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A Journal on Otorhinolaryngology, Head and Neck Surgery,
Plastic Reconstructive Surgery, Otoneurosurgery

Indexed/Abstracted in: EMBASE, Scopus




Otorinolaringologia 2004 March;54(1):15-23

language: English

Allergen specific immunotherapy in allergic rhinitis

Calderon-Zapata M. A., Durham S. R.

Upper Respiratory Medicine National Heart and Lung Institute Imperial College School of Medicine, London, UK


Allergen immu­no­ther­a­py is high­ly effec­tive in select­ed ­patients ­with IgE medi­at­ed dis­ease ­with a lim­it­ed spec­trum of aller­gies who ­fail to ­respond to usu­al ther­a­pies. The mech­a­nism is like­ly to ­involve mod­ifi­ca­tion of the T lym­pho­cyte ­response to sub­se­quent aller­gen expo­sure ­with a ­shift in the Th2/Th1 lym­pho­cyte bal­ance, ­either by ­immune devi­a­tion Th2>Th1 respons­es or ­down-reg­u­la­tion of Th0/Th2 respons­es. Allergen immu­no­ther­a­py has ­been ­shown to be effec­tive in ­patients ­with ­severe sum­mer hay ­fever. Treatment for 3-4 ­years may ­result in ­long-­term ben­e­fit for at ­least 3 ­years fol­low­ing dis­con­tin­u­a­tion. In chil­dren, immu­no­ther­a­py has ­been ­shown to pre­vent the ­onset of new sen­sit­isa­tions. Immunotherapy for sea­son­al hay ­fever in chil­dren, ­when con­tin­ued for 3 ­years, result­ed in a two-three­fold reduc­tion in the ­risk of devel­op­ing phy­si­cian-diag­nosed asth­ma at 5 ­years, 2 ­years fol­low­ing dis­con­tin­u­a­tion. Although high­ly effec­tive, aller­gen injec­tion immu­no­ther­a­py may be asso­ciat­ed ­with ­side ­effects, includ­ing a ­remote ­risk of anaph­y­lax­is. Therefore, the ­risk/ben­e­fit of immu­no­ther­a­py ­should be con­sid­ered in eve­ry ­case, and the treat­ment con­fined to spe­cial­ist clin­ics ­with ­access to resus­ci­ta­tion ­with a wait­ing peri­od of at ­least 30 min­utes ­after injec­tions (60 min­utes with­in the UK).

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