Injection Immunotherapy Research Articles

Poster 2021: The incidence of adverse reactions induced by subcutaneous immunotherapy in an allergy center in Monterrey, México: a retrospective chart review

Results A total of 8069 subcutaneous immunotherapy injections were applied between November 2012 to June 2013. Among them, 1071 local reactions (LR) were observed (13.2%). Of the total of LR, 1067 were considered small local reactions (Local reaction no larger than the size of the palm of the patient’s hand [ 80– 100 mm]) (0.4%). 32 systemic reactions (0.4%) were observed. These SR included respiratory symptoms and cutaneous symptoms. We used the World Allergy Organization Subcutaneous Immunotherapy Systemic Reaction Grading System to classify the SR. 27 SR were classified as grade 1 (84.3%). 3 SR were classified as grade 2 (9.3%), characterized by respiratory symptoms (cough, wheezing) and responded to an inhaled bronchodilator. 2 SR were classified as grade 3 (6.4%) characterized by respiratory symptoms (cough, wheezing, shortness of breath) and did not respond to inhaled bronchodilator and required epinephrine treatment (0.02% of total injections). Neither grade IV nor V systemic reactions were observed.

Allergy education in otolaryngology residency: a survey of program directors and residents

The purpose of this study was to survey program directors of the accredited otolaryngology residency programs and resident attendees of the 2013 American Academy of Otolaryngic Allergy (AAOA) Basic/MOC Course regarding resident education and participation as well as assessment of competency in otolaryngic allergy and immunotherapy. A multiple-choice questionnaire was sent to all accredited otolaryngology residency training programs in the United States as part of resident attendance at the 2013 AAOA CORE Basic/MOC Course. Following this, a similar multiple-choice survey was sent to all resident attendees from the programs that responded positively. Program directors reported that 73% of their academic institutions offer allergy testing and immunotherapy. More PDs than residents indicated that residents participate in allergy practice and perform/interpret skin testing and in vitro testing, and more residents (85%) than program directors (63%) reported inadequate or no allergy training. Program directors and residents equally indicated that residents do not calculate immunotherapy vial formulations or administer immunotherapy injections. The majority of program directors indicated that resident competency in allergy was assessed through direct observation, whereas residents more commonly perceived that no assessment of competency was being performed for any portion of allergy practice. This survey demonstrates a discrepancy between program directors and residents regarding resident involvement and adequacy of training in the allergy practice. Although the majority of otolaryngology residencies report offering otolaryngic allergy services and education, the vast majority of residents report inadequate allergy training and less participation in an allergy practice compared to the majority of program directors.

Allergen immunotherapy for allergic rhinitis

Allergic rhinitis, a risk factor for bronchial asthma, is a global health problem that impairs patients` physical and social activity and consequently their quality of life. Specific Immunotherapy (SIT) involves the administration, subcutaneously or sublingually, of increasing doses of the causative allergen, in order to induce clinical and immunologic tolerance. SIT has been shown to be effective in those with a poor response to conventional drug therapy. Immunotherapy has been shown to have disease-modifying effects and result in long term remission of allergic symptoms and reduces the risk of progression from rhinitis to asthma, as well as the chances of developing new sensitizations to allergens. Injection immunotherapy is a safe treatment for allergic rhinitis with/without mild controlled asthma, provided that it is performed in the context of a harmonious interaction between trained medical personnel and appropriately selected patients. Immunotherapy suppresses early and late responses to allergen exposure by modifying both T-cell and B-cell responses to inhaled allergens. Immune deviation of allergen-specific T cell responses in favour of Th1 and/or the induction of regulatory T cells is crucial in achieving immune tolerance. Increased understanding of the mechanisms of immunotherapy has identified potential biomarkers of the response to treatment and highlighted new therapeutic pathways with potential for even more effective future standardized vaccines.

