.
9. Mungan D, Misirligil Z, Gurbuz L. Comparison of the efficacy subcutaneous and sublingual immunotherapy in mite-sensitive patients with rhinitis and asthma- a placebo controlled study. Ann Allergy Asthma Immunol 1999;82:485-90.
10. Bernardis P, Agnoletto M, Pucinelli P, et al. Injective versus sublingual immunotherapy in Alternaria tenius allergic patients. J Invest Allergol Clin Immunol 1996;6:55-62.
11. Quirino T, Iemoli E, Sicilani E, et al. Sublingual versus injective immunotherapy in grass pollen allergic patients: a double blind (double dummy) study. Clin Exp Allergy 1996;26:1253-61.