Allergic rhinitis immunotherapy

MH, Townley RG. Mokhtarani M. Seyfert-Margohs V, Asare A. Bateman K. Deniz Y Omalizumab pretreatment decreases acute reactions after rush immunotherapy for ragweed-induced seasonal allergic rhinitis. J Allergy Clin Immunol 2006 117 134-140. 

In allergen immunotherapy, specific allergen extracts (also called allergen vaccines) are administered in order to modify or eliminate allergic rhinitis symptoms. 

American Academy of Pediatrics allergen immunotherapy allergic rhinitis central nervous system histamine-1 receptor antagonist immunoglobulin E over the counter perennial allergic rhinitis seasonal allergic rhinitis... 

Wilson DR, Lima MT, Durham SR. Sublingual immunotherapy for allergic rhinitis systematic review and meta-analysis. Allergy 2005 60(1) 4-12. Review. 

Creticos PS, Schroeder JT, Hamilton RG, Balcer-Whaley SL, et al. 2006. Immunotherapy with a ragweed-toll like receptor 9 agonist vaccine for allergic rhinitis. NEJM. 355 1445-1455. 

Passalacqua G. 2007. Allergic rhinitis and its impact on asthma update. Allergen immunotherapy. 

Specific immunotherapy using subcutaneous injections (SCIT) has been used for almost 100 years. It is clearly helpful for allergic rhinitis from pollens. Treatment of asthma, especially from molds, is not as clearly successful. Factors such as the inconvenience and expense of traveling for allergy shots contribute to a dropout rate greater than 50% over a multiyear course of... 

The World Health Organization position paper [31] published in 1998 found that properly conducted double-blind, placebo-controlled trials have shown the effectiveness of sublingual-swallow immunotherapy with grass, Parietaria and mite vaccines. The ARIA (Allergic Rhinitis and Impact on Asthma) [32] guidelines published in 2001 gave specific indications for usage. 

D Amato G, Lobefalo G, Liccardi G, Cazzola M A double-blind placebo-controlled trial of local nasal immunotherapy in allergic rhinitis to Parietaria pollen. Clin Exp Allergy 1995 25 141-148. 

Andri L, Senna GE, Andri G, Dama A, Givanni S, Betteli C, Dimitri G, Falagiani P, Mezzelani P Local nasal immunotherapy for birch allergic rhinitis with extract in powder form. Clin Exp Allergy 1995 25 1092-1099. 

Immunotherapy Allergic rhinitis Iposensitization Allergen specific Prophylaxis... 

Marcucci F, Sensi LG, Caffarelli C, Cavagni G, Bernardini R, Tiri A, Riva G, Novembre E Low-dose local nasal immunotherapy in children with perennial allergic rhinitis due to Dermatophagoides. Allergy 2002 57/l 23—28. 

Nickelsen JA, Goldstein S, Mueller U Local intranasal immunotherapy for ragweed allergic rhinitis. I. Clinical response. J Allergy Clin Immunol 1981 68 33-40. 

Cirla A, Sfoiza N, Roffi G Preseasonal intranasal immunotherapy in birch-alder allergic rhinitis. A double-blind study. Allergy 1996 51 299-306. 

Ariano R, Panzani RC, Chiapella M, Augeri G, Falagiani P Local immunotherapy of seasonal allergic rhinitis in children due to Parietaria officinalis pollen. A preliminary report. Pediatr Asthma Allergy Immunol 1993 7/4 227-237. 

Ohashi Y, Nakai Y, Tanaka A, Kakinoki Y, Ohno Y, Masamoto T, Sakamoto H, Kato A, Washio Y, Yamada K, Hayashi M Clinical role of soluble adhesion molecules during immunotherapy for perennial allergic rhinitis. Arch Otolaryngol Head Neck Surg 1998 124 41—45. 

Ohashi Y, Nakai Y, Sakamoto H, Ohno Y, Sugiura Y, Okamoto H, Tanaka A, Kakinoki Y, Kishimoto K, Hayashi M Serum levels of soluble interleukin-2 receptor in patients with perennial allergic rhinitis before and after immunotherapy. Ann Allergy Asthma Immunol 1996 77 203-208. Ohashi Y, Nakai Y, Tanaka A, Kakinoki Y, Washio Y, Kato A, Masamoto T, Sakamoto H, Yamada K Ten-year follow-up study of allergen-specific immunoglobulin E and immunoglobulin G4, soluble interleukin-2 receptor, interleukin-4, soluble intercellular adhesion molecule-1 and soluble vascular cell adhesion molecule-1 in serum of patients on immunotherapy for perennial allergic rhinitis. Scand J Immunol 1998 47 167-178. 

The treatment of allergic rhinitis combines allergen avoidance (when possible), pharmacotherapy and immunotherapy. 

The efficacy of subcutaneous SIT has been clearly shown in a metaanalysis of 43 double-blind placebo-controlled trials in allergic rhinitis as well as another meta-analysis of 16 double-blind placebo-controlled studies in asthma patients [13]. The mean clinical improvement was 45% reduction in symptoms and medication compared with placebo in rhinitis and 40% in asthma patients, which exceeds the effects of drug therapy. A recent meta-analysis also confirmed that asthma responds favorably to SIT [14], However, recently it could also be demonstrated that SIT is effective in patients with house dust mite allergy, allergic rhinitis and asthma [15]. Immunotherapy in these patients not only reduced rhinitis and asthma symptoms as well as rescue medication, but also had an impact on bronchial hyperreactivity over the 3-year follow-up period. 

The first report of the successful use of grass pollen extract injections to treat allergic rhinitis was published in 1911 by Noon." The therapy was first called desensitization however, this did not seem appropriate because skin reactivity sometimes remained. The name was later changed to hyposensitization. While this term is still used today, immunotherapy is used more commonly and is less confusing. 

The effectiveness of immunotherapy for seasonal allergic rhinitis appears to be better than that seen with perennial rhinitis, in part because it is more difficult to determine which allergen is responsible for perennial symptoms, and it is more due to multiple sensitizations. Effectiveness has been shown in a number of clinical studies using a variety of pollen extracts, even in patients with severe disease resistant to pharmacotherapy." " Specific immunotherapy for house dust mites has had good results in appropriately selected patients, while several studies have described marked improvement in patients with allergy to cats. Data indicate that in some patients 3 years of immunotherapy may be sufficient to give lasting benefit." ... 

Kuehr J, Brauburger J, Zielen S, et al. Efficacy of combination treatment with anti-IgE plus immunotherapy in polysensitized children and adolescents with seasonal allergic rhinitis. J Allergy Qin Immunol 2002 109 274-280. 

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