Sublingual Immunotherapy for the Treatment of Allergic Rhinoconjunctivitis and Asthma

Allergic rhinitis affects up to 40% of the US population. To desensitize allergic individuals, subcutaneous injection immunotherapy or sublingual immunotherapy may be administered. In the United States, sublingual immunotherapy is not approved by the Food and Drug Administration. However, some US physicians use aqueous allergens, off-label, for sublingual desensitization. To systematically review the effectiveness and safety of aqueous sublingual immunotherapy for allergic rhinoconjunctivitis and asthma. The databases of MEDLINE, EMBASE, LILACS, and the Cochrane Central Register of Controlled Trials were searched through December 22, 2012. English-language randomized controlled trials were included if they compared sublingual immunotherapy with placebo, pharmacotherapy, or other sublingual immunotherapy regimens and reported clinical outcomes. Studies of sublingual immunotherapy that are unavailable in the United States and for which a related immunotherapy is unavailable in the United States were excluded. Paired reviewers selected articles and extracted the data. The strength of the evidence for each comparison and outcome was graded based on the risk of bias (scored on allocation, concealment of intervention, incomplete data, sponsor company involvement, and other bias), consistency, magnitude of effect, and the directness of the evidence. Sixty-three studies with 5131 participants met the inclusion criteria. Participants' ages ranged from 4 to 74 years. Twenty studies (n = 1814 patients) enrolled only children. The risk of bias was medium in 43 studies (68%). Strong evidence supports that sublingual immunotherapy improves asthma symptoms, with 8 of 13 studies reporting greater than 40% improvement vs the comparator. Moderate evidence supports that sublingual immunotherapy use decreases rhinitis or rhinoconjunctivitis symptoms, with 9 of 36 studies demonstrating greater than 40% improvement vs the comparator. Medication use for asthma and allergies decreased by more than 40% in 16 of 41 studies of sublingual immunotherapy with moderate grade evidence. Moderate evidence supports that sublingual immunotherapy improves conjunctivitis symptoms (13 studies), combined symptom and medication scores (20 studies), and disease-specific quality of life (8 studies). Local reactions were frequent, but anaphylaxis was not reported. The overall evidence provides a moderate grade level of evidence to support the effectiveness of sublingual immunotherapy for the treatment of allergic rhinitis and asthma, but high-quality studies are still needed to answer questions regarding optimal dosing strategies. There were limitations in the standardization of adverse events reporting, but no life-threatening adverse events were noted in this review.

Using an Established Root Cause Analysis Framework to Evaluate an Unusual Allergen Immunotherapy Error

