Immunotherapy to aeroallergens: Revolutionising allergy treatment for a better quality of life

In his latest online article, Professor George Du Toit gives us his insight into immunotherapy. He discusses, the evolution, the benefits, safety and considerations, treatment duration, expectations, allergy management and age considerations.

Understanding immunotherapy: A brief overview

Immunotherapy, often referred to as "allergy vaccination" or "desensitisation," involves the gradual administration of increasing doses of an allergen extract to the patient. The primary goal of this therapy is to reduce the symptoms caused by the allergen exposure, ultimately leading to a decreased sensitivity to the allergen itself. This approach addresses the root cause of allergies, making it distinct from medications that only manage symptoms.

The evolution of immunotherapy: From injections to sublingual administration

Traditionally, immunotherapy required a series of injections (subcutaneous immunotherapy) administered over several years. However, recent advances have introduced a safer and more convenient alternative, sublingual immunotherapy (SLIT). In SLIT, the allergen extract is placed under the tongue using tablets or drops, eliminating the need for injections. This method has proven to be highly effective and well-tolerated by patients, particularly children.

Benefits of sublingual immunotherapy (SLIT)

Sublingual immunotherapy has demonstrated remarkable benefits for patients. Most notably, children undergoing SLIT have reported significant improvements in symptoms related to allergic rhino conjunctivitis, asthma, and eczema. This improvement often becomes evident within the first year of treatment, offering patients rapid relief. Additionally, SLIT has shown potential in preventing the development of new allergies and reducing the risk of additional allergic diseases, such as asthma.

Safety and considerations

Extensive studies involving hundreds of children, some as young as two years old, have affirmed the safety of SLIT. While mild side effects like mouth itchiness and swelling are common, they can be easily managed by taking antihistamines or adjusting the dosage. The infrequency and mild nature of these side effects rarely lead to discontinuation of treatment.

Treatment duration and expectations

The duration of SLIT treatment varies depending on the specific allergen and the patient's clinical history. For pollen allergies, treatment typically starts a few months prior to the onset of symptoms and continues for a total of three years, with cycles of treatment repeated over this period. While significant improvements are often seen in the first year, research suggests that the benefits of treatment persist for years beyond the last course, enhancing long-term relief.

The role of immunotherapy in allergy management

 Immunotherapy stands as a unique treatment that addresses the underlying cause of allergies, setting it apart from symptom-suppressing medications. While not all patients achieve complete remission of their allergies, the majority experience substantial relief. Around 80-85% of patients with hay fever symptoms report significant improvement in the first year of SLIT treatment.

Getting started with sublingual immunotherapy

Sublingual immunotherapy products are available in various forms, such as sprays, droppers, and tablets. Treatment initiation involves the first dose administered under the supervision of a healthcare professional, who provides guidance on proper usage and management of potential side effects.

Age considerations

Children as young as six years old can typically comply with the daily regimen of sublingual immunotherapy. This approach allows even younger patients to benefit from the advantages of SLIT.

Professor George Du Toit is a highly esteemed consultant paediatrician with more than 20 years of experience. You can book an appointment with Professor Du Toit on his Top Doctors profile.