Multiallergen immunotherapy for allergic rhinitis and asthma

Department of Medicine, National Jewish Health, Denver, CO 80206, USA.
The Journal of allergy and clinical immunology (Impact Factor: 11.48). 03/2009; 123(4):763-9. DOI: 10.1016/j.jaci.2008.12.013
Source: PubMed


The English and non-English language literature on allergen immunotherapy was reviewed for studies simultaneously using 2 or more distinct allergen extracts in either subcutaneous or sublingual immunotherapy. Thirteen studies were identified, 11 using subcutaneous injections, 1 using sublingual administration, and 1 using both. In studies with adequate information, administration of 2 extracts by means of either subcutaneous immunotherapy or sublingual immunotherapy was effective. In studies using multiple allergens, 3 studies showed clear efficacy, whereas in the other 2 studies, lack of efficacy might have been due to inadequate doses of extract or omission of clinically relevant allergens in the treatment regimen. It is concluded that simultaneous administration of more than 1 allergen extract is clinically effective. However, more studies are needed, particularly with more than 2 allergen extracts and with sublingual administration.

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    • "However, AR is often induced by a variety of allergens, and the safety and effectiveness of a multi-allergen SIT is still debatable. Some clinical trials have shown that multiple-allergen immunotherapy is effective in AR and asthma,15,16,17 but others have not.18,19 Multiple-allergen immunotherapy increases the risk of adverse reactions during SIT.20,21 "
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    ABSTRACT: Purpose Specific immunotherapy (SIT) is a suitable but uncommon treatment option for allergic rhinitis (AR) in China. The current understanding and attitude of Chinese ENT (ear, nose, and throat) specialists in regards to SIT is unclear. This study investigates current trends in the awareness and application status of SIT among Chinese ENT specialists. Methods We performed a nationwide, cross-sectional survey with a specially designed questionnaire given to 800 ENT specialists in China. A member of the trained research group conducted face-to-face interviews with each respondent. Results Most of the respondents considered AR (96.0%) and allergic asthma (96.0%) the most suitable indications for SIT. Of all respondents, 77.0% recommended the application of SIT as early as possible; in addition, SIT was considered 'relatively controllable and safe' by most respondents (80.6%). The highest allergen-positive rate in AR was associated with house dust mite (47.7%) and obvious differences existed among geographical regions. Conventional subcutaneous immunotherapy was the most highly recommended treatment option (96.2%). 'The high cost of SIT' (86.6%) and 'lack of patient knowledge of SIT' (85.2%) were probably the main reasons for the lower clinical use of SIT in China. Conclusions Most cases showed that the opinions of Chinese ENT specialists appeared to be in agreement with recent SIT progress and international guidelines; however, many areas still need to enhance the standardization and use of SIT in China. Clinical guidelines for SIT require improvement; in addition, Chinese ENT specialists need continuing medical education on SIT.
    Full-text · Article · Jul 2014 · Allergy, asthma & immunology research
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    • "They all used single-allergen monotherapy to evaluate efficacy, an approach which does not reflect the sensitization status of patients with allergic rhinoconjunctivitis, and may in fact have led to undertreatment and subsequent under-appreciation of the efficacy of SLIT. The number of SLIT (or even SCIT) efficacy studies employing multiple allergens in the treatment regimen is so surprisingly small that their low number and insufficient data on efficacy have been addressed unfavorably [21]. These studies were characterized by their sporadic nature. "
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    ABSTRACT: Due to its excellent safety profile, ease of administration, and economic considerations, sublingual immunotherapy (SLIT) is becoming a preferred form of allergen specific immunotherapy. The efficacy of SLIT is still debated. The purpose of this act of practice trial is to evaluate quality of life outcomes in patients treated with SLIT. Fifty one patients with allergic rhinoconjunctivitis demonstrated by skin testing completed the Rhinoconjunctivitis Quality of Life Questionnaire (RQLQ) at initiation, at four months and at 10-12 months of SLIT. Significant improvement (P < 0.05) on six of seven domain categories of the RQLQ questionnaire was noted. Total RQLQ scores also showed significant improvement. This study supports SLIT as a modality effective in controlling allergic symptoms.
    Full-text · Article · Jan 2012 · Journal of Allergy
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    ABSTRACT: The protospec unifies the concepts of requirements specification and prototype into a single software engineering process. An example of the use of the protospec concept for requirements specification within expert systems development domain is presented. The requirements specification resulting from this example is evaluated from both a user and a software engineering point of view. The result is compared to results for three other specification approaches
    No preview · Conference Paper · Feb 1989
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