RationaleA standardized root cause analysis (RCA) process can reveal the causes of immunotherapy errors.MethodsWe used the Joint Commission's published online “Framework for Conducting a RCA and Action Plan” tool to examine an unusual immunotherapy error that occurred at one of our immunotherapy mail out sites.ResultsA patient receiving immunotherapy at a mail-out site received 1000x the prescribed dose on two separate occasions and developed a systemic reaction to the second administration. The RCA entailed an in depth study in the following domains: human, equipment, controllable environmental, uncontrollable external, and other. The RCA identified potential sources of error in 4 out of the 5 domains. The RCA revealed that the most proximate source of error was that the nurse administered the wrong dose on two occasions by misreading written instructions. Further, the RCA revealed that for the human domain (new nurse unfamiliar with immunotherapy, nurse reluctant to call prescribing provider, and two additional nurses failed to identify the wrong doses), the equipment domain (written immunotherapy instructions confusing), the controllable environmental domain (no allergy immunotherapy training), and the uncontrollable external (low volume immunotherapy injections administered, 4-6 different sets of immunotherapy instructions) were likely contributing factors. As a result of the RCA, we implemented 4 major immunotherapy practice improvements in 4 domains.ConclusionsA formal RCA provided an effective framework for analysis and correction of immunotherapy errors. RationaleA standardized root cause analysis (RCA) process can reveal the causes of immunotherapy errors. A standardized root cause analysis (RCA) process can reveal the causes of immunotherapy errors. MethodsWe used the Joint Commission's published online “Framework for Conducting a RCA and Action Plan” tool to examine an unusual immunotherapy error that occurred at one of our immunotherapy mail out sites. We used the Joint Commission's published online “Framework for Conducting a RCA and Action Plan” tool to examine an unusual immunotherapy error that occurred at one of our immunotherapy mail out sites. ResultsA patient receiving immunotherapy at a mail-out site received 1000x the prescribed dose on two separate occasions and developed a systemic reaction to the second administration. The RCA entailed an in depth study in the following domains: human, equipment, controllable environmental, uncontrollable external, and other. The RCA identified potential sources of error in 4 out of the 5 domains. The RCA revealed that the most proximate source of error was that the nurse administered the wrong dose on two occasions by misreading written instructions. Further, the RCA revealed that for the human domain (new nurse unfamiliar with immunotherapy, nurse reluctant to call prescribing provider, and two additional nurses failed to identify the wrong doses), the equipment domain (written immunotherapy instructions confusing), the controllable environmental domain (no allergy immunotherapy training), and the uncontrollable external (low volume immunotherapy injections administered, 4-6 different sets of immunotherapy instructions) were likely contributing factors. As a result of the RCA, we implemented 4 major immunotherapy practice improvements in 4 domains. A patient receiving immunotherapy at a mail-out site received 1000x the prescribed dose on two separate occasions and developed a systemic reaction to the second administration. The RCA entailed an in depth study in the following domains: human, equipment, controllable environmental, uncontrollable external, and other. The RCA identified potential sources of error in 4 out of the 5 domains. The RCA revealed that the most proximate source of error was that the nurse administered the wrong dose on two occasions by misreading written instructions. Further, the RCA revealed that for the human domain (new nurse unfamiliar with immunotherapy, nurse reluctant to call prescribing provider, and two additional nurses failed to identify the wrong doses), the equipment domain (written immunotherapy instructions confusing), the controllable environmental domain (no allergy immunotherapy training), and the uncontrollable external (low volume immunotherapy injections administered, 4-6 different sets of immunotherapy instructions) were likely contributing factors. As a result of the RCA, we implemented 4 major immunotherapy practice improvements in 4 domains. ConclusionsA formal RCA provided an effective framework for analysis and correction of immunotherapy errors. A formal RCA provided an effective framework for analysis and correction of immunotherapy errors.

Immunotherapy – 2074. Tolerability of sublingual immunotherapy with tropical mite allergen vaccines using different dosing schedules in asthmatic children

Background Immunotherapy with mite allergens is effective both in rhinitis and asthma. However, injection immunotherapy carries a high risk of systemic adverse events, so, the sublingual route (SLIT) is being used more frequently. Efficacy of SLIT in asthma has been widely studied, however, in Cuba, the therapeutic effect of mite vaccines of Dermatophagoides pteronyssinus (Dp), D.siboney (Ds) and Blomia tropicalis(Bt) has been demonstrated only in adults, but not children. This aim is to determinate adherence and tolerability of SLIT with mite allergen vaccines using different treatment schedules in asthmatic children.

A 5-year study of systemic reactions using both shared and patient-specific vaccines.

The safety of shared specific vaccines (SSVs) has been questioned by some experts. The purpose of this study was to evaluate the safety of SSVs. Details of systemic allergic reactions after subcutaneous immunotherapy injections were captured on a standardized form from July 2005 to July 2010. Patient records were evaluated for factors that might be associated with increased rate of systemic reactions and, in addition, were examined for any errors. Systemic reaction rates (SRRs) using a combination of shared and patient-specific vaccines (PSVs) were similar to previously reported studies (0.23 reactions per 100 shots). There were no systemic reactions resulting from errors where the incorrect shared allergen was administered, but we did note one reaction after an erroneously administered PSV. There were two dosage errors associated with both shared and patient-specific immunotherapy. Most reactions were mild to moderate (World Allergy Organization grade, 1 or 2). Severe reactions with 911 activations were noted in six patients. Thirty percent of reactions occurred out of the office and the average time to reaction was 48 minutes. Epinephrine was administered in only 60% of patients. Epicutaneous reactivity to mites, cats, dogs, and pollen but not mold occurred significantly more in reactors. Differences in SRRs were encountered between satellite offices. Using a combination of SSV and PSV, SRRs were similar to previously reported studies; moreover, no systemic reactions occurred where a SSV was erroneously administered. SRR surveillance is a useful safety tool.

