ABSTRACT
Allergen-specific immunotherapy (AIT) is the only allergy treatment that confers long-term symptom amelioration for patients suffering from allergy. The most frequently used allergen application route is subcutaneous injection (SCIT), commonly taken as the gold standard, followed by sublingual (SLIT) or oral (OIT) application of allergen preparations. This is an up-to-date review of the clinical evidence for a novel route of allergen application, i.e., directly into lymph nodes - intralymphatic immunotherapy (ILIT). The major advantages of ILIT over the current AIT approaches are its short duration and the low allergen doses administered. The whole treatment consists of merely 3 ultrasound-guided injections into inguinal lymph nodes 1 month apart. While the number of patients included in randomised controlled trials is still limited, the clinical results for ILIT are encouraging, but more clinical trials are needed, as well as more preclinical work for optimising formulations.
Subject(s)
Allergens/administration & dosage , Allergens/immunology , Desensitization, Immunologic/methods , Lymph Nodes/immunology , Clinical Trials as Topic , Humans , Hypersensitivity/immunology , Hypersensitivity/therapy , Injections, Subcutaneous , Sublingual Immunotherapy , Treatment OutcomeSubject(s)
Allergens/immunology , Conjunctivitis, Allergic/therapy , Desensitization, Immunologic/methods , Poaceae/immunology , Pollen/immunology , Rhinitis, Allergic, Seasonal/therapy , Adolescent , Adult , Double-Blind Method , Humans , Injections, Intralymphatic , Lymph Nodes/diagnostic imaging , Treatment Outcome , Ultrasonography , Young AdultABSTRACT
BACKGROUND: A relation between stress and symptoms of rhinitis has not been established. OBJECTIVE: To determine if participants' reporting of allergy flares correlated with perceived emotional stress, depression, mood, and a biomarker of stress (cortisol). METHODS: This study was a secondary analysis of 179 university employees who participated in a study evaluating the influence of several lifestyle interventions on health symptoms and inflammation. Perceived stress and depressive symptom questionnaires were obtained before each 2-week study period. Online diary entries documenting same-day allergy flares, stressful events, perceived stress, mood, and salivary cortisol levels were collected daily during 2 14-day blocks. RESULTS: Thirty-nine percent of subjects (n = 69) self-reported allergy symptoms. This allergy flare group had higher perceived stress scores than the group without allergy symptoms. Perceived stress, but not depressive symptoms, positively correlated with allergy flares evaluated during 2 independent 14-day periods. There also was a positive relation between negative mood scores and allergy flares over the course of the study. Cortisol had no association with allergy symptom flares. CONCLUSION: These findings suggest that individuals with persistent emotional stress have more frequent allergy flares. Furthermore, those with more flares have greater negative mood.