Immunotherapy to Treat Allergies: Recent Advances and Future Prospects

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Allergen immunotherapy(AIT)has been used to treat allergic diseases, such as asthma, rhinitis, and venom-induced anaphylaxis, for more than 100 years. AIT aims to suppress immune responses established in patients sensitized to allergens, which are mediated by allergen-specific IgE and memory T cells, through the controlled administration of allergens over prolonged periods. AIT in appropriately selected patients effectively reduces the symptoms of allergic diseases. The mechanisms underlying AIT have been suggested to include the very early desensitization of mast cells and basophils; generation of regulatory T/B cell responses; regulation of IgE and IgG4; and regulation of mast cells, basophils, and eosinophils. Two types of AIT, subcutaneous immunotherapy(SCIT)and sublingual immunotherapy(SLIT), are currently used in clinical practice. The main side effect of SCIT is unwanted IgE-mediated reactions. SLIT is safer than SCIT, allowing for home administration. Advances in AIT, such as alternative routes of administration, allergen standardization, modification of allergens, use of adjuvants, and combination with the anti-IgE monoclonal antibody omalizumab, have improved the safety and efficacy of AIT. Other biologics such as those targeting Th2-related pathways have been tested. This review provides a brief overview of advances and future prospects in AIT and biologics to treat allergies.

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