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Immunotherapy for Allergies

Immunotherapy has been around for many years. Injections containing increasing amounts of an extract of the allergen that a person is sensitive to are given at regular intervals in an attempt to teach the immune system to live in harmony with the allergen. These injections are usually given weekly during the initial, or build-up, phase, and then once or twice a month during the second, or maintenance, phase. It tends to be used when other treatments have not been successful. Think of it as being like marriage guidance counselling for couples who can't live with each other but can't live without each other either.

For those with hayfever, animal allergy and insect sting allergy, immunotherapy can be very effective. But it does have its risks. Expose someone to something they are allergic to and they are likely to react, sometimes with tragic consequences. This is what happened in the early 1980s, when a number of immunotherapy-related deaths prompted the Committee on Safety of Medicines in the UK to restrict its use. Despite now being widely available and a part of routine allergy treatment in the USA and other developed countries, today in the UK immunotherapy is only now starting to make a reappearance.

If you are going to reap rewards in life you have to take risks. To get the really big money then the risks have to be great too - whether it's investing in the stock market or planning an 'Italian Job'. With allergies it's the same. If you have hayfever and the pollen count is high you have a choice: minimise the risk of symptoms by staying indoors, increase the risk of symptoms by going outside. With immunotherapy the huge reward is fewer symptoms, less need for medication and, most importantly, hayfever sufferers can enjoy the summer, animal lovers can keep their pets and those with insect-sting allergy that triggers severe allergic reactions (anaphylaxis) can live with less risk of death. The downside with immunotherapy is that severe allergic reaction during administration is a possibility - which is why it should only be performed when resuscitation equipment and facilities are available - and, like financial investments or body building, it can take months, often years, to gain the benefits.

If you're thinking that the solution must be to create something that does the job without the risks then you'd be right. This is already happening as scientists develop substances called allergoids - these are allergens that are modified so that they still teach the immune system to tolerate the target allergen, but don't cause it to react in the process. And what about vaccination? Well, this may not be so far away either. In fact, as we learn more about how and why allergy occurs, the more likely it is that in time it may be preventable in the first place. Then who knows, we may no longer need to go back to the future.


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