Immunotherapy of Allergic Disorders: Traditional and Novel Approaches

For approaches to the immunotherapy of allergic respiratory diseases now under study at Johns Hopkins are reviewed. Traditional high dose parenteral immunization with mixtures of allergens corresponding to patients' allergic sensitivities is being evaluated in the long-term management of allergic asthma in children. Oral desensitization employing doses of short ragweed extract 100 fold higher than for parenteral therapy has been proven safe and efficacious and is now being modified to render it practicable. Intradermal injections of autologous IgG immune complexes with D. pteronyssinus antigens has been reported to improve symptoms and reduce IgE synthesis; a trial to replicate these findings is underway. Immunization with immunodominant peptides from Fel d. I is also under development as a novel immunoregulatory intervention with potential clinical application.