[Specific immunotherapy and therapeutic strategies in allergic diseases. What's new?].
Specific immunotherapy (SIT) can induce tolerance of airborne allergens in patients with rhinitis, conjunctivitis and asthma. SIT is also effective for venom anaphylaxis. In contrast, SIT is not recommended in severe asthma, food allergy or skin allergy. The mechanisms of SITare unclear, but attention has recently focused on regulatory T cells and their capacity to induce tolerance via IL10 and TGF-alfa production. Recent studies show that SIT not only reduces symptom scores but also modifies the natural history of allergic diseases, preventing sensitization to new allergens and/or limiting the onset of asthma in children with rhinitis. Another recent advance is sublingual IT which is allergic effective and suppresses the risk of systemic anaphylactic reactions. Alternatives to SIT are in the pipeline, such as recombinant allergens, nude DNA vaccines, and immunostimulatory sequence/allergen complexes.
Tonnel
André-Bernard
AB
Service de Pneumologie et d'Immuno allergologie, Hôpital Calmette, CHRU de Lille, Lille 59037 Cedex.