Immunotherapeutic targeting of allergic disease

The last decades have shown an increasing incidence of allergic illnesses such as rhinoconjunctivitis, with a prevalence of 20-30% in some industrialised parts of the world. The only treatment that may change the natural course of allergic disease is allergen-specific immunotherapy (SIT), which has been shown to prevent the development of asthma in rhinitic patients and anaphylaxis in insect venom allergic patients. However, the risk-benefit ratio for subcutaneous immunotherapy has changed little from when it was first developed in 1911. Novel developments of adjuvants, and allergens as well as methods of administration, now offer improvements in both the efficacy and safety of SIT. This review describes and discusses these new developments in the context of the many recent advances in our understanding of the mechanisms by which immunotherapy appears to act.