REVIEWS   

Otorinolaringologia 2007 June;57(2):69-75

Copyright © 2007 EDIZIONI MINERVA MEDICA

language: English

Specific allergen immunotherapy: a “tailored” therapy for allergic rhinitis

Calderón M. ¹, Lombardi C. ²

¹ Department of Allergy and Respiratory Medicine Royal Brompton Hospital Imperial College - NHLI London, UK 2 Allergologic Unit Department of Internal Medicine Sant’Orsola Hospital Brescia, Italy

Allergic rhinitis (AR) is an inflammatory disorder of the nose induced by indoor and/or outdoor allergen exposure of the mucosa of the nose driving by IgE on-going production. AR can lead to a significant reduction in quality of life with a negative impact on work productivity, school performance and social activities, and represents a relevant direct and indirect health costs to society. The ARIA therapeutic approach consider the use of different tools on the basis of the severity of the disease with a stepwise approach. Many classes of drugs are currently available for the symptomatic treatment of AR. Allergen-specific immunotherapy (SIT) is a treatment designed to prevent allergic reaction from occurring, thus treating the basic cause of the disease process. SIT interferes with the basic mechanism of allergy and alters the natural course of allergic diseases, which therefore offers a long-lasting and preventive effect. Subcutaneous immunotherapy (SCIT) is the current standard of care. It is established as effective for patients with AR and/or asthma, especially for allergies to grass pollen, ragweed pollen, birch pollen, mountain cedar pollen, house dust mite, cladosporium, alternaria, and cats. It was found that patients treated with SCIT are at increased risk of both local and systemic adverse reactions. In the majority of cases, symptoms were readily reversible with appropriate treatment. The problem of safety was a strong impulse to the search for alternative administration routes. In official documents, sublingual immunotherapy (SLIT) is now considered as a viable alternative to the classic injection route for both adults and children with rhinitis and/or asthma.