Immunotherapy: an option in the management of occupational asthma?

To review clinical data on immunotherapy applied to occupational asthma.

There are very few studies on immunotherapy in occupational asthma. The best documented use of immunotherapy in this disorder corresponds to latex allergy among healthcare workers. There are anecdotic reports of non-well controlled studies using immunotherapy with wheat flour, African maple wood, sea squirt and rat epithelium extracts. Subcutaneous immunotherapy with natural rubber latex extract, at adequate doses, seems to be a useful treatment in reducing cutaneous and respiratory symptoms, but it should be considered as a high-risk treatment due to the appearance of systemic reactions.

At present, subcutaneous immunotherapy with latex extract can only be considered experimental and must be administered by experienced allergists in a hospital setting, similarly to venom immunotherapy. Nevertheless, systemic reactions responded well to treatment. Further clinical trials on efficacy, safety and long-term effectiveness in immunoglobulin E-mediated occupational rhinitis and asthma are clearly needed. Since allergen avoidance is not always possible, no other etiologic treatment but immunotherapy can be offered to patients with occupational rhinitis/asthma.