Specific immunotherapy in children: the evidence.

Area of Science:

• Immunology
• Allergy Research
• Clinical Medicine

Background:

• Specific immunotherapy (SIT) is the sole allergy treatment addressing both symptoms and underlying causes.
• Subcutaneous immunotherapy (SCIT) is the established standard, while sublingual immunotherapy (SLIT) is a newer, accepted alternative.
• Unlike drug treatments, SIT provides enduring clinical benefits and modifies disease progression.

Purpose of the Study:

• To review the current understanding and application of specific immunotherapy (SIT) for allergic diseases.
• To compare the efficacy, mechanisms, and long-term effects of SCIT and SLIT.
• To outline the future directions and emerging approaches in SIT.

Main Methods:

• Review of existing literature and clinical guidelines on SCIT and SLIT.
• Analysis of the immunological mechanisms underlying SIT, including Th1/Th2 responses.
• Comparison of clinical outcomes, long-term effects, and safety profiles of SCIT and SLIT.

Main Results:

• Both SCIT and SLIT modulate Th2-dominant immune responses towards a Th1-polarization, reducing allergic inflammation.
• SIT demonstrates long-lasting effects, altering the disease course by preventing new asthma onset and sensitizations.
• While SCIT has established long-term evidence, further data is needed for SLIT's long-term impact.

Conclusions:

• SIT, in both SCIT and SLIT forms, offers significant advantages over conventional drug treatments for allergies.
• SIT not only manages symptoms but also modifies the disease's natural progression with sustained effects.
• Future SIT research focuses on novel allergen products and applications for food allergies and atopic eczema.