[Specific and nonspecific (anti-IgE) immunotherapy of allergic diseases]

Specific immunotherapy comprises a special form of allergy treatment which consists of stepwise increasing doses of the allergen, given subcutaneously or orally with the aim to reprogram the specific immunity (from allergy to tolerance). This requires some experience and an exact allergological workup, since the main mistake in the treatment of this specific immunotherapy is the selection of unsuitable patients. The effectivity of specific immunotherapy is well documented for bee and wasp venom allergy, pollinosis and more and more also for asthma bronchiale. A type of unspecific passive immunotherapy is the injection of anti-IgE antibodies. However they block only soluble IgE and are not able to remove mast cell bound IgE. Thus, the allergic reactivity persists. Clinical studies have shown some efficacy in asthma as well as in pollinosis. However, at present it is unclear, whether this drug, which has to be given every two to four weeks in relatively high concentrations, is effective in patients with polysensitization (i.e. patients suffering from mite, fungal and pollen allergy) or is effective in patients which have manifestations of their allergy in different organs.