Fear of repeated injections in children younger than 4 years receiving subcutaneous allergy immunotherapy

BackgroundAllergy immunotherapy during early childhood may have potential benefits for the prevention of asthma and allergy morbidity. However, subcutaneous immunotherapy has not yet been prospectively researched in children younger than 4 years, primarily because of safety concerns, including the fear and psychological distress young children may experience with repeated needle injections. ObjectiveTo quantify fear in atopic children younger than 4 years with a history of wheezing who are receiving subcutaneous immunotherapy. MethodsFear of injection was graded during a total of 788 immunotherapy injection visits in 18 children (age, 37 months; SD, 9 months) receiving subcutaneous allergy immunotherapy. The parent and the injection nurse assigned fear scores on a scale of 0 to 10 after each injection visit. ResultsAt the time of analysis, children had a median of 49 injection visits (range, 12-88) during a median study period of 81.5 weeks (range, 15-165 weeks). Fifteen children (83%) lost their fear of injections during the study. A fear score of 0 was achieved after a mean of 8.4 visits (SD, 7.4). The more injection visits were missed, the more likely children were to retain fear of injections (hazard ratio, 0.13; 95% confidence interval, 0.02-1.02; P=.05). Age, adverse events, number of injections at each visit, and change of injection personnel were not associated with increased fear. ConclusionOur analysis suggests that most children receiving weekly subcutaneous immunotherapy lose their fear of injections during the treatment course. Children with increased intervals between visits may be at higher risk of experiencing fear of injections. Clinical Trial Registrationclinicaltrial.gov identifier NCT01028560

Measured depth of subcutaneous tissue on posterolateral arm of aeroallergen immunotherapy patients

Background Subcutaneous immunotherapy (SIT) injections for aeroallergens are often utilized in patients. SIT should be injected into the subcutaneous space in the mid-posterolateral upper arm. If the injections are given intramuscularly (IM), there may be an increased risk of anaphylaxis. In our allergy clinic, SIT is given with BD Safety Glide™ Allergy syringes with needle length 13mm. There is a risk of the SIT being injected IM if patients have a skin to muscle depth (STMD) less than 13mm. Methods Charts were reviewed in an allergy clinic for patients on SIT where an ultrasound of the left posterolateral arm was done to measure STMD. Baseline characteristics of the two groups of patients with STMD greater than, and less than or equal to 13mm were compared. The proportions of patients with STMD greater than 4mm, 6mm, 8mm, and 10mm were calculated. Multivariable logistic regression was performed with age, sex, BMI and race. Results Ultrasounds had been completed on 186 patients on SIT. There were 149 (80%) with STMD less than 13mm. Baseline characteristics including age, sex and BMI differed among the two groups (p < 0.05). Based on the logistic regression analysis, BMI was significantly associated with STMD. There were 168 (90%) patients with more than 4mm STMD. Conclusions With standard allergy syringes, most patients on SIT are at risk of receiving the injections IM. A needle length of 4mm would significantly decrease the risk of SIT being given IM.

Selective Activation of Oxygen-Deprived Tumor-Infiltrating Lymphocytes through Local Intratumoral Delivery of CD137 Monoclonal Antibodies

Hypoxia-inducing transcription factor-1α (HIF-1α) in hypoxic tumors induces the TNF receptor family member CD137 on tumor-infiltrating lymphocytes. This can be exploited for intratumoral low-dose injection of effective systemic immunotherapy with agonist CD137-specific monoclonal antibodies that induce circulation of systemic tumor-specific effector T cells capable of eradicating distant metastases.

