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ALLERGY SHOTS: Science and Success in Solving Chronic Symptoms

By B. Maya Kato, MD

Many people have transitioned from reactively treating allergy symptoms to proactively fighting their allergies. While common allergy medications such as oral antihistamines and nasal corticosteroid sprays often control symptoms, when you stop taking the medication(s) your symptoms return shortly afterwards. An alternative approach is to desensitize your immune system to the antigens that are triggering the symptoms, potentially leading to long-lasting remission of the allergy symptoms. This alternative is called immunotherapy.

Immunotherapy is a century old concept. In 1911, both the electrical ignition system for cars and allergen immunotherapy were introduced. Both represented significant advances in their respective fields. The earliest published success of allergen immunotherapy was based on the work of two English scientists, Leonard Noon and John Freeman. Recognizing that pollen was the cause of hay fever, these researchers hypothesized that injecting hay fever patients with the pollen to which they were allergic could induce immunity and tolerance against the offending pollen.

When your body has an allergen-triggered response your immune system goes on high alert to protect against pollen, mold, dander or other foreign substances. This response causes symptoms of a runny nose, itchy eyes, nasal congestion, headache, and even difficulty breathing. Immunotherapy works by introducing small amounts of an allergen to your body in order to gradually increase your tolerance to the substance. Allergy immunotherapy works best in patients with allergic asthma, allergic rhinitis, and stinging insect allergies. Shots are less effective for those with food allergies.

How is it done?

First, the individual undergoes a medical evaluation that involves identifying the allergen(s) that one is allergic to by skin testing and/or allergy blood tests. The individual is then desensitized to the allergen by gradually presenting them with small doses of allergens given via shots, or sublingual drops. Allergy shots containing increasing amounts of the allergens are given once a week until the target dose is reached. Once the target dose is reached, the maintenance phase begins, which consists of target dose shots for 3-5 years. Many individuals have long lasting remission of allergy symptoms, never requiring treatment again. Others may develop recurrent symptoms after discontinuing their shots, and thus the overall duration of therapy varies.

Over the years, our knowledge about allergen immunotherapy has greatly expanded. Much has been learned about what protocols are needed to make it beneficial, as well as the long term benefits of immunotherapy. The success of allergy immunotherapy is well documented. Among the most important findings are that immunotherapy is safe, it can provide long-term symptom relief for years after treatment is discontinued, and that it is a very cost-effective approach for treating many allergies.

Dr. Kato is the founder of The Ear Institute in Palm Desert. Her top priority is improving the quality of life of her patients. Dr. Kato can be reached at: 760-565-3900.

Resources: Finkelman FD, Boyce JA, Vercelli D, Rothenberg ME. Key advances in mechanisms of asthma, allergy and immunology in 2009. J allergy Clin Immunol. 2010 Feb: 125(2):312-8.; Akdis M. immune tolerance in allergy. Curr Opin Immunol. 2009 Dec:21(6):700-7.; Cappella A, Durham WR. Allergen immunotherapy for allergic respiratory diseases. Hum Vaccin Immunother. 2012 Oct 1;8(10):1499-512.2.

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