Immunotherapy for Allergic Rhinitis

Abstract

Specific allergen immunotherapy (SIT) is demonstrated to decrease symptoms of allergic rhinitis (AR), allergic asthma, conjunctivitis, and allergy for stinging insects in long term. It reduces allergen sensitivity, and usually alleviates allergic symptoms even after the end of the treatment. Therefore, it is an effective and profitable management for many of allergic individuals. SIT includes repetitive administration of allergen extracts for decreasing the symptoms upon subsequent allergen exposures. It improves quality of life (QoL), and produces long-term allergen tolerance. Careful patient selection is important for a successful outcome. SIT is a safe treatment option if sufficient precautions are taken. SIT is recommended in individuals with measurable specific IgE antibodies against allergens that are clinically relevant. Employment of SIT depends on several patient-related variables, including, but not limited to, preference/acceptability, compliance to treatment, need for medications, improvement with allergen protective actions, and side effects of medicines. Effectiveness of SIT in AR has been proven in prospective, randomized, placebo-controlled, single- or double-blind, studies. Randomized, double-blind, placebo-controlled prospective trials have demonstrated beneficial effects of SIT in treatment of allergic asthma. It is effective in most allergic patients if suitable allergy workup has been performed. The main SIT types are subcutaneous immunotherapy (SCIT) and sublingual immunotherapy (SLIT).