IMMUNOTHERAPY IN RESPIRATORY ALLERGIC DISEASE

Key words: Asthma, Allergic rhinitis and rhinoconjunctivitis, Immunotherapy, Inhalant allergens

The Author presents the state-of-the art of specific immunotherapy (SIT) for respiratory allergic diseases. SIT is more efficacious in allergic diseases due to pollen rather than to perennial allergens, in children rather than in adults, in subjects with sensitivity to only one allergen, in patients with recent onset of asthma. In asthmatic patients, SIT provides little adjunctive effect with respect to environmental prophylaxis and inhaled steroids. There are data suggesting that early SIT can favourably affect the natural history of allergic diseases, but the evidence is not conclusive. SIT is a rather expensive and not entirely safe intervention and puts a considerable burden on the family. Costs and benefits must be evaluated on the basis of available evidence and on the specific problems presented by the patient.