|
Allergy & Asthma Advocate: Spring 2004
Immunotherapy: Decreasing sensitivity to allergy symptoms
By Stanley Goldstein, MD, FAAAAI
 Allergy immunotherapy, also known as allergy shots or desensitization, is a form of treatment aimed at decreasing the sensitivity to substances that create allergy symptoms. It is the most effective form of treating the underlying allergic mechanism that causes allergic conditions. It is specifically recommended for people who have nasal allergies, also known as allergic rhinitis, allergic asthma and allergies to insect stings. At present it does not provide a safe and effective treatment for food allergies.
Effectiveness of immunotherapy
Multiple studies have shown that immunotherapy is effective for the treatment of nasal allergies, both in adults and children. A review of 18 published studies involving 789 patients concluded that immunotherapy is highly effective in the treatment of allergic rhinitis. An extensive review of immunotherapy as a treatment for allergic rhinitis in children showed that the only treatment able to affect the natural cause of the disease is immunotherapy.
Immunotherapy may prevent the onset of asthma, and a review of multiple studies showed that allergen immunotherapy is also an effective treatment for asthma. These studies have indicated that treatment with immunotherapy results in reduced symptoms of asthma and improved pulmonary functions, and at the same time, reduces the need for asthma medications.
For individuals with a previously demonstrated allergic susceptibility to insect stings, immunization with insect venom is an extremely effective treatment for preventing future allergic reactions. A review of nine published studies indicates that a course of immunotherapy is highly effective in the management of insect sting allergy.
Who benefits from immunotherapy?  Individuals with allergic rhinitis
Patients who show symptoms of allergic rhinitis after natural exposure to airborne allergens, evidence of specific relevant allergic antibodies (IgE) and one of the following issues may benefit from immunotherapy.
- Poor response to medications or allergen avoidance
- Impractical or impossible to avoid allergens
- Unacceptable medication side effects
- Desire to avoid long-term medications and reduce the cost of medication
- Coexisting allergic rhinitis and asthma
- Possible prevention of asthma in children
- Individuals with allergic asthma
Patients with allergic asthma
Individuals who show symptoms of asthma after natural exposure to airborne allergens, evidence of specific relevant allergic antibodies (IgE) and one of the following issues may benefit from immunotherapy.
- Poor response to medications or allergen avoidance
- Impractical or impossible to avoid allergens
- Unacceptable medication side effects
- Desire to avoid long term medications and reduce the cost of medication
- Coexisting allergic rhinitis and asthma
- Individuals with reactions to insect stings
- Partients with reactions to insect stings
- Individuals with a history of allergic reactions to insect stings, and one of the following issues may benefit from immunotherapy.
- History of a systemic reaction to a bee sting, especially if the reaction was associated with respiratory or cardiovascular symptoms and evidence of specific relevant allergic antibodies (IgE)
- Patient is 16 years or older, has a history of a systemic reaction that is limited to the skin and evidence of specific relevant allergic antibodies (IgE). Patients younger than 16, with a history of a reaction to a bee sting that only involves the skin, may not require immunotherapy
- Patients with a history of a systemic reaction to imported fire ants and specific relevant allergic antibodies (IgE)
Seeing a board-certified allergist/immunologist will help you make an appropriate decision about whether or not to begin allergy immunotherapy. An allergist/immunologist will evaluate you for relevant allergens and help you effectively weigh the decision of allergy immunotherapy versus allergen avoidance and/or medications.
<back>
|
