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Allergen immunotherapy is a treatment approach that involves administering gradually increasing doses of specific allergens to desensitize the immune system and reduce allergic reactions. This therapy can be delivered subcutaneously (allergy shots) or sublingually (under-the-tongue tablets or drops) and is primarily used for environmental allergies, insect venom allergies, and some food allergies.
The treatment works by shifting the immune response from a Th2-dominant allergic response to a more balanced Th1/regulatory T-cell response. Regular exposure to controlled doses of allergens leads to the production of allergen-specific IgG antibodies that compete with IgE antibodies, while also promoting the development of regulatory T-cells that suppress allergic inflammation and reduce mast cell and basophil degranulation.
Allergen immunotherapy is indicated for patients with confirmed IgE-mediated allergies who have inadequate symptom control with medications or experience significant side effects from pharmacotherapy. The treatment requires careful patient selection, proper allergen identification through testing, and close monitoring due to the risk of systemic allergic reactions, making it essential to weigh benefits against potential adverse effects for each individual patient.