In line with its mission, the Editorial Board of MedTvoiLokony makes every effort to provide reliable medical content supported by the latest scientific knowledge. The additional flag “Checked Content” indicates that the article has been reviewed by or written directly by a physician. This two-step verification: a medical journalist and a doctor allows us to provide the highest quality content in line with current medical knowledge.
Our commitment in this area has been appreciated, among others, by by the Association of Journalists for Health, which awarded the Editorial Board of MedTvoiLokony with the honorary title of the Great Educator.
Desensitization is one of the most effective methods in allergology – it affects the natural course of an allergic disease, prevents allergies to other allergens, and its effects persist for many years after the end of therapy.
Immunotherapy (desensitization) induces tolerance to allergens to which the patient is allergic. The composition of the vaccine is adjusted to the patient’s needs. This method can be used in patients aged 5 to about 60 with:
• allergic rhinitis,
• mild or moderate atopic asthma,
• allergic to Hymenoptera venom (wasps, bees, ants).
All-season and pre-season
Desensitization most often involves the administration of an allergen solution in the form of subcutaneous vaccines. The amount of allergen administered gradually increases until it reaches a maintenance dose that should be administered regularly over several years. During the initial treatment with increasing doses of the allergen, injections are given every 7-14 days, and then the patient receives maintenance doses every 4-6 weeks. Depending on the type of vaccine, desensitization is carried out in an all-year or pre-season system.
Year-round desensitisation – after the maintenance dose is reached, the injections are given every 4-6 weeks for 5 years. This desensitization scheme is always valid if you are allergic to year-round allergens, such as house dust mites and molds.
Pre-season desensitization – before each pollen season, 7 to 9 injections of the allergen are administered at intervals of 7-14 days. We also continue the pre-season therapy for 5 years.
Watch out for symptoms
Patients must avoid exercise, hot water baths, saunas and alcohol consumption for 24 hours after vaccination. In patients with bronchial asthma, airway function is checked before and after the injection. After vaccination, the patient is observed for at least 30 minutes. Any symptom that occurs during this time must be reported immediately.
The patient should take an antihistamine on the day of vaccination. Patients allergic to pollen should eliminate from the diet on this day foods that cross-react with pollen, e.g. certain vegetables and fruits. However, those who are allergic to dust mites should avoid eating seafood.
During desensitization, local and systemic adverse reactions may occur, such as swelling, erythema and itching of the skin at the injection site, occurring 10-15 minutes after vaccination, or subcutaneous tissue swelling with itching at the vaccination site, occurring 6-24 hours after vaccination. Systemic symptoms such as hives, itching of the skin, swelling of the throat mucosa, dyspnoea or anaphylactic shock are rare. But due to the possibility of their appearance, allergy vaccinations must be carried out under the supervision of an allergist in specialist clinics.
Contraindications and recommendations
There are specific contraindications for desensitization. The most important of them are:
• lack of cooperation and informed consent on the part of the patient (in the case of a child, the parents decide about the treatment),
• coexistence of overt autoimmune diseases, cancer, severe cardiovascular diseases (coronary artery disease, arterial hypertension),
• a pregnancy where immunotherapy should not be started, but supportive treatment can be continued,
• age below 5 years,
• severe atopic dermatitis (AD),
• severe asthma.
Desensitization is the best form of treatment for inhalation allergies. However, it requires a lot of discipline and consistency.
Paulina Szczęsnowicz-Dąbrowska, MD, PhD
Source: Let’s live longer