[Is protective therapy possible in occupational asthma? Role of immunotherapy]

Specific immunotherapy (ITS) can be a preventative measure for occupational allergy when allergens cannot be fully eliminated. Many allergens provoke IgE-mediated reactions, but when they are haptens and the physiopathology is complex, then the value of ITS is restricted. However, with common allergens whose density increases with occupation, such as house dust and house dust mites for domestic employees, pollens for florists and animal epithelia for breeders, then ITS is effective. On the other hand, when the allergen is specific for the job, of which there are two well documented examples in bakers asthma from wheat flour and laboratory worker's asthma to small laboratory animals there are disparate results. Overall, there is only a modest place for ITS in the treatment of professional asthma, because of the lack of purified, well-standardised extracts.