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Topic of the Month: February 2005:
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 In this month's topic you will learn: |
During the colder months of the year seasonal allergy sufferers might find some relief from watery eyes and runny noses. However, peak allergy season is right around the corner and now is the time to begin immunotherapy treatments.
Allergen immunotherapy is a form of treatment aimed at decreasing your sensitivity to substances called allergens. Allergens such as pollen and cat dander trigger your allergy symptoms when you are exposed to them. These allergens are identified by allergy testing. Immunotherapy has been shown to prevent the development of new allergies and, in children, it can prevent the progression of allergic rhinitis to asthma.
To help patients better understand the importance and benefits of starting immunotherapy, Linda Cox, MD, a Fellow of the American Academy of Allergy, Asthma & Immunology and chair of the Immunotherapy and Allergy Diagnostics Committee, offers the following information regarding immunotherapy treatment:
When is the best time for allergy sufferers to begin their immunotherapy treatments?
As a general rule it is probably not a good idea to begin immunotherapy during the peak of the allergy season, particularly if the individual becomes very symptomatic during their season.
Symptomatic allergies are one of the risk factors for immunotherapy, which means this person would be at a greater risk for having a reaction to their allergy injection when they had increased allergy or asthma symptoms. Preferably, immunotherapy should be started at a time of year when the allergic individual has minimal symptoms.
However, many individuals have perennial symptoms (year round) because they have allergies to pets or dust mites. In these situations, immunotherapy should be started after the allergy/asthma symptoms have been stabilized with appropriate medications. Individuals with poorly controlled asthma/allergies should not begin immunotherapy until their disease has become stable.
What are benefits of immunotherapy?
Immunotherapy is currently the only medical intervention that could potentially modify/change the allergic disease.
Unlike medications, immunotherapy may provide long-term relief of allergy symptoms even years after the person has discontinued the allergy injections. Medications, on the other hand, may work well to control symptoms but once the medication is discontinued, the allergy symptoms shortly return.
The benefits of immunotherapy have been demonstrated both in allergic rhinitis and asthma and include reduced need for medication and improved symptoms. Improved lung function has also been demonstrated in asthmatics. Immunotherapy has been shown to be highly effective in preventing serious life-threatening reactions in individuals who have wasp/bee/hornet/yellow jacket and fire ant allergic reactions. Immunotherapy also may prevent the development of asthma in children who only have allergic rhinitis and there is some evidence immunotherapy may prevent the development of new allergies.
Why is immunotherapy effective?
Immunotherapy involves injecting small amounts of the allergen(s) causing the allergy problem, i.e, ragweed or dust mites. Immunotherapy works by changing the way the immune system responds to the allergen(s) which results in tolerance to the allergen. Some individuals may experience a long-term remission after a treatment course of immunotherapy.
Why is an allergist/immunologist the preferred specialist to see regarding immunotherapy?
Board certified allergists have extensive training in allergy and immunology because they have completed a specialized two to three year training program/fellowship focused on the diagnosis and treatment of allergic diseases. Through this advanced training the board certified allergist has the knowledge, experience and expertise to diagnose and treat allergic conditions. Physicians who have not undergone allergy and immunology specialty training may not be as proficient in the diagnosis or treatment of allergy conditions. The allergist/immunologist is more likely to have a greater knowledge of the safety issues regarding immunotherapy and staff who have a greater expertise in the treatment of allergic condition and allergy immunotherapy injection reactions.
What are some tips or precautions an allergy sufferer can take to prepare themselves for the allergy season?
Allergy sufferers should begin their allergy medications at least two weeks before their anticipated season and continue the medications throughout the season. If they wait until symptoms begin to take their medications it may take a longer period time and more medications to get their allergy symptoms under control. I also recommend that asthmatics receive the influenza vaccine every fall because influenza/flu may aggravate their asthma. Changes in immunotherapy regimen are sometimes made in individuals who become very symptomatic during their season and these changes may include dosage modifications or increasing the frequency of the immunotherapy injections.
Additional Resources:
Tips to Remember: What are "Allergy Shots?" Quiz: How much do you know about Allergen Immunotherapy? Allergy & Asthma Advocate: Spring 2004: Immunotherapy: Decreasing sensitivity to allergy symptoms Tips to Remember" Role of an Allergist Find an Allergist
This topic was reviewed on 1/31/2005 by Stuart Friedman, MD, FAAAAI,
Patients & Consumers Web Editor.
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