Specific immunotherapy

Immunotherapy (desensitisation) has been used in the treatment of allergic diseases since 1911. Extracts of allergen to which the patient is sensitised are given in increasing concentration, starting with a very dilute solution, until tolerance is achieved. Allergen immunotherapy is specific to the allergen being administered. The exact mechanism is unknown but presumably depends on the development of specific IgG antibodies which bind to the IgE receptor on mast cells and basophils, thus making it unavailable for IgE. This mode of treatment has been used successfully for the treatment of pollen and insect allergy but its usefulness in other allergic diseases has been controversial.

Several studies evaluating the effectiveness of specific immunotherapy in food allergic diseases such as peanut and fish allergy produced conflicting results. The majority of the studies did not find evidence of protection in peanut allergic patients, and severe reactions during the treatment were common. However, some studies have supported the use of immunotherapy in the treatment of fish and egg allergy. The overall consensus is that specific immunotherapy has no place in the treatment of food allergy.

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