Requirements for acquiring a high-quality house dust mite extract for allergen immunotherapy

The house dust mite is a major cause of respiratory allergy worldwide. The management of mite allergy is based on avoidance measures, drug treatment, and allergen immunotherapy, but only allergen immunotherapy is able to modify the natural history of the disease. Injectable subcutaneous immunotherapy was introduced a century ago, while sublingual immunotherapy was proposed in the 1980s and emerged in the ensuing years as an effective and safe option to subcutaneous immunotherapy. However, the quality of the extracts to be used in allergen immunotherapy is crucial for the success of treatment. The mite extract for sublingual immunotherapy known as Staloral 300 was developed to offer optimal characteristics concerning the mite culture medium, standardization, and allergen dose. Double-blind, placebo-controlled trials with Staloral 300 have provided a substantial part of the clinical evidence analyzed in a meta-analysis of the efficacy of allergen immunotherapy in mite-induced rhinitis and asthma. Safety and tolerability are very good, mild local reactions in the mouth being the most common side effect. This makes it feasible to carry out sublingual immunotherapy for the 3-5-year duration needed to achieve long-lasting tolerance to the specific allergen. The performance of Staloral 300 may provide optimal conditions for an effective and safe sublingual immunotherapy in patients with mite-induced respiratory allergy.

11 Efficacy and Tolerability of HDM Injective Immunotherapy With Monomeric Allergoid

BackgroundSubcutaneous immunotherapy (SCIT) is an effective treatment of respiratory allergy and carbamylated monomeric allergoids (monoids), by virtue of their reduced IgE-binding activity, resulted clinically safe by sublingual administration. Purpose of this study was to investigate the efficacy and tolerability of immunotherapy with house dust mites (HDM) monoid administered by injective route in patients with allergic rhinoconjunctivitis (AR).MethodsA preparation of 0.70 mL of 10 BU/mL containing modified extract with 50% Dermatophagoides pteronyssinus and 50% Dermatophagoides farinae (amount of major allergen: 4 μg of group 1 per milliliter) was delivered monthly for 12 months, following a 5-week build-up induction phase (0.10–0.20–0.30–0.50–0.70 mL), to 58 patients (60% males, mean age 25.1 ± 12.7) suffering from AR due to mites for at least 2 years, whereas 60 patients with similar baseline characteristics were observed as controls. All patients were allowed to assume traditional drug therapy for their condition. At the end of the study changes from baseline in symptoms scores, in number of days with drug assumption, in severity of AR (according to ARIA classification) were compared between the 2 groups; moreover an overall assessment of clinical efficacy and tolerability was based on patients' and physicians' judgements (unsatisfactory, mild, good, optimal).ResultsIn respect to baseline both groups showed, after 1 year, an improvement in symptoms score (P < 0.001) with a significant difference in favour of SCIT group (P < 0.05). Days of drug intake were significantly lower in patients receiving SCIT (P < 0.05). The number of patients with severe AR decreased in the first group while no variation was observed in controls. The subjective clinical overall assessment was optimal in 31 cases and good in 24 according to physicians' and patients' judgements; similarly 38 patients judged tolerability as optimal and 18 as good, whereas according to physicians it was optimal in 37 patients and good in 19; in only 1 patient the treatment was considered unsatisfactory.ConclusionsIn this prospective controlled study, SCIT with HDM carbamylated allergoid was associated with a significant clinical benefit observed through objective and subjective outcomes; the traditional safety of monomeric allergoids was confirmed by the subjective judgements of tolerability.

