IMMUNOTHERAPY FOR ALLERGIES

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Allergen immunotherapy is a definitive treatment for allergies. It consists of exposing the patient to small, and increasing doses of an allergen. This helps to build up a tolerance to the allergen. Building up immune tolerance reduces or eliminates allergy symptoms.  

Allergen immunotherapy works by introducing gradually increasing quantities of the allergen into a patient’s immune system. This is done on a regular frequent schedule, till a maintenance level is reached. Tolerance for this allergen also continues after immunotherapy ends. However, the over months to years success rate varies from patient to patient.  

Several environmental allergies can now be treated with immunotherapy. Food allergy immunotherapy is also available now for peanuts in the USA.  

Immunotherapy for environmental allergens is proven to be very successful for:  

• pollen allergies, including immunotherapy for grass and ragweed. 
• mold allergy in the research phase.
• animal dander, including immunotherapy for cat allergies and dog allergies in some countries,
• and house dust mite allergy in the world over.
• cockroach allergy under research.
• insect venom hypersensitivity, one of the highest success rate world over.

In addition to decreasing allergy symptoms, immunotherapy might also help prevent new allergies. It may also stop the progression of allergic diseases, from allergic rhinitis to eczema and asthma or from eczema to asthma. It also helps in controlling asthma by interrupting the allergic response that sets off symptoms.  

Food allergy immunotherapy

•  Food allergy immunotherapy is used to build up a tolerance for small quantities of a food allergen. It is a treatment, not a permanent cure, for food allergies. Peanut allergy immunotherapy is now available in USA, not in India. 

• Allergy shots are also called subcutaneous immunotherapy or SCIT. They're the most well known and studied form of immunotherapy used for environmental allergens. Also, many times several different allergens can be combined in one injection. This may help to build tolerance to multiple allergens at once.  
• Shots are administered in a board-certified allergist’s office once or twice weekly. That schedule will continue for about 6-12 months. Your allergist increases the level of allergen extract in your injections until the maintenance dose is reached.  

Depending on your response to immunotherapy, your allergist might then decrease the frequency of your shots from once a week to once a month. If you are doing well after 3-5 years and no longer need most of the allergy medications, your allergist may stop immunotherapy.  

• SLIT tablets approved by FDA treat grass and ragweed pollens and house dust mites. Each SLIT tablet covers one type of allergen.  
• SLIT oral solutions or drops are available in India.
• Also, if you have severe or uncontrolled asthma, you are not eligible to start immunotherapy.  

The first SLIT dose is always administered in the doctor’s office, similar to allergy shots. Then patients may take the tablets at home. But epinephrine auto-injectors or injections in a safe box , must be always available in case of a severe allergic reaction, or anaphylaxis.

Talk with a Certified allergist about how your allergy symptoms affect your activities and health, then consider whether immunotherapy may help more 

than allergen avoidance and/or medications. 

Can Use the following questions to help guide you with your decision:

• Have reliable allergy tests diagnosed that you are allergic to an allergen that can be successfully treated with immunotherapy? 
• Is the particular allergen one that is difficult to avoid exposure to in everyday life? 
• Do your symptoms repeatedly interfere with daily activities? 
• Have your symptoms been very difficult to control with allergy medications? 
• Do you have any of the related conditions such as eczema, sinusitis or asthma that complicate your allergies? 
• Are you able to follow properly the immunotherapy schedule?

If you are considering allergen immunotherapy of any type, don’t be fooled by the allergen immunotherapy given by uncertified doctors. Many of the treatments they recommend are inconsistent with established standards of practice. These practices are designed to protect you as the patient.    

In food allergy oral immunotherapy (OIT), individuals are given the food they are allergic to. It starts with a very minute amount and then gradually larger amounts. This helps the body become desensitized to the particular food. Currently peanut allergy immunotherapy is approved by FDA in USA. Other allergens including egg and milk are being studied for OIT.