Immunotherapy: A Comprehensive Overview

With a rich history spanning over a century in medicine, allergen immunotherapy (AIT) emerges as a cornerstone in the management of allergic diseases. The seminal work of Leonard Noon and John Freeman, published in the esteemed scientific journal Lancet in 1911, marked the inception of this transformative treatment modality. AIT stands out as the sole therapeutic intervention capable of modulating the specific immune response to allergens like house dust mites, animal dander, and pollens.

Renowned for its efficacy in controlling allergic rhinitis, rhino conjunctivitis, and asthma, recent studies have unveiled promising outcomes in the treatment of atopic dermatitis as well. Notably, AIT finds indication in addressing allergy to hymenopteran insect bites (bee, ant, wasp) in cases where patients have a history of severe systemic reactions.

Endorsed by the World Health Organization (WHO), AIT stands as the foremost treatment capable of altering the natural course of allergic diseases, thereby alleviating symptoms and curtailing the reliance on medications such as antihistamines, oral and inhaled corticosteroids.

Personalized to suit each patient's unique allergic profile as discerned through allergic tests, AIT boasts an exemplary safety and efficacy profile. Scientific evidence attests to its approximate 90% effectiveness, with enduring results that sustain allergic symptom control for an average of 10 years post-treatment cessation.

The current state-of-the-art in allergen immunotherapy facilitates prolonged remission of allergic diseases, obviating the need for ongoing medication use and markedly enhancing quality of life.

Typically spanning a duration of 3 to 5 years, AIT necessitates prescription and oversight by a specialized physician in Allergy and Immunology to ensure optimal patient outcomes and safety.

1.Noon L. Prophylatic inoculation against hay fever. Lancet. 1911;177(4580):1572–1573.
2.Bousquet J, Lockey RF, Malling HJ, et al. Informe da Organização Mundial da Saúde. Genebra; 1997.
3.Canonica GW, Cox L, Pawankar R, et al. Sublingual immunotherapy: world Allergy Organization position paper 2013 update. World Allergy Organ J. 2014;7(1).
4.Roberts G, Pfaar O, Akdis CA, et al. EAACI guidelines on allergen immunotherapy: allergic rhinoconjunctivitis. Allergy. 2018;73(4):765–798.
5.Bousquet J, Pfaar O, Togias A, et al. 2019 ARIA Care pathways for allergen immunotherapy. Allergy. 2019;74(11):2087–2102.
6.Incorvaia C, Ridolo E, Bagnasco D, Scurati S, Canonica GW. Personalized medicine and allergen immunotherapy: the beginning of a new era? Clin Mol Allergy. 2021;19(1):10.

What is allergen immunotherapy?