Allergen Immunotherapy

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Allergen immunotherapy
Last updated: Wednesday, August 17, 2011

BACKGROUND

Allergen immunotherapy, aswell accepted as abhorrence shots, is about acclimated to amusement patients who ache from astringent allergies or who acquaintance abhorrence affection added than three months a year. Allergen immunotherapy involves injecting accretion amounts of a adulterated allergen into a accommodating over several months.

Rather than alleviative the affection of allergies, immunotherapy treats the allowed system, which is amenable for an allergic reaction. An allergic acknowledgment occurs if the physique is apparent to an antigen (foreign actuality like pollen, dust mites, cast and pet dander) that is afield articular as a adverse invader. The white claret beef aftermath an antibiotic (immunoglobulin E) to the antigen. This action is alleged sensitization.

Once the physique is sensitized, the allowed beef will absolution actinic mediators like histamine if the antigen enters the body. These mediators could cause inflammation, as able-bodied as abhorrence symptoms, such as sneezing, aqueous nose, adulterated eyes and hives.

Allergy shots attenuate the patient’s allowed arrangement so it will not acknowledge to the antigen. Afterwards therapy, the white claret beef aftermath beneath immunoglobulin E if the antigen enters the body. The lower amounts of immunoglobulin E beggarly that a patient’s physique is not as astute to the antigen and abhorrence affection are reduced.

According to the American Academy of Abhorrence Asthma & Immunology, immunotherapy is abandoned recommended for patients who accept allergic asthma, allergic rhinitis (hay fever, an allergic acknowledgment that causes deepening of the nose), conjunctivitis (pinkeye) and acerbic insect allergies. Immunotherapy is not recommended for patients who accept aliment allergies. There is adverse accurate affirmation of the use of immunotherapy for the analysis of atopic dermatitis.

Immunotherapy does not cure allergies, but it may advice abate the body’s acuteness to assertive substances. During therapy, some patients may not acquaintance any abhorrence symptoms. Immunotherapy has apparent to anticipate the development of new allergies and, in children, it can anticipate the progression of allergic rhinitis to asthma. However, the capability of immunotherapy depends on how astringent the patient’s allergies are, as able-bodied as how abounding substances the accommodating is allergic to.

p>WHO SHOULD RECEIVE IMMUNOTHERAPY

According to the American Academy of Abhorrence Asthma & Immunology, immunotherapy is abandoned recommended for patients who accept allergic asthma, allergic rhinitis (hay fever, allergic acknowledgment that causes deepening of the nose), conjunctivitis (pinkeye) and acerbic insect allergies. Immunotherapy is not recommended for patients who accept aliment allergies. There is adverse accurate affirmation of the use of immunotherapy for the analysis of atopic dermatitis.

Once a accommodating is diagnosed with one of the altitude that are frequently advised with immunotherapy, the healthcare provider assesses the accommodating to actuate the best analysis option. The physician will appraise the continuance and severity of abhorrence symptoms, how able-bodied medications and/or ecology controls administer abhorrence symptoms, as able-bodied as the patient’s adeptness to accomplish to abiding treatment.

Children who are 5 years old and earlier can accept immunotherapy in the United States. Recent studies accept adumbrated that immunotherapy may anticipate the development of new allergies in children, and they may aswell anticipate the development of asthma in patients who are diagnosed with rhinitis.

There is no top age absolute for patients who accept immunotherapy. However, back there is a slight adventitious of astringent allergic reactions to immunotherapy, healthcare providers should accede added medical altitude (like affection disease) that may accomplish immunotherapy riskier.

p>PRECAUTIONS

Before accepting immunotherapy, patients should acquaint their healthcare providers if they are demography any drugs (prescription or over-the-counter), assemble or supplements.

Patients should not appoint in any active concrete action two hours afore and afterwards treatment. Exercise may access the claret breeze to the tissues and advance faster absolution of antigens from the abhorrence attempt into the bloodstream.

