ALLERGEN IMMUNOTHERAPY AND AVOIDANCE - 08/09/11

Doi : 10.1016/S0095-4543(05)70093-2

William A. Fawcett IV, MD ^{^{*
Department of Medicine, University of Texas Medical Branch–Galveston, Galveston; and Baylor College of Medicine, Houston, Texas}}

Resumen

Classic symptoms of allergic rhinitis were recognized by Bostock^{4 Bostock J: Medical and Chirurgical Transactions (vol 10). 1819, p 16

Haga clic aquí para ir a la sección de Referencias} 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 Wyman M. Autumnal catarrh Cambridge: Hurd and Houghton (1872).

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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 Curtis H.H. The immunizing cure of hay fever Medical News, Volume 1900 ; 77 : 16

Haga clic aquí para ir a la sección de Referencias} 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 Noon L. Prophylactic inoculation against hay fever Lancet 1911 ; 1 : 1572 [cross-ref]

Haga clic aquí para ir a la sección de Referencias} Freeman and Cook later reported most patients with favorable outcomes following pollen immunotherapy.^{9 Cooke R.A. The treatment of hay fever by active immunization Laryngoscope 1915 ; 25 : 108

Haga clic aquí para ir a la sección de Referencias, 13 Freeman J. Vaccination against hay fever: Report of results during the last three years Lancet 1914 ; 1 : 1178 [cross-ref]

Haga clic aquí para ir a la sección de Referencias} 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 Report of the Joint Committee on Standards J Allergy 1935 ; 6 : 408

Haga clic aquí para ir a la sección de Referencias} 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 Ohman J.L. Clinical and immunologic responses to immunotherapy Allergen Immunotherapy New York: Marcel Decker (1991).
209-232

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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 Stanworth D.R. Reaginic antibodies Adv Immunol 1963 ; 3 : 181

Haga clic aquí para ir a la sección de Referencias} Reaginic antibodies were identified by radioimmunoassay. Ishizaka and Ishizaka isolated the reaginic antibody, and the World Health Organization (WHO) named it IgE.^{17 Ishizaka T., Ishizaka K. Biology of immunoglobulin E Prog Allergy 1975 ; 19 : 60

Haga clic aquí para ir a la sección de Referencias} 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 Rocklin R.E. Clinical and immunologic aspects of allergic or of allergen-specific immunotherapy in patients with seasonal allergic rhinitis or allergic asthma J Allergy Clin Immunol 1983 ; 72 : 323-343 [cross-ref]

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