Conventional and new approaches to hyposensitization

Hyposensitization in IgE-mediated allergic diseases has traditionally been induced by immunotherapy in which increasing amounts of allergens have been injected until a maximal tolerated dose has been achieved. Among the most obvious immunological effects of immunotherapy have been the production of allergen-specific IgG and some impairment in the synthesis of allergen-specific IgE. In addition to allergen-specific IgG (sometimes described as blocking antibodies) anti-idiotypic and anti-isotypic (IgG anti-IgE) have recently attracted attention as possibly being involved in hyposensitization. The effects of immunotherapy at the cellular level (either as T cell control of IgE synthesis or as modulation of mediator release by effector cells) also deserve further investigation.