What is Allergy Immunotherapy?

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Allergic immunotherapy, also known as allergy shots, is a long-term form of allergy treatment that relieves symptoms for many people with allergic rhinitis, allergic asthma, conjunctivitis, or allergies. insect sting response. The mechanism of this therapy is to reduce allergen sensitivity, resulting in long-term relief of allergy symptoms even after treatment is discontinued. Therefore, it has become an effective treatment for many patients.

1. What is Allergy Immunotherapy?

Depending on the type of allergy, the patient will be applied to be able to "train" the body to be less allergic. Immunotherapy is a preventive treatment for allergic reactions to common life-threatening chemical irritants such as grass pollen, house dust mites, and bee venom.
Immunotherapy involves exposure and gradually increasing the dose of the allergen or allergen to which the person is provoked. The increased availability of a specific allergen causes the immune system to become less sensitive to the substance, reducing its ability to produce antibodies in response, thus reducing allergy symptoms when the substance is present. real encounter in the future.
Therefore, immunotherapy is always chosen to reduce the inflammation characteristic of allergic rhinitis, asthma or atopic dermatitis.
Before initiating treatment with allergic immunotherapy, the immunologist and the patient will jointly identify the triggers for allergy symptoms. Skin tests are sometimes done to confirm specific allergens to which a person has antibodies. Since then, the selection of antigens to perform allergic immunotherapy becomes more accurate, enhancing the effectiveness of treatment.

2. Types of Allergic Immunotherapy

To date, allergic immunotherapy is considered the most common and most effective form of allergy treatment. It is the only treatment that actually changes the immune system, helping to prevent the formation and development of allergic diseases such as allergic rhinitis and asthma.
Allergy immunotherapy has the following forms:
Allergy pills are a form of immunotherapy that is administered sublingually, which helps to provide an active source of allergens into the body to treat Some allergies do not need to be vaccinated. Like injections, sublingual medications will also help relieve symptoms by helping the body "get used to" gradually, reducing the ability to resist the effects of the allergen.
Allergy drops are another form of sublingual immunotherapy and work like a pill. Drops may be easier to use in young children.
Oral medications are a form of oral immunotherapy that helps treat people with food allergies by feeding gradually increasing amounts of food allergens to raise the threshold for triggering react.
Subcutaneous injection is the most commonly used form of allergy immunotherapy. Subcutaneous immunotherapy regimens include weekly injections in the initial phase, followed by a monthly maintenance phase, and a stabilization phase with intervals of up to time. 3-5 years period.
In the initial phase, the patient is given an injection containing an increasing amount of the allergen approximately once or twice per week. The length of this phase depends on the frequency of injections but typically ranges from three to six months. Once the effective dose is reached, the maintenance phase and the steady-state phase follow and are administered varyingly depending on the individual's response to the initiation phase.

3. When should allergic immunotherapy be indicated?

Both children and adults can receive immunotherapy, although it is not usually recommended for children under the age of five. This is because of the unpredictable adverse reactions that younger children may experience. At the same time, when considering allergy vaccination for the elderly, patients should also be considered for medical co-morbidities such as cardiovascular disease, metabolic disease and discussed with an allergist and immunologist first. there.
When the patient's condition is determined to be eligible, the allergist immunologist prescribes allergy immunotherapy based on indications for:
Length of allergy season and severity of symptoms Availability of medication and/or environmental control of allergy symptoms Need to avoid long-term medication Availability of time for complete treatment

4. Who should not perform allergy immunotherapy?

Allergic immunotherapy is contraindicated in patients with medical conditions that increase the risk of death from treatment-related systemic reactions, such as those with severe asthma or who are at poorly controlled or co-existing with serious cardiovascular diseases, eg, unstable angina, recent myocardial infarction, arrhythmias, and uncontrolled hypertension.

5. How effective is allergy immunotherapy?

Allergic immunotherapy has been shown to significantly reduce the symptoms of many allergic diseases, halting the progression of allergic disease from allergic rhinitis to asthma.
However, the effectiveness of allergy shots is related to the duration of the treatment program as well as the dose of the allergen. Some people may experience long-term remission with allergy symptoms, while others may experience a relapse after stopping allergy shots.
At this point, failure to respond to shots in allergen immunotherapy can be caused by a number of factors such as:
Inadequate dose of antigen in injections Improper identification of allergens in initial allergen assessment There is a higher level of the allergen present in the environment There is significant exposure to other possible allergens, such as cigarette smoke, pollen flower..., which has not been identified

6. Are there any risks to allergic immunotherapy?

Most patients with persistent allergies do not have much trouble performing allergic immunotherapy. However, the possible risks of this therapy should also be explained to the patient and family before initiating:
Local reactions, which may include redness, swelling, and swelling or irritation at the injection site. These common reactions usually begin within a few hours of the injection and go away soon after. Systemic reactions, less common - but potentially more serious. The sick person may have sneezing, a stuffy nose, or a rash. More severe reactions may include throat swelling, wheezing, or chest tightness. Anaphylaxis is a rare but life-threatening reaction to an allergy shot. This is a condition that can lead to a drop in blood pressure and difficulty breathing. Anaphylaxis usually begins within 30 minutes of injection, but sometimes begins even later. In order to prevent the above risks, the doctor may prescribe the patient to take an antihistamine before the vaccination. At the same time, for the absolute safety of the patient, allergen immunotherapy is performed only under the supervision of a specialist, in a facility equipped with adequate human resources and equipment. rescue ready.
In addition, follow-up in the clinic for at least 30 minutes after each injection is a must for all cases of allergic immunotherapy.
In summary, allergic immunotherapy is a potential therapy for allergies, which is effective in allergic rhinitis, allergic conjunctivitis, asthma, and insect sting hypersensitivity. When used in the right patients for the right indications, allergen-specific immunotherapy is considered extremely safe, minimizing uncomfortable symptoms, thereby helping to improve the quality of life for people. sick.
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Articles source references: NCBI, acaai.org, mayoclinic.org