IMMUNOTHERAPY IN ALLERGIC RHINITIS AND LOWER AIRWAY OUTCOMES

FCAAIA Notes: I have written about the upper-lower airway connection in this blog many times.  Most young people with asthma have allergies and 20-60% of those with allergies will develop asthma.  The two conditions can be thought of as the same disease affecting different ends of the respiratory system or “allergic airway disease”.

There is a large literature supporting the fact that treating the upper airway (nose) can lead to improved control of the lower airway (asthma).  In fact, the most recent iteration of national guidelines for the care of asthma tell us that anyone with persistent asthma (defined in part as symptoms >2 days per week or night time symptoms > 2 nights per month) and allergies should consider allergy shots as a potential cure for his allergic airway disease.

Talk to your allergist about whether you should consider allergen immunotherapy.

(Source: https://www.doximity.com/doc_news/v2/entries/4288678?_eda_link_uuid=c3af3399-5073-436e-a79f-35e8e8106b8b&_r=1&_ref=digest&clicked=true&position=4&signature=adcbd8430dc397246f53ce917b919dae918b61c9&source=email_doc_news%3A%3Aspecialty_digest&token=56483193a29efa211df81ca74c2294b76947eb0b&user_id_hash=8f9d6c02f29de56b1f7ed856542ced553281a8be&login_from_email=mrlester602%40gmail.com July 30, 2016)

Allergic rhinitis and asthma constitute two clinical expressions of a single condition, respiratory allergy. Allergen immunotherapy (AIT) is a form of treatment specifically aimed at modifying the response to sensitizing allergens. The inherent potential benefit of AIT is the simultaneous treatment of all clinical expressions of respiratory allergy. Current data support the effectiveness of subcutaneous and sublingual immunotherapy in rhinitis. Studies also provide proof for a beneficial effect in allergic asthma. Even more, substantial evidence points to the preventive effect on the progression from rhinitis to asthma. Despite the current knowledge on the basic mechanisms underlying the immunological effect of AIT is vast, the specific mechanisms for the preventive effect of primary sensitization or new sensitizations are poorly understood. This review aims to provide a critical overview of the current knowledge on the effectiveness of AIT and its potential role in secondary prevention of respiratory allergy progression.

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