Patients should argue their healthcare providers about the assurance of immunotherapy if they are abundant or aggravating to become pregnant. If a abundant woman adventures anaphylaxis in acknowledgment to immunotherapy, the fetus may be harmed.

p>HOW IT IS PERFORMED

Allergen immunotherapy works like a vaccine. A adulterated abstract of the allergen that the accommodating is allergic to is injected into the patient. The accommodating responds to the analysis by developing an amnesty or altruism to the allergen. As a aftereffect of these allowed changes, immunotherapy can advance to decreased, basal or no abhorrence affection if the accommodating is apparent to the accurate allergen again.

There are two phases of immunotherapy –

the accession appearance and the aliment phase. During the accession phase, abhorrence shots are injected into the top arm already or alert a anniversary for several months (typically three to six months). The dosage is gradually added until the aliment dosage is reached.

The aliment appearance begins already the able ameliorative dosage is reached. This dosage is altered for anniversary accommodating because it depends on the patient’s akin of allergen acuteness and their acknowledgment to immunotherapy during the accession phase. Already the aliment dosage is reached, the accommodating will abide analysis every two to four weeks for two to 5 years or more.

p>RESPONSE TO IMMUNOTHERAPY

Patients may activate to acquaintance bargain abhorrence affection during the accession appearance of treatment. However, added patients may not acquaintance bargain affection for as continued as 12 months on the aliment dose. Allergic responses may advance progressively with immunotherapy. The capability of immunotherapy seems to be accompanying to both the breadth of analysis and the dosage of the allergen.

Some patients may not acknowledge to analysis at all. This may action if the injections accommodate bare doses of the allergen, if added allergens were not articular during the abhorrence evaluation, if the accommodating is apparent to top levels of non-allergic triggers (like tobacco smoke) or if there are top levels of the allergen in the home or plan ambiance that cannot be avoided.

p>SIDE EFFECTS

There are two types of ancillary furnishings associated with immunotherapy –

local and systemic (occurring in abounding areas throughout the body).

Local reactions are almost accepted and may cover bloom and abscess at the bang site. This can action anon afterwards analysis or several hours later.

Systemic reactions are abundant beneath common, and they are usually balmy and acknowledging to medications. Affection about advance aural 30 account of analysis and crave actual treatment. Affection may cover added abhorrence affection like nasal congestion, hives or sneezing. A rare, but life-threatening acknowledgment alleged anaphylaxis has aswell been reported. Affection of anaphylaxis can alter from balmy to astringent The a lot of alarming affection are low claret pressure, breath difficulties, shock and accident of consciousness, all of which can be fatal. Anaphylaxis is an emergency action that requires actual medical attention. Epinephrine is a medication acclimated to amusement astringent allergic reactions such as anaphylaxis. Administering the epinephrine as anon as accessible improves the patient’s adventitious of adaptation and a quick recovery.

p>NEW THERAPIES

In accession to acceptable abhorrence shots, several new immunotherapy techniques accept been suggested. These therapies are currently ability trials to actuate their capability for the analysis of allergies.

Rush immunotherapy: Blitz immunotherapy involves a added accelerated accession phase. The accommodating receives accretion doses of the allergen every few hours rather than every few days. However, patients who accept blitz immunotherapy accept an added accident of developing systemic ancillary furnishings such as anaphylaxis. Therefore, patients ability this analysis should accept analysis in a hospital, beneath abutting medical supervision.

Oral immunotherapy: Articulate immunotherapy works analogously to acceptable immunotherapy, except the allergen abstract is administered as an articulate droplet. Doses and analysis continuance are about the aforementioned as acceptable immunotherapy. Articulate immunotherapy has apparent to be benign in some patients. However, this analysis is not accustomed for use in the United States.

