Immunotherapy for respiratory allergic diseases: indications, efficacy and monitoring

The author reports a detailed analysis of the indications for Specific Immuno-Therapy (SIT) in allergic rhinitis and asthma. After pointing out the requirements for a correct clinical trial, the efficacy of SIT towards various allergenic agents is examined (pollen, mites, cat and dog danders, moulds). Clinical monitoring--by means of clinical diaries, symptom score, drug consumption, skin tests, challenge tests--and immunological monitoring--by means of measuring of IgE and IgG serum antibodies, mediator and cytokine release, lymphocyte study, etc.--are then discussed. Immunological and clinical parameters to evaluate the efficacy of SIT are compared: clinical parameters being the most effective means of evaluation of clinical improvement.