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Current Opinion in Allergy & Clinical Immunology:
doi: 10.1097/ACI.0b013e32834cb994
Immunotherapy and new treatments: Edited by Giovanni Passalacqua and Robert Bush

Long-term clinical and immunological effects of allergen immunotherapy

Eifan, Aarif O.; Shamji, Mohamed H.; Durham, Stephen R.

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Abstract

Purpose of review: The present review updates current findings on long-term clinical and immunological outcomes after cessation of allergen immunotherapy for allergic respiratory disease.

Recent findings: Recent studies have shown that allergen immunotherapy has sustained disease-modifying effects that persist for years after discontinuation. This is in contrast to the effects of antiallergic drugs that do not induce tolerance to offending allergens. Long-term effects of immunotherapy include a reduction in nasal symptoms, a decrease in the use of rescue medication and improvement in quality of life. These benefits are accompanied by immunological changes such as the induction of allergen-specific IgG antibodies with inhibitory activity for IgE-facilitated binding of allergen–IgE complexes to B cells. One study reported a reduction in the development of asthma in children with seasonal pollen-induced rhinitis.

Summary: Allergen immunotherapy induces clinical and immunological tolerance as defined by persistence of clinical benefit and associated long-term immunological parameters after discontinuation of treatment. These findings are largely confined to studies of subcutaneous and sublingual immunotherapy for seasonal pollinosis. Further studies are needed to address potential long-term clinical effects for other seasonal and perennial inhaled allergens in both children and adults, and to identify potential biomarkers of tolerance.

Copyright © 2011 Wolters Kluwer Health, Inc. All rights reserved.

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