World Allergy Week 2019: Immunotherapy : Modifying Allergic Disorders

We have have started the discussion for treatment of allergic disorders in the previous post.

Allergy testing has been discussed . Once the type and cause of allergy has been determined, what should be the treatment for the same.

The primary treatment of allergy is to avoid the cause of allergy

In case of food allergies, this is quite possible

Maintain a diary for food.

  • On avoiding a certain food for a week and re-introducing it, we can see whether it is the cause of allergy. If it is so, symptoms will show within half an hour.
  • Certain foods can be avoided, otherwise lessened
  • The patient should have a bracelet or carry a card informing of the food, allergies, in case they are causing severe reactions

In case of environmental allergens, environmental control is important

However, it is very difficult to control allergens such as pollen and dust mites due to travel, changing environment and obvious other reasons.

Symptomatic medication is effective only as long as the patient is taking it. Symptoms of allergy recur once the medication is stopped

Immunomodulators like Anti IgE therapy helps in severe cases of allergy, Monoclonal antibodies like Omalizumab, etc. Your allergy specialist will guide you on these medicines.

The other therapy of allergy is immunotherapy

  • Immunotherapy is the only therapy which can modify the outcome of allergic diseases
  • It’s effect is long lasting .
  • It improves immunity and reduces the incidence of other allergies.

What is immunotherapy?

By immunotherapy we administer the problematic allergen in gradually increasing quantities. This reduces the sensitivity of the immune system to the allergen and the body gets adapted to it.

  • It is completely natural.
  • It is a biological product
  • No pharmaceutical, steroidal or alternative medicine preparation is used

What are the types of immunotherapy?

There are 2 types of immunotherapy: subcutaneous and sublingual

Subcutaneous immunotherapy:

In this form of immunotherapy injections are administered below the skin

  • It is said to be more effective than sublingual immunotherapy
  • However, it requires multiple hospital visits for administration
  • It is painful as multiple injections are required over a long period of time
  • separate injections are required for separate allergens
  • 30 minutes observation is advisable because of the risk of anaphylaxis. However, hypoallergenic allergoid preparations are available too
  • It is best administered in a hospital with proper resuscitation facilities and an ICU backup

Sublingual immunotherapy:

In this particular therapy drops are administered below the tongue on an empty stomach, wait for a few minutes, then swallow. Do not eat or drink anything for an hour after doing so

  • It is safe, and can be taken at home.
  • Repeated hospital visits are not required
  • It is as effective as subcutaneous immunotherapy.
  • The drops are administered from twice weekly to daily dose as per the requirement of the patient.

What are the allergens chosen for immunotherapy?

Immunotherapy has to be effective. Each and every allergen tested positive does not require immunotherapy. so the allergen which has

  • The strongest positive reaction
  • Proven allergenicity
  • Prevalence in the environment
  • Clinical correlation with the patient’s history

Therapy of a single allergen is preferable than mixing of allergens.

What is the duration of immunotherapy?

Immunotherapy should be administered for 3-5 years for maximum efficacy

It’s effect lasts from 10-15 years or longer.

Your allergy specialist will be helpful in guiding you for what therapy is best for you!

Published by allergy care

I am an ENT specialist practicing allergy for the last 5 years. feel free to contact me

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