Intralymphatic allergen-specific immunotherapy: An effective and safe alternative treatment route for pollen-induced allergic rhinitis
(2013) In Journal of Allergy and Clinical Immunology 131(2). p.412-420- Abstract
- Background: Allergen-specific immunotherapy is the only causative treatment of IgE-mediated allergic disorders. The most common administration route is subcutaneous, which may necessitate more than 50 allergen injections during 3 to 5 years. Recent evidence suggests that direct intralymphatic injections could yield faster beneficial results with considerably lower allergen doses and markedly reduced numbers of injections. Objective: To evaluate the effects of intralymphatic allergen-specific immunotherapy in pollen-allergic patients. Methods: In an open pilot investigation followed by a double-blind, placebo-controlled study, patients with allergic rhinitis were treated with 3 intralymphatic inguinal injections of ALK Alutard (containing... (More)
- Background: Allergen-specific immunotherapy is the only causative treatment of IgE-mediated allergic disorders. The most common administration route is subcutaneous, which may necessitate more than 50 allergen injections during 3 to 5 years. Recent evidence suggests that direct intralymphatic injections could yield faster beneficial results with considerably lower allergen doses and markedly reduced numbers of injections. Objective: To evaluate the effects of intralymphatic allergen-specific immunotherapy in pollen-allergic patients. Methods: In an open pilot investigation followed by a double-blind, placebo-controlled study, patients with allergic rhinitis were treated with 3 intralymphatic inguinal injections of ALK Alutard (containing 1000 SQ-U birch pollen or grass pollen) or placebo (ALK diluent). Clinical pre- and posttreatment parameters were assessed, the inflammatory cell content in nasal lavage fluids estimated, and the activation pattern of peripheral T cells described. Results: All patients tolerated the intralymphatic immunotherapy (ILIT) treatment well, and the injections did not elicit any severe adverse event. Patients receiving active treatment displayed an initial increase in allergen-specific IgE level and peripheral T-cell activation. A clinical improvement in nasal allergic symptoms upon challenge was recorded along with a decreased inflammatory response in the nose. In addition, these patients reported an improvement in their seasonal allergic disease. No such changes were seen in the placebo group. Conclusions: Although this study is based on a limited number of patients, ILIT with grass-pollen or birch-pollen extracts appears to reduce nasal allergic symptoms without causing any safety problems. Hence, ILIT might constitute a less time-consuming and more cost-effective alternative to conventional subcutaneous allergen-specific immunotherapy. (J Allergy Clin Immunol 2013;131:412-20.) (Less)
Please use this url to cite or link to this publication:
https://lup.lub.lu.se/record/3589935
- author
- Hylander, Terese ; Latif, Leith LU ; Westin, Ulla LU and Cardell, Lars-Olaf LU
- organization
- publishing date
- 2013
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- Allergen-specific immunotherapy, allergic rhinitis, intralymphatic, immunotherapy, seasonal allergic rhinitis
- in
- Journal of Allergy and Clinical Immunology
- volume
- 131
- issue
- 2
- pages
- 412 - 420
- publisher
- Elsevier
- external identifiers
-
- wos:000314661500019
- scopus:84873359531
- pmid:23374268
- ISSN
- 1097-6825
- DOI
- 10.1016/j.jaci.2012.10.056
- language
- English
- LU publication?
- yes
- id
- b879830c-9323-4f31-a752-d2ef621fdf92 (old id 3589935)
- alternative location
- http://www.ncbi.nlm.nih.gov/pubmed/23374268
- date added to LUP
- 2016-04-01 12:57:26
- date last changed
- 2024-02-07 18:46:42
@article{b879830c-9323-4f31-a752-d2ef621fdf92,
abstract = {{Background: Allergen-specific immunotherapy is the only causative treatment of IgE-mediated allergic disorders. The most common administration route is subcutaneous, which may necessitate more than 50 allergen injections during 3 to 5 years. Recent evidence suggests that direct intralymphatic injections could yield faster beneficial results with considerably lower allergen doses and markedly reduced numbers of injections. Objective: To evaluate the effects of intralymphatic allergen-specific immunotherapy in pollen-allergic patients. Methods: In an open pilot investigation followed by a double-blind, placebo-controlled study, patients with allergic rhinitis were treated with 3 intralymphatic inguinal injections of ALK Alutard (containing 1000 SQ-U birch pollen or grass pollen) or placebo (ALK diluent). Clinical pre- and posttreatment parameters were assessed, the inflammatory cell content in nasal lavage fluids estimated, and the activation pattern of peripheral T cells described. Results: All patients tolerated the intralymphatic immunotherapy (ILIT) treatment well, and the injections did not elicit any severe adverse event. Patients receiving active treatment displayed an initial increase in allergen-specific IgE level and peripheral T-cell activation. A clinical improvement in nasal allergic symptoms upon challenge was recorded along with a decreased inflammatory response in the nose. In addition, these patients reported an improvement in their seasonal allergic disease. No such changes were seen in the placebo group. Conclusions: Although this study is based on a limited number of patients, ILIT with grass-pollen or birch-pollen extracts appears to reduce nasal allergic symptoms without causing any safety problems. Hence, ILIT might constitute a less time-consuming and more cost-effective alternative to conventional subcutaneous allergen-specific immunotherapy. (J Allergy Clin Immunol 2013;131:412-20.)}},
author = {{Hylander, Terese and Latif, Leith and Westin, Ulla and Cardell, Lars-Olaf}},
issn = {{1097-6825}},
keywords = {{Allergen-specific immunotherapy; allergic rhinitis; intralymphatic; immunotherapy; seasonal allergic rhinitis}},
language = {{eng}},
number = {{2}},
pages = {{412--420}},
publisher = {{Elsevier}},
series = {{Journal of Allergy and Clinical Immunology}},
title = {{Intralymphatic allergen-specific immunotherapy: An effective and safe alternative treatment route for pollen-induced allergic rhinitis}},
url = {{http://dx.doi.org/10.1016/j.jaci.2012.10.056}},
doi = {{10.1016/j.jaci.2012.10.056}},
volume = {{131}},
year = {{2013}},
}