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Related Concept Videos

Allergic Reactions: Anaphylaxis01:30

Allergic Reactions: Anaphylaxis

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Anaphylaxis is a severe, life-threatening hypersensitivity reaction mediated by Immunoglobulin E (IgE) antibodies. When IgE binds to allergens, it triggers the release of mediators– histamine, leukotrienes, and prostaglandins from mast cells and basophils. These mediators cause vasodilation, edema, and inflammation, leading to various symptoms.The primary allergens causing anaphylaxis include food items (e.g., peanuts, shellfish), drugs (e.g., penicillin, asparaginase, corticotropin,...
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Allergic reactions related to drugs are hypersensitivity responses driven by the immune system and bear no connection to the drug's therapeutic action. While drugs in isolation do not trigger an immune response, they can interact with endogenous proteins to form antigens. These antigens stimulate lymphocytes to produce antibodies. IgE-type antibodies attach themselves to mast cells. Upon subsequent exposure to the same stimulus, the antigen-antibody interaction is initiated, unleashing...
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EAACI Guidelines on Allergen Immunotherapy: Allergic rhinoconjunctivitis.

G Roberts1,2,3, O Pfaar4,5, C A Akdis6,7

  • 1The David Hide Asthma and Allergy Research Centre, St Mary's Hospital, Newport, Isle of Wight, UK.

Allergy
|September 24, 2017
PubMed
Summary

Allergen immunotherapy (AIT) offers a disease-modifying treatment for allergic rhinoconjunctivitis (AR), targeting its root causes. Both subcutaneous (SCIT) and sublingual (SLIT) AIT are recommended for short-term symptom relief in AR patients.

Keywords:
allergen immunotherapyallergic conjunctivitisallergic rhinitisallergyrhinoconjunctivitis

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Area of Science:

  • Allergy and Immunology
  • Clinical Medicine
  • Pharmacology

Background:

  • Allergic rhinoconjunctivitis (AR) affects 20% of the population, with symptoms often persisting despite conventional treatments.
  • Pharmacotherapy for AR can cause side effects and does not address the underlying disease mechanisms.
  • Allergen immunotherapy (AIT) is the only treatment targeting AR pathophysiology, potentially offering disease modification.

Purpose of the Study:

  • To provide evidence-based clinical recommendations for allergen immunotherapy (AIT) in allergic rhinoconjunctivitis (AR).
  • To offer guidance on subcutaneous (SCIT) and sublingual (SLIT) AIT routes based on systematic review and meta-analysis.
  • To inform healthcare professionals on the efficacy and application of AIT for AR management.

Main Methods:

  • A formal systematic review and meta-analysis informed the guideline development.
  • The Appraisal of Guidelines for Research and Evaluation (AGREE II) approach was followed.
  • Involvement of a wide range of stakeholders ensured comprehensive guideline creation.

Main Results:

  • Broad evidence supports the clinical efficacy of AIT for AR, though product-specific evaluation is advised.
  • SCIT and SLIT are recommended for both seasonal and perennial AR, providing short-term benefits.
  • Strongest evidence for long-term benefit is for grass AIT, particularly grass tablets, with a minimum of 3 years of therapy recommended for sustained efficacy.

Conclusions:

  • AIT is a recommended treatment for AR, offering both short-term symptom control and potential long-term disease modification.
  • A minimum of 3 years of AIT is recommended to achieve long-term efficacy.
  • Further research is needed to address evidence gaps, especially regarding long-term benefits and AIT use in pediatric populations.