Abstract
Allergen immunotherapy (AIT) is a specific treatment involving the administration of relevant allergens to allergic patients, with subtypes including subcutaneous immunotherapy (SCIT) and sublingual immunotherapy (SLIT). In asthma, AIT using the house dust mite (HDM) alleviates clinical symptoms and decreases airway hyper responsiveness and medication dose. In addition, AIT can improve the natural course of asthma. For example, the effects of AIT can be preserved for at least a few years, even after ending treatment. AIT may increase the remission rate of asthma in children and suppress sensitization to new allergens. If AIT is introduced in pollinosis, AIT may prevent the development of asthma. Moreover, AIT can control other allergic diseases complicated by asthma, such as allergic rhinitis, which also improves the control of asthma. The indication of HDM-SCIT for asthma is mild-to-moderate HDM-sensitized allergic asthma in a patient with normal respiratory function. To date, HDM-SLIT is applicable in Japan for allergic rhinitis, not for asthma. However, the effect of SLIT on asthma has been confirmed internationally, and SLIT is available for asthma in Japan if allergic rhinitis is present as a complication.
Highlights
Allergen immunotherapy (AIT) is a treatment involving the administration of increasing doses of clinically relevant allergens to patients who have allergic disease [1]
The effect of sublingual immunotherapy (SLIT) on asthma has been confirmed internationally, and SLIT is available for asthma in Japan if allergic rhinitis is present as a complication
inhaled corticosteroid (ICS) is ineffective for allergic rhinitis, which is often encountered as a complication in asthmatics
Summary
Allergen immunotherapy (AIT) is a treatment involving the administration of increasing doses of clinically relevant allergens to patients who have allergic disease [1]. The effect of AIT has been clinically confirmed in the cases of allergic asthma, allergic rhinitis, and hymenoptera hypersensitivity [1,2]. We reported that adding HDM-SCIT, introduced using rush methods, to the guideline treatment decreased the ICS dose and improved the treatment step of bronchial asthma with the inhibition of HDM-induced interleukin (IL)-5 and IL-13 production from peripheral blood mononuclear cells (PBMCs) (Figure 1) [8]. AIT acts to suppress sensitization to new allergens, maintain effects for at least a few years even after treatment is discontinued, and control other allergic diseases such as allergic rhinitis, which is often seen as a complication in asthma. In rush SCIT, the maintenance dose is reached by performing injections several times daily intensively within several days [23,24,25], and immediate effects can be expected
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