Dr. María Basagaña Torrentó is an allergist and belongs to Top Doctors, the select circle of top doctors in Spain. As an expert in immunotherapy, she will explain the details of this treatment.
What is immunotherapy?
Immunotherapy is the causal treatment of respiratory allergic disease, which includes both allergic rhinitis and allergic asthma. It is a treatment with a widely proven efficacy since it has been used for the treatment of respiratory allergy since the beginning of the 20th century. It consists of the administration of increasing doses of the foreign substance to which the patient has become allergic, what we call the allergen, until reaching a maintenance dose that will end up in a matter of 3 to 5 years giving tolerance to that substance.
Exactly how does it work?
In immunotherapy, what the immunopathogenic mechanism does is to block or modify the allergic patient’s defense system. It basically does so by reducing, blocking, both the antibodies and the cells that enhance the inflammatory reaction and enhancing those antibodies, those cells, that block the inflammatory response. This can be achieved in 2 ways, there are 2 routes of administration of immunotherapy, subcutaneously which is the one in which we have more experience and it is administered in monthly doses in the deltoid, or sublingually in which the patient administers the extract under the tongue at home. In any case, the maintenance dose, whether subcutaneous or sublingual, must always be maintained for 3 to 5 years.
How effective is the treatment?
Immunotherapy is a highly effective treatment for respiratory allergy. It is considered that approximately 80% of patients with immunotherapy already notice some benefit within the first 6-8 months of going on allergy vaccines. Currently, the efficacy of immunotherapy is assessed mainly by clinical parameters, either by the reduction of symptoms in the face of exposure to the allergen or by the reduction of rescue medication to alleviate these symptoms. Immunotherapy is a treatment endorsed by the various scientific societies, pulmonology, otorhinology, allergology, for the treatment of allergy, and is included in all treatment guidelines for rhinitis and allergic asthma. Even the WHO has made a position endorsing the efficacy of immunotherapy for the treatment of rhinitis and allergic asthma.
What are the advantages of the treatment?
The main advantage of immunotherapy treatment for respiratory allergic disease is that it is the only treatment capable of altering the natural history of the allergic disease, i.e. preventing its progression. Both, for example, that rhinitis progresses to asthma and also avoiding new sensitizations, i.e. that the allergic patient recognizes new allergens as foreign.