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Free Content Coronavirus disease 2019, allergic diseases, and allergen immunotherapy: Possible favorable mechanisms of interaction

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Both, allergen immunotherapy (AIT) and SARS-COV-2 infection cause a set of immunologic changes that respectively vary during the course of the treatment or the disease.


To review immune changes brought along by each of these entities and how they might interrelate.


We start presenting a brief review of the structure of the new coronavirus and how it alters the functioning of the human immune system. Subsequently, we describe the immune changes induced by AIT and how these changes could be favorable or unfavorable in the allergic patient infected with SARS-CoV-2 at a particular point of time during the evolving infection.


We describe how a healthy immune response against SARS-CoV-2 develops, versus an immune response that is initially suppressed by the virus, but ultimately overactivated, leading to an excessive production of cytokines (cytokine-storm-like). These changes are then linked to the clinical manifestations and outcomes of the patient. Reviewing the immune changes secondary to AIT, it becomes clear how AIT is capable of restoring a healthy innate immunity. Investigators have previously shown that the frequency of respiratory infections is reduced in allergic patients treated with AIT. On the other hand it also increases immunoregulation.


As there are many variables involved, it is hard to predict how AIT could influence the allergic patient's reaction to a SARS-CoV-2 infection. In any case, AIT is likely to be beneficial for the patient with allergic rhinitis and/or allergic asthma in the context of the SARS-CoV-2 pandemic as controlling allergic diseases leads to a reduced need for contact with healthcare professionals. The authors remind the reader that everything in this article is still theoretical, since at the moment, there are no published clinical trials on the outcome of COVID-19 in allergic patients under AIT.

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Keywords: COVID-19; SARS-CoV-2; allergen immunotherapy; allergy; asthma; immunotherapy; innate immunity; interferon; mechanisms; risk factor; viral infection

Document Type: Research Article

Affiliations: 1: From the Médica Sur, Clinical foundation and hospital, Mexico City, Mexico; 2: Centro Universitario de Ciencias de la Salud, Universidad Autónoma del Estado de Hidalgo, Mexico; 3: Private practice, Hospital Médica Sur, Mexico City, Mexico; 4: Universidad Autónoma de Tamaulipas, Matamoros, Mexico; 5: Departamento de Disciplinas Filosóficas Metodoloógicas e Instrumentales, Universidad de Guadalajara, Jalisco, Mexico; 6: Grupo COSTAMED, Playa del Carmen, Mexico; 7: Facultad de Medicina y Hospital Universitario Dr. José Eleuterio González, Universidad Autónoma de Nuevo León, Monterrey, Mexico; 8: Servicio de Alegia e Inmunología Clínica, Hospital Infantil de Mexico Federico Gómez, Mexico City, Mexico; 9: Subdirección de Enseñanza e Investigación, Hospital General de Especialidades Juan María Salvatierra, Baja California Sur, Mexico; 10: División de Medicina, Hospital Juárez de Mexico, Ciudad de Mexico, Mexico; 11: Centro de Inmunologia, Alergia y Pediatria, Hospital Angeles Lomas, Estado de Mexico, Mexico; and 12: Hospital General de Zona N. 1, Instituto Mexicano del Seguro Social, Oaxaca, Mexico

Publication date: May 1, 2021

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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