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De Carli M, Capezzali E, Tonon S, Frossi B. Mechanism and clinical evidence of immunotherapy in allergic rhinitis. Front Allergy 2023; 4:1217388. [PMID: 37601646 PMCID: PMC10434251 DOI: 10.3389/falgy.2023.1217388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Accepted: 07/21/2023] [Indexed: 08/22/2023] Open
Abstract
Allergic rhinitis is a common upper airway disease caused by hypersensitivity to various aeroallergens. It causes increased inflammation throughout the body and may be complicated by other otolaryngological pathologies such as chronic hyperplastic eosinophilic sinusitis, nasal polyposis, and serous otitis media. Allergic rhinitis is an IgE-mediated disease and immunotherapy can be a possible approach for patients to limit the use of antihistamines and corticosteroids. There is evidence that allergen immunotherapy can prevent the development of new sensitizations and reduce the risk of later development of asthma in patients with allergic rhinitis. However, some patients do not benefit from this approach and the efficacy of immunotherapy in reducing the severity and relapse of symptoms is still a matter of debate. This review highlights new aspects of allergic rhinitis with a particular focus on the impact of sexual dimorphism on the disease manifestation and efficacy to the allergen specific immunotherapy.
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Affiliation(s)
- Marco De Carli
- Second Unit of Internal Medicine, University Hospital of Udine, Udine, Italy
| | | | - Silvia Tonon
- Department of Medicine, University of Udine, Udine, Italy
| | - Barbara Frossi
- Department of Medicine, University of Udine, Udine, Italy
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Abstract
Clinical trials for allergen immunotherapy products’ development and approval are conducted, aiming to monitor safety and efficacy of them. Symptom scores and the use of rescue medication are the primary clinical endpoints used in the conducted clinical trials, while Quality of Life scores and symptom-free days are measurements also used as secondary endpoints. Although the use of in vitro biomarkers might have been more practical and objective, there are yet no broadly used reliable ones accurately reflecting the clinical effects of allergen immunotherapy. On the contrary, in vivo biomarkers, such as the nasal allergy provocation test, are reliable and successfully used. The aim of this review is to describe how to adapt and use biomarkers and clinical outcomes in the everyday practice of Allergists who perform allergen immunotherapy.
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Affiliation(s)
- Constantinos Pitsios
- Allergy Outpatient Clinic, Medical School, University of Cyprus, Nicosia, Cyprus
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Caminiti L, Panasiti I, Landi M, De Filippo M, Olcese R, Ciprandi G, Vernich M, Carelli F, Votto M, Barberi S. Allergen immunotherapy in atopic dermatitis: Light and shadow in children. Pediatr Allergy Immunol 2020; 31 Suppl 26:46-48. [PMID: 33236444 DOI: 10.1111/pai.13390] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Revised: 09/30/2020] [Accepted: 09/30/2020] [Indexed: 11/28/2022]
Abstract
Atopic dermatitis (AD) is a chronic remitting-relapsing inflammatory skin disorder. Due to the multifactorial pathogenesis, there are numerous therapeutic management approaches, mainly based on symptomatic treatments. In recent years, allergen immunotherapy (AIT) has been progressively advanced as targeted disease-modifying treatment of allergic disease. The most recent guideline from the American Academy of Dermatology concludes that data available do not support its use in AD. The Joint Task Force and The European Academy of Dermatology suggest that clinicians can consider AIT treatment in selected patients characterized by aeroallergen sensitization, prevalently HDM, severe AD, and clinical exacerbation after exposure to the causative allergen. Nevertheless, its role in AD is still under debate, especially in children.
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Affiliation(s)
- Lucia Caminiti
- Department of Paediatrics, Allergy Unit, University of Messina, Messina, Italy
| | - Ilenia Panasiti
- Department of Paediatrics, Allergy Unit, University of Messina, Messina, Italy
| | - Massimo Landi
- Paediatric National Healthcare System Turin, Institute of Biomedical Research and Innovation IRIB, Palermo, Turin, Italy
| | - Maria De Filippo
- Paediatric Clinic, Department of Paediatrics, Fondazione IRCSS-Policlinico San Matteo, University of Pavia, Pavia, Italy
| | - Roberta Olcese
- Allergy Center, Istituto Giannina Gaslini, Genova, Italy
| | | | | | - Francesco Carelli
- Paediatric Unit, Azienza Ospedaliera Universitaria, Policlinico Giovanni XXIII, Bari, Italy
| | - Martina Votto
- Paediatric Clinic, Department of Paediatrics, Fondazione IRCSS-Policlinico San Matteo, University of Pavia, Pavia, Italy
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