© Crisafulli et al; licensee BioMed Central Ltd. 2014
Published: 11 August 2014
Allergen Immunotherapy (AIT), is effective in reducing the clinical symptoms associated with allergic rhinitis, asthma and venom induced anaphylaxis . Subcutaneous (SCIT) and Sublingual (SLIT) with unmodified allergen extracts are the two routes of administration of allergen vaccines.
Moreover due to the complexity of IgE mediated disorders, each component of triad: SCIT, SLIT or Oral Immunotherapy (OIT) could be considered as complementary or synergic therapy. Currently, in paediatrics, the challenge is represented by the possibility of defeat the reluctance to encourage the implementation of early intervention in IgE mediated allergic diseases, with the goal of achieving either secondary prevention or long lasting benefit through immunotherapy(ies) which is the only antigen specific immunomodulatory treatment routinely available .These effects are of particular relevance in paediatric population with the aim of impairing the natural history of allergic diseases.
The mechanisms of action of AIT have been elucidated: a diminished allergen specific T-cell proliferation and suppressed secretion of TH2 cell responses are the characteristic hallmarks. In addiction, T regulatory (Treg) cells inhibit the development of allergen specific TH2 and TH1 cell responses an therefore exert key roles in healthy immune response to allergens. Treg cells potently suppress IgE production and directly or indirectly control the activity of effectors cells of allergic inflammation, such as eosinophils, basophils, and mast-cells .
Therefore, AIT in different forms represent an effective therapeutic approach in children with IgE mediated respiratory disorders. Moreover, in other allergic disorders that are no part of the respiratory disease spectrum, the evidence is beginning to emerge that these diseases also will respond to allergen specific immunotherapy.
- Cox L, Nelson H, Lockey R: Allergen Immunotherapy: A practice parameter third update. J Allergy Clin Immunol. 2011, 127 (1 Suppl): 1-55. 10.1016/j.jaci.2010.09.034.View ArticleGoogle Scholar
- Calderon MA, Gerth van Wijk R, Eichler I, Matricardi PM, Varga EM, Kopp MV, Eng P, Niggemann B, Nieto A, Valovirta E, Eigenmann PA, Pajno G, Bufe A, Halken S, Beyer K, Wahn U, European Academy of Allergy and Clinical Immunology: Perspectives on allergen-specific immunotherapy in childhood: an EAACI position Statement. Pediatr Allergy Immunol. 2012, 23: 300-306. 10.1111/j.1399-3038.2012.01313.x.View ArticlePubMedGoogle Scholar
- Nurmatov U, Venderbosch I, Devereux G, Simons FE, Sheik HA: Allergen-specific oral immunotherapy for peanut allergy. Cochrane Database Syst Rev. 2012, 9: CD0009014-10.1002/14651858.CD009014.pub2.Google Scholar
- Passalacqua G, Landi M, Pajno GB: Oral Immunotherapy for cow’s milk allergy. Curr Opin Allergy Clin Immunol. 2012, 12: 271-277. 10.1097/ACI.0b013e3283535b93.View ArticlePubMedGoogle Scholar
- Bae JM, Choi YY, Park CO, Chung KY, Lee KH: Efficacy of allergen – specific immunotherapy for atopic dermatitis: a systemic review and meta-analysis of randomized controlled trials. J Allergy Clin Immunol. 2013, 132: 110-117. 10.1016/j.jaci.2013.02.044.View ArticlePubMedGoogle Scholar
- Akdis M, Akdis CA: Mechanisms of allergen specific immunotherapy multiple suppressor Factors at work in immune tolerance to allergens. J Allergy Clin Immunol. 2014, 133: 621-631. 10.1016/j.jaci.2013.12.1088.View ArticlePubMedGoogle Scholar
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