Advances in the management of alopecia areata

Spontaneous remission occurs in up to 80% of patients with limited patchy alopecia areata (AA) within 1 year. Therefore, not all patients of AA simplex/multiplex need extensive treatments, and "wait and see" is one of the choices for some patients. However, once the hair loss show progressive course, it is really difficult to manage well and may be recalcitrant to any treatment in some cases. Hair loss symptom is not life-threatening but severely decreases quality of life. There have been two widely known guidelines for AA from the British Association of Dermatologists and the National Alopecia Areata Foundation (USA). These guidelines have been substantial and provide clues for dermatologists but needed to be updated. Recently, the Japanese Dermatological Association also published a guideline for the management of AA. This guideline suggests treatments followed by recommendations and evidence levels. Several new treatments are added such as corticosteroid pulse therapy and antihistamine drugs in addition to Japanese historical therapies. Although the highly recommended therapies are still contact immunotherapy and local injection of corticosteroid, it may result in improvement of AA by use of appropriate treatments decided by age, hair loss type, disease course and desire of the AA patient.

Antibacterial properties of additives used in injection immunotherapy

Previous studies have reviewed the safety of preparing and administering allergy injection immunotherapy in a physician's office, and showed no evidence of infectious complications. The current study examines the antimicrobial properties of the common additives used in preparation of multidose immunotherapy vials. Vials were prepared with varying concentrations of glycerin (0-25%), phenol (0-0.4%) and combinations of glycerin with phenol. A standard inoculum of Staphylococcus aureus was introduced in each vial and incubated. Optical densities were measured and colony counts were performed at 24 and 48 hours. Follow-up broth microdilution assays were performed using varying inocula of bacteria and the highest concentrations of additives to determine the number of bacteria for which these solutions were bacteriostatic and/or bactericidal. Optical densities were measured and colony counts were performed as in the vial assays. All vials with varying dilutions of glycerin, phenol, and their combination showed bacterial growth with the standard inoculum of Staphylococcus aureus. Visible turbidity and optical density were inversely related to additive concentration. Follow-up microdilution assays with differing concentrations of bacteria demonstrated bactericidal activity with inocula of 1 × 10(3) colony forming units (CFU) of Staphylococcus aureus at clinically used concentrations of glycerin and phenol. Higher concentrations of additives show better inhibition of bacterial growth. Solutions containing glycerin showed superior bactericidal activity than those containing only phenol. At concentrations of additives used in preparing allergy immunotherapy vials, antibacterial effects were observed with inoculation of 1 × 10(3) CFU or less of Staphylococcus aureus.

Current practices among allergists on writing self-injectable epinephrine prescriptions for immunotherapy patients

Current practices among allergists on writing self-injectable epinephrine prescriptions for immunotherapy patients

Immediate and delayed-onset systemic reactions after subcutaneous immunotherapy injections: ACAAI/AAAAI surveillance study of subcutaneous immunotherapy–year 2

Incidences of subcutaneous immunotherapy (SCIT) related systemic reactions (SRs) and fatal reactions (FRs) are not well defined, nor are delayed-onset SRs and their treatment. To estimate SCIT-related SRs/FRs, and the incidence and treatment of delayed-onset SRs. In 2008 and 2009, American Academy of Allergy, Asthma & Immunology (AAAAI) and American College of Allergy Asthma & Immunology (ACAAI) members completed a survey about SCIT-related SR severity (grade 1 = mild; grade 2 = moderate; grade 3 = severe anaphylaxis). In 2009, members reported the time of onset and use of epinephrine (EPI), with early onset defined as beginning ≤30 minutes, and delayed onset beginning more than 30 minutes after injections. As in year 1, no FRs were reported during year 2 (630 total practices responded). Among 267 practices providing data on the timing of SRs, 1,816 early-onset SRs (86%) and 289 (14%) delayed-onset SRs were reported. Fifteen percent (226/1,519) of grade 1, 10% (54/538) of grade 2, and 12.5% (9/72) of grade 3 SRs were delayed-onset. Among early-onset SRs, EPI was given for 71% of grade 1, 93% of grade 2, and 94% of grade 3s. Among delayed-onset SRs, EPI was given for 56% of grade 1, 67% of grade 2, and 100% of grade 3s (P = .0008 for difference in EPI administration based on severity; P = .07 based on time of onset). Delayed-onset SRs are less frequent than previously reported. Epinephrine was given less frequently for grades 1 and 2 (but not grade 3) delayed-onset SRs compared with early-onset SRs. Further study of prescribing self-injectable EPI for SCIT patients in the event of delayed-onset SRs may be warranted.

