The evolution of allergen and non-specific immunotherapy: past achievements, current applications and future outlook

Abstract

Recent epidemiological studies estimated that more than 30% of European suffer from allergic rhinitis or conjunctivitis, while up to 20% suffer from asthma and 15% from allergic skin conditions, while for many other regions the prevalence is increasing. Allergen immunotherapy represents the only available treatment that can modify the allergic disease process, and thus is worth considering as a treatment in affected individuals. A beneficial effect of allergen immunotherapy has been shown in both adults and children affected by allergic rhinitis, allergic conjunctivitis, allergic asthma and hymenoptera venom allergy. The present study represents an overview on allergen immunotherapy, focusing on the principal aspects of the use of immunotherapy in the past, its recent clinical applications and future outlook.

Keywords:

• allergen-specific immunotherapy
• allergic asthma
• allergic inflammation
• allergic rhinitis
• atopy
• cytokines
• monoclonal antibody
• prevention
• respiratory allergy
• treatment

Financial & competing interests disclosure

GB Pajno is a Board Member of the Paediatric Section of the European Academy of Allergy and Clinical Immunology, and received fees for this. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

No writing assistance was utilized in the production of this manuscript.

Key issues

• Both subcutaneous immunotherapy and sublingual immunotherapy are the standard delivery methods in allergen-specific immunotherapy.

• Oral immunotherapy represents the new active treatment for IgE-mediated food allergy. It could be performed in selected medical centers and under strict medical supervision.

• Treg perform their immunomodulatory function inhibiting dendritic cells, effector T cells (Th1, Th2, Th17), basophils, mast cells, eosinophils. Treg play a pivotal role in mechanism(s) of action of specific immunotherapy.

• Non-specific immunotherapy, mostly with anti-IgE antibody, may change in the future, the therapeutic approach for severe allergic disorders.

Notes