Desensitization therapy for allergy: theory and practice Essay

Allergies are one of the most common complaints for which patients seek medical attention. They disrupt patients’ lives and can even make others uncomfortable. While symptomatic relief can be obtained with antihistamines and similar medications, most patients would rather live completely symptom free and thus they turn to desensitization therapy. Here, I will explain the mechanism behind allergies and the different forms of desensitization therapies that are available today. An allergy is a hypersensitivity reaction by the immune system that occurs to certain antigens for which the body perceives as a threat and has an overreaction to. Patients generally experience inflammation of the airways, among other symptoms caused by the inappropriate release of histamine. The purpose of desensitization therapy in the allergic patient is to induce tolerance to the allergens that cause the patient to have symptoms.1 Several methods of desensitization therapy exist, the more prominent being subcutaneous injections and sublingual administration, and the less popular methods of intralymphatic and transcutaneous immunotherapy.2 Before desensitization can begin, however, it has to be determined what the patient is in fact allergic to. This is done by using purified antigen from the suspected allergen and doing either a skin test or a blood test. In the skin test, the suspected allergen is scratched into the skin and is positive when a wheal develops.3 In the blood test, the patient’s blood is mixed with the allergen in order to observe the presence of antibodies—specifically IgE. Therapy can only begin when the appropriate allergen is determined because the immunotherapy is allergen specific. Allergens work by inducing a Type 1 ... ...lege of Allergy, Asthma, & Immunology. Aug 2006;97(2):126-137; quiz 137-140, 202. 12. Ohashi Y, Nakai Y, Murata K. Effect of pretreatment with fexofenadine on the safety of immunotherapy in patients with allergic rhinitis. Annals of allergy, asthma & immunology : official publication of the American College of Allergy, Asthma, & Immunology. Apr 2006;96(4):600-605. 13. Larsen JN, Houghton CG, Vega ML, Lowenstein H. Manufacturing and standardizing allergen extracts in Europe. Clinical allergy and immunology. 2008;21:283-301. 14. Moingeon P, Mascarell L. Induction of tolerance via the sublingual route: mechanisms and applications. Clinical & developmental immunology. 2012;2012:623474. 15. Iglesias-Cadarso A, Hernandez-Weigand P. Risk factors for systemic reactions to allergen immunotherapy. Current opinion in allergy and clinical immunology. Dec 2011;11(6):579-585.