ALLERGEN IMMUNOTHERAPY AND AVOIDANCE - 08/09/11
Résumé |
Classic symptoms of allergic rhinitis were recognized by Bostock4 in the early 1800s, but their cause was unknown. Further observation suggested that pollen caused the hay fever symptoms and that the mucous membranes and the skin of hay-fever–sensitive patients react differently from those of normal individuals.38
Immunotherapy for allergic rhinitis began in the early 1900s. Curtis conducted some of the first experiments in this area when he immunized patients with grass pollen vaccines.10 In 1911, Noon prepared pollen extracts based on the weight of the pollen. These extracts were administered subcutaneously at 1- to 2-week intervals. He observed that patients receiving injections of grass pollen extract had diminished ocular allergen challenge reactions; the response to the administration of these allergens was dose dependent; and large doses of allergen extracts could provoke a systemic reaction.25 Freeman and Cook later reported most patients with favorable outcomes following pollen immunotherapy.9, 13 Immunotherapy antigens expanded to include molds, trees, weeds, house dust mites, and stinging insects. Studies have confirmed the relationship between IgE-mediated sensitivity and nasal/airway responsiveness.
In 1931, the Joint Committee of Survey and Standardization set standards for immunotherapy materials and methods.30 Over the next several decades, controlled studies were done to define the role of allergen immunotherapy for the treatment of allergic rhinitis, allergic conjunctivitis, insect anaphylaxis, and asthma.26
The mechanisms of the allergic response have been defined over the past several decades. The passive transfer of serum from an allergic person to a nonallergic person was characterized by the Prausnitz-Küstner reaction.32 Reaginic antibodies were identified by radioimmunoassay. Ishizaka and Ishizaka isolated the reaginic antibody, and the World Health Organization (WHO) named it IgE.17 Later studies showed a seasonal rise in IgE antibodies in pollen sensitive patients, and clarified T-cell and B-cell cooperation in the production of IgE antibodies.31
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Vol 25 - N° 4
P. 869-883 - décembre 1998 Retour au numéro
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- BRONCHIAL ASTHMA : Update on the Revised Guidelines for Diagnosis and Management
- J. Andrew Grant
- FUTURE ROLE OF THE ALLERGIST-IMMUNOLOGIST
- Dean D. Metcalfe
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