Allergen Immunotherapy

2 learning resources available for this topic

About Allergen Immunotherapy

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.

Pathophysiology

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.

Clinical Reasoning

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.

References

  1. Allergic Diseases. StatPearls. https://www.ncbi.nlm.nih.gov/books/NBK447113/
  2. AAAAI/ACAAI Allergy Practice Parameters. Joint Task Force. https://www.allergyparameters.org/
  3. Allergen Immunotherapy Practice Parameter Update. Annals of Allergy. https://doi.org/10.1016/j.anai.2020.06.014
  4. Subcutaneous Immunotherapy Guidance. AAAAI. https://www.aaaai.org/tools-for-the-public/conditions-library/allergies/allergy-shots

Related Topics

ImmunotherapyAllergic RhinitisAnaphylaxis