Allergiaimmunoterapia

Allergiaimmunoterapia is a medical intervention designed to modify the immune response to allergens by administering gradually increasing doses of the relevant allergen. The goal is long-term symptom control and disease modification, and it is distinct from symptomatic pharmacotherapy such as antihistamines or intranasal corticosteroids, although it is often used in combination with them.

There are two main routes: subcutaneous immunotherapy (SCIT), delivered by injections typically in a clinic with a build-up phase followed by a maintenance phase, and sublingual immunotherapy (SLIT), using tablets or drops placed under the tongue and often suitable for home use after initial supervision. Venom immunotherapy for Hymenoptera venom allergies is another form, usually administered as SCIT and considered highly effective.

Indications include moderate to severe allergic rhinitis or allergic asthma related to aeroallergens, or a documented venom allergy, particularly when symptoms persist despite standard pharmacotherapy or when a patient wishes to reduce reliance on medications. Immunotherapy may also reduce the development of new sensitizations and may alter the natural history of allergic disease in some patients.

Mechanism involves shifting the immune response away from IgE-mediated reactions toward IgG4 blocking antibodies, promoting regulatory T cell activity, and reducing inflammatory mediators. Efficacy is well-supported for pollens, dust mites, animal dander, and venom allergies; evidence for food allergens is more limited and evolving.

Duration is typically 3 to 5 years, with some patients benefiting from longer treatment. Safety considerations include adverse effects ranging from local reactions to systemic events; rare anaphylaxis can occur. Treatments require monitoring, especially during initiation, and clinicians assess contraindications such as poorly controlled asthma or certain cardiovascular conditions.