Allergen-specific immunotherapy of asthma and allergic rhinitis

Abstract:

Allergen-specific immunotherapy (ASIT) is the only causal form of therapy for allergic diseases. Immunotherapy along with allergen avoidance and pharmacological treatment holds an important place in the treatment of allergic rhinitis (AR) and asthma. Depending on the dose and duration of the treatment, there is evident clinical improvement and biological tolerance that lasts years after discontinuing the therapy. Symptom reduction, long-term remission, prevention of new sensitization and prevention of conversion of AR to asthma is achieved. The use of immunotherapy is associated with the immunodeviation of Th2 to Th1 response and with the induction of IL-10 release and TGF-β from T regulatory cells in blood and inflamated airways. These changes are equally visible in subcutaneous (SCIT) and sublingual immunotherapy (SLIT). SCIT is effective for the treatment of AR and asthma and has long-lasting effects after discontinuing the therapy. Disadvantages of SCIT are the frequent applications of injections, along with possible serious topical or systemic side effects. SLIT may offer safe and effective administration and may enhance tolerance, compliance and patient consent to the treatment. 

Key words:
allergic rhinitis; asthma; immunotherapy