Jeffrey R. Stokes, MD

Although many effective pharmacological therapiesare available for patients with allergies, only allergen-specificimmunotherapy has been shown to have significant and longlastingtherapeutic and immunomodulatory effects in the managementof allergic rhinitis, allergic asthma, and venom hypersensitivity.Standard allergen immunotherapy consists of subcutaneousinjections of relevant allergens. It requires a buildupphase during which the dose of the vaccine is increased until atherapeutic (maintenance) level is achieved. This maintenancedose is usually continued for 3 to 5 years, and most patientscontinue to do well after injections are discontinued. Most patientstolerate immunotherapy well, but local reactions are notuncommon. Immunotherapy should be administered only in aphysician's office, because some patients may experience systemicanaphylactic reactions requiring immediate therapy.Even with newer therapies on the horizon, allergen immunotherapywill continue to have an important role in the treatmentof allergic diseases. (J Respir Dis. 2008;29(3):136-141)