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Allergic Rhinitis: What Do We Know About Allergen-Specific Immunotherapy?

Tadech Boonpiyathad1, Mongkol Lao-Araya2, Chirawat Chiewchalermsri3

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Allergen-specific immunotherapy (AIT) effectively treats allergic rhinitis (AR) by inducing immune tolerance. However, challenges like long treatment duration and high costs necessitate exploring novel approaches and biomarkers for AIT optimization.

Keywords:
allergen-specificallergicimmune toleranceimmunotherapyrhinitis

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Area of Science:

  • Immunology
  • Allergy Research
  • Clinical Medicine

Background:

  • Allergic rhinitis (AR) is an IgE-mediated Th2-inflammatory disease.
  • Allergen-specific immunotherapy (AIT) is a treatment option for AR unresponsive to conventional therapies.
  • AIT aims to induce allergen tolerance by modulating immune responses.

Purpose of the Study:

  • To provide an updated overview of allergen-specific immunotherapy (AIT) for allergic rhinitis (AR).
  • To discuss the mechanisms, efficacy, and administration routes of AIT.
  • To highlight the challenges and future directions in AIT research.

Main Methods:

  • Review of current literature on AIT for AR.
  • Analysis of AIT mechanisms, including induction of regulatory cells (Tregs, Tfr, Bregs, DCregs, IL-10+ ILCs, NKregs).
  • Discussion of subcutaneous, sublingual, and novel AIT administration routes.

Main Results:

  • AIT is effective in alleviating AR symptoms, reducing medication use, improving quality of life, and preventing disease progression.
  • Key mechanisms involve the induction of various regulatory immune cells.
  • Disadvantages include long treatment duration, high cost, potential for allergic reactions, and lack of predictive biomarkers.

Conclusions:

  • AIT is a valuable treatment for AR, inducing immune tolerance through complex cellular mechanisms.
  • Ongoing research focuses on overcoming AIT limitations through adjunctive therapies, adjuvants, and novel technologies.
  • Future directions include developing biomarkers for predicting treatment response and exploring new administration routes.