title: Intralymphatic immunotherapy.
abstract: OBJECTIVE
  IgE-mediated allergy can be treated by subcutaneous allergen-specific immunotherapy (SCIT). However, the percentage of allergic patients undergoing SCIT is low, mainly due to the long duration of the therapy and the risk of severe systemic allergic reactions associated with the allergen administration. Typically, SCIT requires dozens of subcutaneous allergen injections that stretch over 3-5 years. Over the last decade, sublingual immunotherapy has been established as an alternative to SCIT, but treatment duration and dosing frequencies could not be reduced. Recently, immunotherapy by direct administration of the allergen into lymph nodes [intralymphatic immunotherapy (ILIT)] has proven a promising alternative and this method is the focus of the present review.
  
  
  RESULTS
  Several studies on animals and on humans have shown that direct injection into lymph nodes enhanced immune responses to protein, peptide, and naked DNA vaccines. Moreover, ILIT strongly improved allergen immunotherapy, so that the number of allergen administrations as well as the allergen dose could be reduced. As ILIT was also well tolerated, practically painless, and easy to perform, patient compliance was improved as compared with SCIT.
  
  
  CONCLUSIONS
  Direct ILIT into a subcutaneous lymph node markedly enhances protective immune responses, so that both the dose and the number of allergen injections can be reduced, making ILIT safer and faster than other forms of immunotherapy, and most importantly, this enhances patient convenience and compliance.
authors.affiliation: Clinical Trials Center, Center for Clinical Research, University and University Hospital of Zurich, Switzerland. gabriela.senti@usz.ch
authors.forename: Gabriela
authors.initials: G
authors.lastname: Senti
authors.forename: Pål
authors.initials: P
authors.lastname: Johansen
authors.forename: Thomas M
authors.initials: TM
authors.lastname: Kündig
mesh_terms: D000485:Allergens / Q000008:administration & dosage* / Q000009:adverse effects; D000818:Animals; D002986:Clinical Trials as Topic; D003888:Desensitization, Immunologic; D004334:Drug Administration Schedule; D006801:Humans; D006969:Hypersensitivity, Immediate / Q000276:immunology / Q000628:therapy*; D007272:Injections, Intralymphatic; D008213:Lymphocyte Activation / Q000187:drug effects; D010349:Patient Compliance; D013997:Time Factors
chemical_list: D000485:Allergens