Auckland Allergy Clinic ? Whats New January 2004

Welcome to the Auckland Allergy Clinic web site. This section will bring you the latest breaking news in Allergy & Clinical Immunology and also additions we have made to the Clinic in the last month.

The Allergy News information provided on this web site is reviewed and approved by the Allergists at the Auckland Allergy Clinic. The information is sourced from International Medical Journals and Newspapers. These articles are chosen either because they are thought to be particularly good studies, very interesting Allergy News or relevant to New Zealand. The articles may not necessarily be the views of the editor. Where relevant the editor will add his/her comments at the bottom of the review.

These updates are provided for educational, communication and information purposes only.

Previous Newsletters:

Therapeutic Options in Allergy ? Advances in Immunotherapy

Vincent St Aubyn Crump ? January 2004

The prevalence of allergic diseases such as asthma and allergic rhinitis has substantially increased over the past few decades, and despite the introduction of increasingly potent and effective anti-symptomatic drugs we have been unable to halt the increasing prevalence or find a cure for these diseases. There is therefore a definite need for new disease-modifying treatments that will prevent or reverse the chronic allergic inflammation.

Specific Allergen Immunotherapy

Immunotherapy sometimes called allergy vaccine, desensitisation shots, or hyposensitization shots 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. Typically allergy shots are given once or twice a week for about three to six months. 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.

Specific allergen immunotherapy was first used in 1900, when ragweed injections were proposed as therapy for hay fever. Advances in allergen immunotherapy have depended on the improved understanding of IgE-mediated immunologic mechanisms, the characterisation of specific allergens, and the standardisation of allergen extracts. Numerous well-designed, controlled studies prove that allergen immunotherapy is efficacious in treating allergic rhinitis, allergic asthma, and stinging insect hypersensitivity.

The article also discusses:

" Role for anti-IgE in combination with specific allergen immunotherapy
" Oral immunotherapy (desensitisation) in food allergy
" Immunotherapy with genetically engineered reagents
" Immunotherapy with mycobacteria