Allergen immunotherapy does not increase risk of autoimmune disease
Published Online: October 17, 2011
For 100 years, allergen-specific immunotherapy (AIT) has been used for treatment of IgE-mediated allergic diseases such as hay fever, allergic asthma, and allergy to wasp/bee. The concept of AIT is that the introduction of increasing doses of allergens to the immune system, usually administered for 2-3 years, lowers the threshold for the elicitation of allergic reactions and increases immune tolerance to the offending allergens. Although the beneficial effects of AIT on these diseases are well-documented, little is known about potential effects on the risk of other immune-related diseases. Over the years, a few causistic reports of single cases of autoimmune disease, e.g. multiple sclerosis, occurring during AIT has caused concern that AIT may act as a trigger of autoimmune disease.
Linneberg et al performed the first epidemiological study on the association between AIT and risk of immune-related disease. All Danish citizens without other known diseases were linked and followed through central registries on medications and hospital admissions. Persons receiving AIT and persons receiving conventional allergy treatment (nasal steroids or oral antihistamines) were compared with regard to their risk of developing autoimmune diseases. During the 10-year study period (1997 to 2006), receiving AIT as compared to conventional allergy treatment was associated with a 14% lower risk of autoimmune disease. Somewhat surprising, AIT was also associated with lower risk of ischemic heart disease as well as lower mortality. Linneberg et al note in their research article published in The Journal of Allergy and Clinical Immunology (JACI) that caution should be exercised when interpreting data from a non-randomized study such as this. Nevertheless, from a clinical point of view they find it reassuring that AIT was not associated with increased risk of autoimmune disease. Thus, development of autoimmune disease should probably not be viewed as a side-effect of AIT. The association with ischemic heart disease is intriguing, but needs further investigations.
The Journal of Allergy and Clinical Immunology (JACI) is the official scientific journal of the AAAAI, and is the most-cited journal in the field of allergy and clinical immunology.