title: Epicutaneous allergen administration: is this the future of allergen-specific immunotherapy?
abstract: IgE-mediated allergies, such as allergic rhinoconjunctivitis and asthma, have become highly prevalent, today affecting up to 30% of the population in industrialized countries. Allergen-specific immunotherapy (SIT) either subcutaneously or via the sublingual route is effective, but only few patients (<5%) choose immunotherapy, as treatment takes several years and because allergen administrations are associated with local and, in some cases, even systemic allergic side-effects because of allergen accidentally reaching the circulation. In order to resolve these two major drawbacks, the ideal application site of SIT should have two characteristics. First, it should contain a high number of potent antigen-presenting cells to enhance efficacy and shorten treatment duration. Secondly, it should be nonvascularized in order to minimize inadvertent systemic distribution of the allergen and therefore systemic allergic side-effects. The epidermis, a nonvascularized multilayer epithelium, that contains high numbers of potent antigen-presenting Langerhans cells (LC) could therefore be an interesting administration route. The present review will discuss the immunological rational, history and actual clinical experience with epicutaneous allergen-specific immunotherapy.
authors.affiliation: Clinical Trials Center, University Hospital of Zürich, Zürich, Switzerland.
authors.forename: G
authors.initials: G
authors.lastname: Senti
authors.forename: S
authors.initials: S
authors.lastname: von Moos
authors.forename: Thomas M
authors.initials: TM
authors.lastname: Kündig
mesh_terms: D000279:Administration, Cutaneous; D000485:Allergens / Q000008:administration & dosage* / Q000276:immunology; D002986:Clinical Trials as Topic; D003888:Desensitization, Immunologic / Q000009:adverse effects* / Q000379:methods / Q000639:trends*; D004817:Epidermis / Q000276:immunology*; D006801:Humans; D007114:Immunization; D006255:Rhinitis, Allergic, Seasonal / Q000276:immunology / Q000628:therapy*; D016896:Treatment Outcome
chemical_list: D000485:Allergens