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Immunotherapy

Immunotherapy is a preventive treatment for allergic reactions to substances such as house dust mites and animal dander. This form of therapy involves giving gradually increasing doses of the substance (i.e. allergen) to which the person is allergic. The incremental doses of the allergen cause the immune system to become less sensitive to the substance, probably by causing production of a “blocking” antibody, which reduces the symptoms of allergy when the substance is encountered in the future. (American College of Allergy, 2023)

Allergen specific immunotherapy is now recognized as an allergic disease modifying treatment. Studies have shown that allergen specific immunotherapy (AIT) can prevent new allergic sensitization, reduce medication use in allergic respiratory disease and prevent the development of asthma in patients suffering from allergic rhinitis. It works by reducing the inflammation that characterizes rhinitis and asthma, thus improving allergy symptoms and quality of life in the long term.

Before starting treatment, the doctor and patient identify trigger factors for allergy symptoms. Blood tests are performed to determine / confirm the specific allergens to which the person has IgE antibodies. Immunotherapy is usually recommended only if the person seems to be selectively sensitive to several allergens. (American College of Allergy, 2023)

Allergy immunotherapy: Who, what, when … and how safe?

Current form of immunotherapy available here at DTAP clinic is sublingual immunotherapy. This means that a tablet is placed under the tongue during treatment. The AIT tablet contains the house dust mite extract that patients are allergic to. So, some side effects (particularly in the mouth / throat) can be expected during treatment.

Indications for sublingual immunotherapy:

  • Ages 2 – 65 years old
  • Persistent moderate to severe allergic rhinitis
  • Allergic rhinitis with atopic dermatitis (eczema)
  • Allergic asthma with good lung function

Contraindications:

  • Recent episodes of airway narrowing
  • History of a severe, potentially life-threatening allergic reaction
  • Acute flare-up of bronchial asthma (within the last 3 months)
  • History of hypersensitivity
  • Allergic asthma with poor lung function
  • Acute respiratory infection (treatment should be postponed)
  • Active or poorly controlled autoimmune diseases, immune defects, immunodeficiencies, immunosuppression, malignant cancers
  • Acute severe oral inflammation or oral wounds
  • Pregnancy, lactation and fertility challenges

Method of administration:

  1. The tablet is placed under the tongue (sublingual)
  2. Kept under the tongue for 1 minute (do not swallow)
  3. No food or beverages for 30 minutes
  4. Once a day therapy for 3 years

At least 8 – 14 weeks will pass before there is an improvement in symptoms, and you will continue to see benefits over time. Please make an appointment to consult a doctor here who can best advise you on this life-changing form of therapy for allergy sufferers.

References:

Woo, K., 2021. Sublingual immunotherapy with allergen specific immunotherapy tablet. Medical Journal of Malaysia, pp.1-1. (American College of Allergy, 2023)

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