Recombinant allergen-based monitoring of antibody responses during injection grass pollen immunotherapy and after 5 years of discontinuation

Subcutaneous injection immunotherapy (SCIT) is considered as antigen-specific and disease-modifying treatment with long-lasting effect. We used a panel of recombinant grass pollen allergens for analyzing allergen-specific IgE, IgG(1) -IgG(4) , IgM, IgA, and light-chain (kappa, lambda) responses in grass pollen-allergic patients who had received one course of injection immunotherapy (SCIT) with an aluminum hydroxide-adsorbed grass pollen extract or only anti-inflammatory treatment. Serum samples were analyzed before and after 5 months of treatment as well as after 5 years. After 5 months of SCIT but not of anti-inflammatory treatment, IgG(1) > IgG(4) > IgG(2) > IgA antibody responses using both kappa and lambda light chains specific for major grass pollen allergens (Phl p 1, Phl p 5, Phl p 6, Phl p 2) increased significantly, whereas specific IgM or IgG(3) levels were unaltered. Allergen-dependent basophil degranulation was only inhibited with SCIT sera containing therapy-induced allergen-specific IgG antibodies. Likewise, decreases in Phl p 1- and Phl p 5-specific IgE levels and significant (P<0.001) reduction in symptom and medication scores were found only in the SCIT group but not in the group of patients receiving anti-inflammatory treatment. After 5 years, allergen-specific IgG antibody levels in the SCIT group had returned to baseline levels and there was no significant difference regarding symptoms between the SCIT and non-SCIT groups. The results from our observational study demonstrate that only SCIT but not anti-inflammatory treatment induces allergen-specific IgG and reduces boosts of allergen-specific IgE production but that one SCIT course was not sufficient to achieve long-term immunological and clinical effects.

Will We Be Able to Desensitize Food Allergies by Either Injection or Oral Immunotherapy?

Will We Be Able to Desensitize Food Allergies by Either Injection or Oral Immunotherapy?

Skin Prick Testing and Immunotherapy in Nasobronchial Allergy: Our Experience

In the present study of 331 patients suffering from signs/symptoms of nasal allergy, 9 nasal polyps, allergic conjunctivitis and allergic asthma, who were referred by clinician, were taken up for diagnosis of allergy with skin prick test (Ten et al. Mayo Clin Proc 70(8):783-784, 1995) and subjective improvement of patients by immunotherapy. Out of 331 patients tested 321 patients showed significant positive results and rest of them tested negative for allergy. High incidences of positive results were noted in third and fourth decade age of patients. Dust and pollen allergens were positive in most of the patients compare to insect's antigens. Among the pollen antigens tested, those of Parthenium hysterophorus was found to be the most common (30%) followed by Prosopis julifora (25%). 75.22% patients were positive to house dust, 19.33% patients were positive to Aspergillusmoulds. D. farinae was the most common offender amongst the mites. Patients who attended, allergy clinic in Kamineni Hospitals during the last 4years were referral patients, who had been on prolonged treatment without much relief. Immunotherapy was advised to patients who were having perineal allergy, in whom, medical treatment had become only palliative. Immunotherapy injections were administered subcutaneously, and their results were monitored.

AAAAI/ACAAI Surveillance Study of Subcutaneous Immunotherapy (SCIT) injections (Year 2): Time of Onset and Treatment of Systemic Reactions (SRs)

AAAAI/ACAAI Surveillance Study of Subcutaneous Immunotherapy (SCIT) injections (Year 2): Time of Onset and Treatment of Systemic Reactions (SRs)