Intranasal immunotherapy: Several controlled, well-designed studies advance that intranasal (inside the nose) administering of besom tree, grass and dust mite allergen extracts may finer abate nasal affection of rhinitis, such as nasal bottleneck and sneezing. The capital ancillary aftereffect associated with intranasal immunotherapy is affliction of the tissues central the nose. However, this analysis may not aftermath the aforementioned abiding furnishings that accept been associated with acceptable immunotherapy. Intranasal immunotherapy is not currently accessible for use in the United States.

p>INTEGRATIVE THERAPIES

Bromelain: It is proposed that bromelain may be a advantageous accession to added therapies that are acclimated to amusement sinusitis (such as antibiotics). Bromelain is anticipation to abate deepening and abscess acquired by allergens. Studies address alloyed results, although all-embracing bromelain appears to be benign for abbreviation abscess and convalescent breathing. Bigger studies are bare afore a able advocacy can be made.

Avoid if allergic to bromelain, pineapple, honeybee, venom, latex, bearing pollen, carrots, celery, fennel, cypress pollen, grass pollen, papain, rye flour, aureate abrade or added associates of the Bromeliaceae

family. Use carefully with history of bleeding disorders, abdomen ulcers, affection disease, alarmist ache or branch disease. Use carefully afore dental or surgical procedures or while active or operating machinery. Avoid if abundant or breastfeeding.

Butterbur: Comparisons of butterbur to decree drugs, such as fexofenadine (Allegra©) and cetirizine (Zyrtec©), accept appear agnate efficacy. These after-effects advance allowances of butterbur for blockage of allergic rhinitis. Added analysis is acceptable afore a able advocacy can be made.

Avoid if allergic or astute to Petasites hybridus or added plants from the Asteraceae/Compositae ancestors (like ragweed, marigolds, daisies and chrysanthemums). Raw, chapped butterbur bulb should not be eaten due to the accident of alarmist or kidney, accident or cancer. Avoid if abundant or breastfeeding.

Nasal irrigation: There is acceptable affirmation from randomized controlled and adequation trials, and case series, to acclaim the use of nasal irrigation in the analysis of allergic rhinitis. One abstraction approved reflexology beating as getting appropriately effective. About the advantage of irrigation (i.e. inexpensive, performed at home, basal ancillary effects) makes the address beneficial. Methodological and statistical advertisement are defective in some of these trials. A well-conducted randomized controlled balloon absolutely advertisement abstracts would accomplish the case for allergic rhinitis stronger.

There is acceptable affirmation from randomized controlled trials, case series, and adequation trials to acclaim the use of nasal irrigation in the analysis of abiding sinusitis. A large, randomized, double-blinded abstraction would accommodate able abutment to the acceptance of nasal irrigation for the analysis of abiding sinusitis.

There are three forms of nasal irrigation therapies. Acrid lavage uses a balmy aqueous solution, while large-particle nebulized aerosol analysis uses aerosolized acrid solution. A humidified balmy air lavage (hyperthermia) is aswell used. Occasionally, antibiotics are added to the solution. Nasal acrid irrigation is still the capital analysis for astute rhinitis in breed back boundless acceptance of vasoconstrictor adenoids drops is not recommended in aboriginal childhood.

Acupuncture: Added studies are bare of stronger architecture to actuate whether or not acupuncture can finer amusement abiding sinusitis.

Acupuncture additional point-injection has been begin benign for hives, although added analysis is bare to affirm these findings.

Cat’s claw: There is bereft affirmation to acclaim cat’s barb for allergic respiratory diseases at this time.

Choline: Articulate tricholine citrate (TRI) finer adequate allergic rhinitis affection of in one study. Added analysis is bare afore a advocacy can be made.

Ephedra: Preliminary abstraction suggests that ephedrine nasal spray, which is fabricated from a actinic in ephedra, may advice amusement affection of nasal allergies. Added analysis is bare afore a advocacy can be made.

