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House dust mite allergen extract + grass pollen allergen extract is a combination biologic product used for sublingual immunotherapy (SLIT). It is composed of standardized extracts from house dust mites (Dermatophagoides pteronyssinus and Dermatophagoides farinae) and grass pollens. The formulation is specifically investigated for the primary or secondary prevention of new allergic sensitizations in young children (aged 2–4 years) who are already monosensitized to one of these allergens. The mechanism of action involves the induction of immunological tolerance by shifting the immune response from a Th2-driven allergic state to a regulatory state. This is achieved through the activation of regulatory T (Treg) and B (Breg) cells, the production of allergen-specific IgG4 blocking antibodies that compete with IgE, and the upregulation of anti-inflammatory cytokines such as Interleukin-10 (IL-10) and Transforming growth factor beta (TGF-β).
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