Specific immunotherapy in allergic rhinitis

Allergic rhinitis is a common condition, with significant impact on quality of life depending on severity and quality of control. Allergen-specific immunotherapy (allergen-SIT) is the only known treatment able to alter the natural course of allergic rhinitis. Although well known to allergologists, i...

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Bibliographic Details
Published in:European annals of otorhinolaryngology, head and neck diseases head and neck diseases, 2017-09, Vol.134 (4), p.253-258
Main Authors: Mortuaire, G., Michel, J., Papon, J.F., Malard, O., Ebbo, D., Crampette, L., Jankowski, R., Coste, A., Serrano, E.
Format: Article
Language:English
Subjects:
Administration, Sublingual
Allergens - administration & dosage
Allergy
Asthma
Asthma - prevention & control
Desensitization, Immunologic - methods
Humans
Immunotherapy
Meta-Analysis as Topic
Quality of Life
Rhinitis
Rhinitis, Allergic - drug therapy
Rhinitis, Allergic - prevention & control
Treatment Outcome
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Summary:Allergic rhinitis is a common condition, with significant impact on quality of life depending on severity and quality of control. Allergen-specific immunotherapy (allergen-SIT) is the only known treatment able to alter the natural course of allergic rhinitis. Although well known to allergologists, it has yet to be fully adopted by the ENT community. This review, based on the most recent meta-analyses and clinical studies, shows that SIT significantly reduces symptoms and medication requirements (nasal corticosteroids, H1-antihistamines) in allergic rhinitis. It can reduce the risk of progression to asthma and, if initiated early enough, of developing new sensitizations. Immunobiological analysis shows an altered inflammatory profile following SIT, with immune tolerance involving T-regulatory lymphocyte induction and IgG production. Sublingual SIT with drops is as effective as subcutaneous SIT and is simpler to use, with less anaphylactic risk. Standardization of trial protocols in terms of treatment response assessment and side effect grading is recommended to improve comparative studies. Sublingual SIT with tablets has recently been introduced, providing a good opportunity for ENT practitioners to adopt the SIT approach in rhinitis triggered by allergy to pollens and, in the near future, to house dust mites.
ISSN:1879-7296
1879-730X
DOI:10.1016/j.anorl.2017.06.005