Immunotherapy of Allergic Contact Dermatitis

Abstract

The term 'immunotherapy' refers to treating diseases by inducing, enhancing or suppressing immune responses. As allergy is an excessive, detrimental immune reaction to otherwise harmless environmental substances, immunotherapy of allergic disease is aimed at the induction of tolerance toward sensitizing antigens. This article focuses on the historical developments, present state and future outlook for immunotherapy with haptens as a therapeutic modality for allergic contact dermatitis. Inspired by the effectiveness of immunotherapy in respiratory allergies, attempts were undertaken at curing allergic contact dermatitis by means of controlled administration of the sensitizing haptens. Animal and human experiments confirmed that tolerance to haptens can be induced most effectively when the induction of tolerance precedes attempted sensitization. In real life, however, therapy is sought by people who are already sensitized and an effective reversal of hypersensitivity seems more difficult to achieve. Decades of research on Rhus hypersensitivity led to a conclusion that immunotherapy can suppress Rhus dermatitis, however, only to a limited degree, for a short period of time, and at a high risk of side effects, which makes this method therapeutically unprofitable. Methodological problems with most available studies of immunotherapy of contact allergy to nickel make any definite conclusions impossible at this stage.

Pharmacologic inhibition of hypoxia‐inducible factor (HIF)‐hydroxylases ameliorates allergic contact dermatitis

“…Allergic contact dermatitis (ACD) is a T cell-mediated inflammatory reaction to epidermal sensitization that causes an over-activation of the immune response upon repeated exposure to the sensitizing hapten [22,23]. This allergic reaction involves an initial sensitization phase that leads to an elicitation or inflammatory phase [24] [25,26].…”

Contact dermatitis: a comparative and translational review of the literature

“…Allergen‐specific immunotherapy (ASIT) is controversial in humans with ACD . Data published to date do not allow for any definitive statement regarding the effectiveness of oral or injectable ASIT in ACD patients . In animals there have been very few evidence‐based studies of ASIT for the treatment of ACD.…”

Alergia kontaktowa i alergiczny wyprysk kontaktowy

“…Dopiero koincydencja z innymi procesami immunologicznymi (np. zapalenie wywołane przez inne czynniki) może skutkować indukcją nadwrażliwości [1].…”

“…Mimo podejmowanych od stulecia prób, jak dotąd nie zaproponowano skutecznej metody odczulania w alergii kontaktowej. Należy przy tym zwrócić uwagę nie tylko na brak skuteczności, ale wręcz ryzyko wywołania systemowej reaktywacji alergicznego wyprysku kontaktowego (SRACD) u osób poddawanych takim ,,odczulaniom'' niklem lub innymi haptenami (przegląd w [1]). …”