Auckland Allergy & Eczema Clinic

Therapeutic Options in Allergy - Advances in Immunotherapy

Specific Allergen Immunotherapy

Specific Allergen Immunotherapy

Specific allergen immunotherapy is a specialist treatment offered under the expert supervision of our clinic.

Specific allergen immunotherapy is the closest thing we have to a cure for allergy and although it does not work immediately, improvements are usually noticed after 4-5 months. Whilst on the treatment, you can still use your allergy medications and this is particularly important if you take asthma medications.

Specific allergen immunotherapy is available in injection and sublingual (under the tongue) forms.

Immunotherapy injections

Sometimes called allergy shots, allergy vaccine or desensitisation shots. The treatment is delivered through the use of injections containing small amounts of allergen/s given on a schedule over a period of time. The goal is to decrease the body's sensitivity to the allergen/s injected. Allergens are the allergy-causing substances to which the allergic individual reacts. The purpose of allergy (vaccine) shots is to increase tolerance to the specific allergen/s being injected.

To be effective and reduce adverse events, allergy shots are given on an incremental increasing dose schedule. Starter injections are given at increasing doses, after that, they are given about once a month for three to five years. If there are no adverse reactions, the allergen dose is increased each time a shot is given. Gradually the body learns to accept the allergen as the harmless substance it is. As this happens, allergy symptoms should decrease.

The potential for severe side effects (including anaphylactic shock) associated with conventional allergen-specific immunotherapy limits its widespread use & novel strategies or alternative approaches to minimize side effects and improving efficacy are being considered.

Injection immunotherapy was first used in 1900, when ragweed injections were used as therapy for hay fever and has been used for over 100 years. Numerous well-designed, controlled studies prove that allergen immunotherapy is effective in treating allergic rhinitis, allergic asthma, and stinging insect allergy.

Sublingual immunotherapy

Sometimes called allergy tablets, allergy drops or sprays. The treatment is delivered under the tongue at very high doses on a daily basis. As with immunotherapy injections, the goal is to decrease the body's sensitivity to the allergen.

The advantages are fewer doctor visits with home doses being taken after the first treatment. There is a lower chance of serious reactions but it is not yet clear if sublingual immunotherapy is as effective as allergy injections. In Europe, however, this treatment is used more commonly than immunotherapy injections.

The costs of this therapy are more than that of injection immunotherapy as more allergen needs to be swallowed than injected. This additional cost should be weighed against the savings of fewer doctors visits and may be preferred in younger children as it does not involve regular injections.

Sublingual immunotherapy is not available for insect allergy.

Oral immunotherapy (desensitisation) in food allergy

Current figures show that up to 5% of children and ~2% of adults suffers from food allergy. In the USA approximately 150 people die from food anaphylaxis each year. Currently avoidance is the only recommendation to provide to these patients. Recognition of the potential hazards of food hypersensitivity has prompted allergists to seek for effective treatments of this condition already decades ago.

Oral desensitisation’s to foods have been reported in numerous limited trials but with various results. Whilst food allergen desensitisation research is growing, food allergen immunotherapy remains the subject of studies and is not ready for general clinical use.