Immunotherapy

Allergen Immunotherapy is a highly effective treatment that allows your body to build a tolerance to the allergens that cause your symptoms. It is a preventative treatment for allergic reactions to substances like pollens, dust mite, dog and cat dander, and bee venom. Immunotherapy involves giving gradually increasing doses of the natural substance, or allergen, to which the person is allergic. This causes the immune system to become less sensitive to the substance when encountered in the future. Immunotherapy also reduces the inflammation that characterizes rhinitis and asthma.

Allergen Immunotherapy is available in shots, drops, and for some specific allergens, tablets. Your best option will depend on what you are allergic to, and the number of different allergens to which you are allergic.

Allergy Shots

What Are Allergy Shots?

Allergy shots, also referred to as allergy injections or immunotherapy, are a series of injections that help control allergy symptoms. Allergy shots are not a medication. They are a vaccine that contains allergens. Receiving allergy shots desensitizes patients to their specific allergens and is the best way to decrease the immune system’s abnormal reactions to allergens. Allergy patients frequently choose to get rid of their allergies and become medication “free.” During immunotherapy, the patient will gradually develop a stronger tolerance for his or her allergic triggers. With allergy shots, allergy symptoms can be decreased, minimized or even eliminated.

Who Should Consider Receiving Allergy Shots

Patients should consider allergy shots if complete avoidance of trigger allergens is impossible or if they:

• have moderate to severe allergies
• have frequent respiratory tract infections
• do not respond or tolerate allergy medications
• would prefer to avoid a lifetime of allergy medication use
• are willing to commit to a regularly scheduled treatment plan
• have chronic sinusitis or asthma due to allergies
• have anaphylaxis from insect stings

How Do Allergy Shots Work?

Allergy shots work like a vaccine. Whereas a vaccine contains traces of a specific disease or bacteria, allergy shots contain traces of your specific allergens—the pollens, molds, animal allergen and dust mite we live with daily—that trigger an allergic reaction from your immune system. By gradually increasing the doses of your allergen, your body develops an immunity and/or tolerance to that allergen. In essence, allergy shots turn off an inappropriate immune response (your allergic reaction to a plant, tree, pet or mold) while still allowing your immune system to respond normally to infectious agents, especially viruses.

Allergy shots occur in two phases:

1. Build-up phase: involves a routine of injections with increasing amounts of allergens. The frequency of injections generally ranges from one to three times a week with an average duration of three to six months.
2. Maintenance phase: begins when the effective therapeutic dose is achieved. Once this maintenance dose is reached, the time between treatments will increase, ranging from every one to four weeks. You may begin to see the benefits of allergy shots during the build-up phase, but it may take as long as 12 months on the maintenance dose to start seeing significant results. On average, maintenance therapy is continued for three to five years.

What Is the Treatment Commitment?

You must be willing to commit to a regular schedule of allergy shot treatments. Although some people may consider this an inconvenience, a three- to five-year commitment to allergy shots is minimal compared to a lifetime of taking over-the-counter drugs or prescription medications.

You must be able to receive allergy shots by a healthcare provider at a facility with proper staff and equipment so that any potential adverse reactions can be identified and treated. It is recommended that you remain in the office 30 minutes after receiving your allergy shots to ensure that the injected allergen does not cause any adverse reactions.

Will I Experience Any Negative Reactions to the Allergy Shots?

Two types of adverse reactions can occur with allergy shots: local and/or systemic.

1. Local: Local reactions are more common than systemic and appear as redness and swelling at the injection site. They can occur immediately or several hours after treatment and are not serious.
   Future local reactions can be prevented by adjusting the dosage of your allergy shot.
2. Systemic: Systemic reactions are uncommon and are usually mild.
   They require immediate treatment but respond quickly to medications. Rarely, a serious systemic reaction called anaphylaxis can develop. Symptoms of anaphylaxis can include swelling in the throat, wheezing or a sensation of tightness in the chest, nausea or dizziness. The majority of adverse reactions develop within 30 minutes after the injection, which is why you should commit to remaining in the office in case such a reaction should occur.

Can Children Receive Allergy Shots?

Allergy shots can be started at any age. Recent studies suggest that allergy shots may prevent development of new allergies in children and also may prevent the development of childhood asthma.

Are Allergy Shots Safe During Pregnancy?

Allergy shots are generally safe during pregnancy. Since patients receiving allergy shots frequently need less medication to control symptoms, it can be helpful for the pregnant patient who is already receiving allergy shots to continue these throughout her pregnancy. It is best to check with your physician when you do become pregnant.

Allergy Drops (SLIT)

Allergy drops, also referred to as sublingual immunotherapy or SLIT, are a series of liquid drops containing traces of your specific allergens placed underneath the tongue. By gradually introducing these allergens into your system, your body develops an immunity or tolerance to them. In essence, you start changing the way your immune system typically responds to the allergens. Allergy drops “turn off” your allergic reactions. With allergy drops, your allergy symptoms can be decreased, minimized or even eliminated.

Who Should Consider Allergy Drops?

You are a candidate for allergy drops if complete avoidance of your allergens is impossible or if you:

• have only a few specific allergies
• travel frequently or have an unpredictable, busy schedule
• have changed your lifestyle or limited your activities because of allergies
• take multiple allergy medications but continue to suffer from allergies

What Is My Treatment Requirement?

A regular schedule of self-administered allergy drops taken on a daily basis is required. The doses increase gradually and eventually build up to the top or maintenance dose.

You may begin to see the benefits of allergy drops within six months, but it may take as long as 12 months to see significant improvements. On average, allergy drop therapy is continued for three to five years.

Will I Experience Any Negative Reactions?

Allergy drops have a very low risk of causing serious side effects. The most common side effect is that some patients may experience minor irritation of the lips and/or mouth and in some cases, nausea.

Can Children Receive Allergy Drops?

Yes. Recent studies suggest that allergy drops may prevent the development of new allergies in children and also may prevent the development of childhood asthma. Speak with your allergist to determine what the proper age is for your child to begin therapy.

Note:
Clinical research shows that although SLIT may not be quite as effective as allergy shots it does work and can be very helpful for certain types of allergy patients. At this time SLIT is not yet approved by the FDA and is considered an investigational therapy in the United States. Since SLIT is not approved by the FDA, insurance companies are not currently reimbursing for this treatment.

Allergy Tablets

Allergy tablets are another form of oral immunotherapy and have recently been approved by the FDA for use in the United States. These fast-dissolving tablets are placed under the tongue and work to help the body build tolerance to allergens through consistent exposure. The tablets only contain one type of allergen and are indicated for people with allergies to grass, ragweed and dust mites.

Speak with your board certified Atlanta Allergy & Asthma physician to determine the best treatment option for your allergic triggers.