Intralymphatic immunotherapy for allergic rhinitis: A systematic review and meta-analysis

Area of Science:

• Immunology
• Allergy and Clinical Immunology
• Otolaryngology

Background:

• Allergen-specific immunotherapy (AIT) is underutilized due to cost and inconvenience of traditional subcutaneous injections.
• Intralymphatic immunotherapy (ILIT) presents a potentially faster AIT alternative with fewer injections.
• This review evaluates the efficacy and safety of ILIT for allergic rhinitis.

Purpose of the Study:

• To systematically review and meta-analyze the evidence supporting intralymphatic immunotherapy (ILIT) for allergic rhinitis.
• To assess the impact of ILIT on symptom scores, medication use, and immunological responses.

Main Methods:

• Systematic review and meta-analysis of 17 clinical trials.
• Evaluation of treatment outcomes including symptom, medication, and combined scores using standardized mean differences.
• Analysis of provocation testing (nasal and skin-prick) and adverse event rates.

Main Results:

• ILIT significantly improved combined symptom and medication scores (SMD -0.72, p < 0.0001).
• ILIT demonstrated significant effects on nasal provocation (SMD -1.00, p < 0.0001) and skin-prick testing (SMD -0.73, p < 0.0001).
• Adverse events occurred in 39.5% of ILIT patients, with 98.4% being mild; placebo group had 23.5% adverse events.

Conclusions:

• Intralymphatic immunotherapy (ILIT) is a safe and effective treatment for allergic rhinitis, leading to desensitization.
• ILIT alleviates symptoms and reduces medication requirements in allergic rhinitis patients.
• Larger, randomized, double-blind, placebo-controlled trials are needed for wider adoption of ILIT.