Patient's Education Portal
Treating Allergy with Allergen Immunotherapy (AIT)
Allergen immunotherapy is a long-term treatment that counters the cause of allergy by getting the immune system accustomed to environmental triggers, offering lasting relief.
Immediate Attention Required
Serious reactions to allergen immunotherapy are rare, but when they do occur, they require immediate medical attention. Anaphylactic symptoms include swelling in the throat, wheezing, chest tightness, nausea, and dizziness. Most serious reactions develop within 30 minutes of the injection.
Overview & Pathology
An allergy is an exaggerated defense reaction of the immune system to some normally harmless environmental substances called allergens. The aim of allergy treatment is not only to reduce symptoms but also to prevent disease progression and subsequent organ damage. Allergen immunotherapy (AIT) is a form of long-term treatment that decreases symptoms for many people with allergic rhinitis, allergic asthma, conjunctivitis (eye allergy), or stinging insect allergy. They decrease sensitivity to allergens and often lead to lasting relief of allergy symptoms even after treatment is stopped, making it a cost-effective, beneficial treatment approach. Allergen immunotherapy is the only form of treatment that counters the cause of allergy and may thus have a lasting effect on one’s state of health. Discomfort is alleviated and the quality of life improved. It also prevents progression of the allergic disease—preventing the march of allergy from the upper airways (allergic rhinitis) to the lower airways (allergic asthma) as well as the development of new allergies. It is therefore best suited for young patients with allergy (≥ 5 years) and for patients with early allergic rhinitis or allergic asthma. Likewise, allergen immunotherapy may significantly contribute to symptomatic improvement even in patients with a prolonged illness.
Treatment Course & Administration Modes
Once you have opted for allergen immunotherapy, there are two ways to introduce allergy-triggering allergens into your body: subcutaneous immunotherapy (SCIT) as an injection into subcutaneous tissue, or via the oral mucosa (sublingual immunotherapy, SLIT). AIT is generally given for three years. Symptoms may regress even in the first year after starting treatment and may continue improving noticeably in the following years.
Timing & Candidate Selection
For seasonal complaints (like pollen), SCIT is usually started at the end of the season during the symptom-free period. For all-year-round symptoms (like mite allergy), therapy may be commenced at any time. Both children (≥ 5 years) and adults can receive AIT. It is typically not recommended for children under 5 due to difficulties in cooperating and articulating adverse symptoms. For older adults, conditions like cardiac disease must be discussed with an allergist first.
Factors to decide with your allergist include: length and severity of symptoms, effectiveness of environmental control measures, desire to avoid long-term medications, time commitment required, and cost.
Mechanism of Action & Efficacy
AIT works like a vaccine. Your body responds to injected or ingested amounts of a particular allergen, given in gradually increasing doses, by developing immunity or tolerance to the allergen.
It decreases symptoms, prevents new allergies, and stops progression to asthma in children. Effectiveness relates to program length and allergen dose. If no improvement is seen after a year of maintenance therapy, failure may be due to:
- Inadequate dose of allergen in the allergy vaccine.
- Missing allergens not identified during initial evaluation.
- High levels of allergen in the environment.
- Significant exposure to non-allergic triggers, such as tobacco smoke.
Indications & Target Symptoms
Indications & Target Symptoms
- Allergic Rhinitis (Nasal allergies)
- Allergic Asthma
- Conjunctivitis (Eye allergy)
- Stinging Insect Allergy
Exclusions
- Food Allergies (AIT is not used to treat food allergies; strict avoidance is required)
Treatment Phases & Course
Initiation Therapy (Build-Up Phase)
An increasing amount of allergen is injected subcutaneously into the upper arm until the maximum dose for the individual patient (maintenance dose) is reached. The interval between injections is usually one week, lasting three to six months.
Maintenance Therapy Phase
After reaching the maximum dose, intervals are extended to 4 or 8 weeks as decided by your allergist. Decreased symptoms may be noticed during build-up, but it may take up to 12 months on maintenance dose to notice full improvement. Successful maintenance continues for 3 to 5 years.
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