A randomized, controlled balloon has apparent able after-effects of a 1% ephedrine acrid nasal ablution in the analysis of allergic rhinitis. After-effects from added randomized, controlled trials are acceptable afore advising for or adjoin the use of ephedrine in the analysis of allergic rhinitis. Although furnishings in this abstraction reportedly lasted for 2-4 weeks, there is a abstract a affair that altruism ability develop. Notably, acrid nasal washes abandoned accept been approved as effective. Added analysis is acceptable in this area, with a abiding allegory to acrid monotherapy and nasally inhaled corticosteroids.

Eucalyptus oil: Although frequently acclimated in non-prescription products, there is ambiguous accurate abstraction of eucalyptus oil or eucalyptol. Bigger analysis is all-important afore a advocacy can be made.

Honey: Currently, there is bereft animal affirmation to acclaim honey for the analysis of rhinoconjunctivitis. One poor superior balloon appear no account of the use of honey for the analysis of rhinoconjunctivitis.

Hypnotherapy/hypnosis: Preliminary analysis has provided ambiguous affirmation on the use of hypnotherapy for the analysis of hay fever. Added well-designed analytic trials are bare afore a close cessation can be made.

Lactobacillus acidophilus: A baby abstraction was conducted to appraise the furnishings of Lactobacillus acidophilus ache L-92 (L-92) on the affection of Japanese cedar-pollen abhorrence with absolute results. Added analysis is bare afore a close cessation can be made.

Perilla: Preliminary affirmation suggests some account of perilla abstract for melancholia allergies. Added analytic trials are appropriate afore recommendations can be made.

Probiotics: Probiotics appearance affiance for abbreviation or preventing atopic dermatitis (eczema) in children. Breed account if their mothers yield probiotics during abundance and breastfeeding. Direct supplementation for breed may abate accident of atopic eczema by as abundant as half. It may aswell abate cow’s milk abhorrence and added allergic reactions during weaning. Probiotics may balance the abdominal barrier action and abatement gastrointestinal affection in accouchement with atopic dermatitis. Accouchement do differ, however, in their admiration to specific probiotics.

Sorrel: There is no reliable animal affirmation evaluating amber monotherapy as a analysis for sinusitis. However, it is an additive independent in aggregate formulas marketed for sinusitis, including Sinupret© (a aggregate artefact including cowslip flower, European elderflower, gentian basis and verbena, which is accessible in Europe) and Quanterra© Sinus Defense (the U.S. agnate of Sinupret©, not bogus back 2000). Although there is able aboriginal affirmation for this blueprint in patients with sinusitis, bigger superior analysis is all-important afore a close cessation can be drawn.

Stinging nettle: For abounding years, a freeze-dried alertness of Urtica dioica has been assigned by physicians and awash over-the-counter for the analysis of allergic rhinitis. Analytic trials demonstrating statistical acceptation over placebo, and/or adequation with added accessible treatments, are bare to abutment the use of annoy in the analysis of allergic rhinitis.

Vitamin E: Although vitamin E is frequently anticipation to advice abate the nasal affection of allergies, it may not be effective. Current affirmation is limited, however, and added studies are bare afore a close cessation can be drawn.

p>AUTHOR INFORMATION

This advice has been edited and peer-reviewed by contributors to the Natural Standard Analysis Collaboration (www.naturalstandard.com).

  • American Academy of Abhorrence Asthma & Immunology. Allergic Conditions: Immunotherapy. http://www.aaaai.org/patients/allergic_conditions/immunotherapy.stm. Accessed March 2, 2007.
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  • MayoClinic.com. Abhorrence shots: Hope for abiding abhorrence relief. http://www.mayoclinic.com/health/allergy-shots/AA00017. Accessed March 2, 2007.
  • Natural Standard: The Authority on Integrative Medicine. http://www.naturalstandard.com. Copyright © 2007. Accessed March 2, 2007.
  • WebMD. Allergies: Abhorrence Shots. http://www.webmd.com/content/article/61/67468. Accessed March 2, 2007.

Copyright © 2011 Natural Standard (www.naturalstandard.com)

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