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Allergen Immunotherapy for Local Respiratory Allergy.

I Eguiluz-Gracia1, A Ariza2, A Testera-Montes1

  • 1Allergy Department, IBIMA-Hospital Regional Universitario de Málaga-ARADyAL, Málaga, Spain.

Current Allergy and Asthma Reports
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Summary

Local respiratory allergy (LRA) is an eosinophilic airway disease. Allergen immunotherapy (AIT) shows promise in managing LRA symptoms, unlike standard therapies, but long-term effects require further study.

Keywords:
Allergen immunotherapyDual allergic rhinitisEndophenotypesLocal allergic asthmaLocal allergic rhinitisLocal respiratory allergy

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Area of Science:

  • Immunology
  • Allergology
  • Respiratory Medicine

Background:

  • Local respiratory allergy (LRA) represents an eosinophilic phenotype within chronic airway diseases.
  • The LRA spectrum includes local allergic rhinitis (LAR), local allergic asthma (LAA) in non-atopic individuals, and dual allergic rhinitis (DAR) in atopic patients.

Purpose of the Study:

  • To review current therapeutic strategies for LRA.
  • To evaluate the evidence for various treatment options in managing LRA.

Main Methods:

  • Review of existing literature on LRA treatments.
  • Analysis of randomized clinical trials and observational studies focusing on allergen immunotherapy (AIT) and standard therapies.

Main Results:

  • Standard therapies (antihistamines, corticosteroids, bronchodilators) lack controlled studies for LRA efficacy.
  • Three randomized clinical trials and one observational study indicate AIT effectively controls nasal/ocular symptoms in LAR, reduces rescue medication use, and improves quality of life.
  • While nasal/inhaled steroids may reduce eosinophilic inflammation, they do not alter the disease's natural course.

Conclusions:

  • Allergen immunotherapy (AIT) demonstrates significant benefits for local allergic rhinitis (LAR) symptom control and quality of life.
  • Further research is needed to investigate the long-term and disease-modifying effects of AIT in the broader LRA spectrum.