Pediatric subcutaneous allergen immunotherapy

Abstract

Subcutaneous immunotherapy (SCIT) is a widely used therapy for allergic rhinitis and asthma. It is a useful adjunct to standard medical management of these conditions that can lead to long-term benefits and possible resolution of symptoms. The benefits of SCIT, particularly for children, include avoiding prolonged use and side effects from medications, preventing new aeroallergen sensitizations, and reducing the risk of developing asthma. The primary risks of SCIT include local and systemic reactions. Standard schedules for SCIT include advancing through multiple doses usually in four vials (diluted to 1:1000) on a weekly basis; however, there are benefits of using accelerated schedules, especially for children who need to coordinate school and parent work schedules. Special considerations for pediatric patients include fear of needles, avoiding discomfort with injections, consent, optimal injection scheduling, and difficulty communicating about symptoms during reactions in very young children. Overall, SCIT can be a safe and beneficial therapy for children.

Predictive Value of Der P 2-Specific IgE for Subcutaneous Immunotherapy in Children With Allergic Rhinitis

“…AR is a type I allergic inflammation and IgE -mediated by sensitization to inhaled allergens, involving a variety of immunoactive cells and type 2 (T2) cytokines [21]. AIT is currently the only treatment to modify the natural history of allergic diseases characterized by the induction of regulatory Treg and Breg cells [22,23], which can release regulatory cytokines such as IL-10 and transforming growth factor-β to induce immune tolerance against Der p allergen [24]. Meanwhile, AIT can increase the production of specific IgG4 antibodies [25], which can inhibit the binding of the allergen-IgE compound to the receptor on the surface of B cells and reduce the inhibition of the allergen presented to specific T cells, thereby blocking type I hypersensitivity [26].…”

Preventive allergen immunotherapy with inhalant allergens in children

“…Several reports, meta-analyses and systematic reviews have substantially improved our understanding of pAIT. 2,11,18,20,21,29,38,[45][46][47][48][49] The prevention of respiratory allergies seems possible, but the effects of pAIT need to be better explored. 2,15,20,50 Currently, implementing pAIT still faces challenges due to age-related factors 27,45 and limited data.…”

“…The evidence for applying preventive allergen immunotherapy (pAIT) is growing rapidly. Several reports, meta‐analyses and systematic reviews have substantially improved our understanding of pAIT 2,11,18,20,21,29,38,45–49 . The prevention of respiratory allergies seems possible, but the effects of pAIT need to be better explored 2,15,20,50 .…”