Update on allergy immunotherapy: American Academy of Allergy, Asthma & Immunology/European Academy of Allergy and Clinical Immunology/PRACTALL consensus report

• Published in: Journal of allergy and clinical immunology Vol. 131; no. 5; pp. 1288 - 1296.e3
• Main Authors: Burks, A. Wesley, Calderon, Moises A., Casale, Thomas, Cox, Linda, Demoly, Pascal, Jutel, Marek, Nelson, Harold, Akdis, Cezmi A.
• Format: Journal Article
• Language: English
• Published: New York, NY Mosby, Inc 01.05.2013; Elsevier; Elsevier Limited
• Subjects: adjuvants; Allergen immunotherapy; allergens; Allergies; Allergy and Immunology; anaphylaxis; Antigens; asthma; atopic dermatitis; atopic disease; Biological and medical sciences; Chronic obstructive pulmonary disease, asthma; Clinical medicine; Desensitization, Immunologic - adverse effects; Desensitization, Immunologic - trends; Disease; Europe; food allergies; Fundamental and applied biological sciences. Psychology; Fundamental immunology; grasses; Human subjects; Humans; Hypersensitivity - immunology; Hypersensitivity - therapy; Immune system; immune tolerance; Immunology; Immunopathology; immunosuppression; Immunotherapy; Lymphocytes; Medical sciences; patients; Pneumology; pollen; Production increases; Proteins; rhinitis; Sarcoidosis. Granulomatous diseases of unproved etiology. Connective tissue diseases. Elastic tissue diseases. Vasculitis; Societies, Medical; United States; Venom; venoms; United States; North America; Europe; America; United States > US; immune tolerance; SLIT; atopic disease; Treg; OIT; TLR; Allergen immunotherapy; AIT; SCIT; Allergy immunotherapy; Subcutaneous immunotherapy; Sublingual immunotherapy; Oral immunotherapy; Regulatory T; Toll-like receptor; Lung disease; Allergy; Immunopathology; Desensitization; Respiratory disease; Consensus; Asthma; Atopy; Immunology; Treatment; Immunotherapy; Immune tolerance; Bronchus disease; Obstructive pulmonary disease
• ISSN: 0091-6749; 1097-6825; 1097-6825
• DOI: 10.1016/j.jaci.2013.01.049

Allergy immunotherapy (AIT) is an effective treatment for allergic asthma and rhinitis, as well as venom-induced anaphylaxis. In addition to reducing symptoms, AIT can change the course of allergic disease and induce allergen-specific immune tolerance. In current clinical practice immunotherapy is delivered either subcutaneously or sublingually; some allergens, such as grass pollen, can be delivered through either route, whereas others, such as venoms, are only delivered subcutaneously. Both subcutaneous and sublingual immunotherapy appear to have a duration of efficacy of up to 12 years, and both can prevent the development of asthma and new allergen sensitivities. In spite of the advances with AIT, safer and more effective AIT strategies are needed, especially for patients with asthma, atopic dermatitis, or food allergy. Novel approaches to improve AIT include use of adjuvants or recombinant allergens and alternate routes of administration. As part of the PRACTALL initiatives, the European Academy of Allergy and Clinical Immunology and the American Academy of Allergy, Asthma & Immunology nominated an expert team to develop a comprehensive consensus report on the mechanisms of AIT and its use in clinical practice, as well as unmet needs and ongoing developments in AIT. This resulting report is endorsed by both academies.