Citation:
Thomas WR. Broad perspectives of allergen specific immunotherapy. Hum Vaccines Immunother. 2017;13(10):2385-9
Abstract: Allergen specific immunotherapy aims to subvert or divert immune responses to allergens to ones that do not cause immunological hypersensitivities. It is performed by the administration of the offending allergen usually in doses low enough not to elicit allergic reactions but high enough to induce protective immune responses or extinguish effector responses. Historically and even today the predominant strategy has been the subcutaneous injection therapy (SCIT) pioneered by Noon and published in 1911 for hay fever induced by pollen allergens. Many people receive benefit from this treatment that can be apparent during a single course of injections and if used for about 5 years can persist without further injections. The protracted injection therapy, the often-incomplete relief, adverse reactions and the expense of medical supervision leave enormous scope for improvements and for food allergens non-injection routes of administration can more effective and safer. Also immunotherapy with allergens other than pollen and for diseases other than rhinitis is not so well developed and might best be accomplished by different procedures. In contrast to pollen-induced rhinitis the symptoms from house dust mite and fungal allergy induced asthma are precipitated by insults such as viral infection on tissue inflamed by chronic allergy instead of acute exposure to allergen so different immunological outcomes might be required. Even within allergies caused by the same allergen recent studies of anti-IgE and anti-cytokine therapies have revealed that the damaging component of the allergic immune response differs between individuals.