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Allergen immunotherapy now and in the future

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Background:

Subcutaneous (SCIT) and sublingual (SLIT) immunotherapy provide effective treatment for allergic rhinitis and allergic asthma with clinical improvement following an adequate course of therapy persisting in most patients for years after treatment is discontinued. However, both require prolonged courses of therapy and many or most patients either do not begin or stop long before they have completed the prescribed course of treatment.

Methods:

Based on review of the recent medical literature, the current status of SCIT and SLIT was reviewed as well as new approaches to allergy immunotherapy (AIT) that have promise to overcome the safety and inconvenience concerns of both the current approaches.

Results:

New approaches to AIT include application of extracts to the skin with patches, injection into inguinal lymph nodes, alterations in the allergen molecules by chemical treatment or recombinant technology to make them less reactive with specific IgE, shifting the immune response by stimulation of toll-like receptors or suppression of Th2 responses, and finally by adjuvants such as probiotics and vitamin D.

Conclusions:

Current forms of immunotherapy require years of treatment. New approaches, although differing markedly in their approach to AIT, all offer marked reduction in the required period of treatment. Hopefully, some of these new approaches will prove safe and effective and obtain approval for general use. If approved, they should make AIT more widely utilized to the benefit of the allergic population.
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Keywords: Allergy immunotherapy; adjuvant; allergoids; epicutaneous; intralymphatic; recombinant; subcutaneous; sublingual; toll-like receptors

Document Type: Research Article

Affiliations: Department of Medicine, Allergy/Immunology Division, National Jewish Health, Denver, Colorado

Publication date: July 1, 2016

More about this publication?
  • Allergy and Asthma Proceedings is a peer reviewed publication dedicated to distributing timely scientific research regarding advancements in the knowledge and practice of allergy, asthma and immunology. Its primary readership consists of allergists and pulmonologists.

    The goal of the Proceedings is to publish articles with a predominantly clinical focus which directly impact quality of care for patients with allergic disease and asthma and by having the potential to directly impact the quality of patient care. AAP welcomes the submission of original works including peer-reviewed original research and clinical trial results. Additionally, as the official journal of the Eastern Allergy Conference (EAC), AAP will publish content from EAC poster sessions as well as review articles derived from EAC lectures.

    Featured topics include asthma, rhinitis, sinusitis, food allergies, allergic skin diseases, diagnostic techniques, allergens, and treatment modalities. Published material includes peer-reviewed original research, clinical trials and review articles.

    Articles marked "F" offer free full text for personal noncommercial use only.

    The journal is indexed in Thomson Reuters Web of Science and Science Citation Index Expanded, plus the National Library of Medicine's PubMed service.
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