[Allergic diseases of the upper and lower airways]

Allergic diseases of the lower and upper airways affect up to 25% of the population in Switzerland and have increased substantially during the last centenary. Possible reasons include the genetic background, air pollution and lack of microbial stimulation. The diagnosis of inhalant allergies is based on the clinical history and examination, skin tests and the determination of specific IgE in the serum. For treatment allergen avoidance, pharmacotherapy and allergen-specific immunotherapy are available and should ideally be combined. A proper patient and allergen extract selection, an ideally adapted applications regimen and a good guidance of the patient are all decisive for the success of immunotherapy. Under such conditions immunotherapy ideally can lead to a benefit in more that 80% of patients suffering from moderate to severe allergic rhinoconjuncitivis and intermittent or mild persistent asthma. By component-resolved diagnosis an important step in a much more differentiated in-vitro-diagnosis of allergic diseases is starting. Currently several approaches studying changed application regimens and using modern molecular technologies to improve the efficacy of immunotherapeutic allergens are undergoing and will possibly substantially improve the efficacy, safety and last but not least acceptance of allergen specific immunotherapy.