Novel strategies for the treatment of grass pollen-induced allergic rhinitis.
Allergic rhinitis (AR) affects over 20% of the population of Europe and the United States. Allergen immunotherapy (AIT) is currently the only form of treatment that affects symptoms and modifies the progression of disease. Established forms of AIT include subcutaneous (SCIT) and sublingual (SLIT) immunotherapy and are widely effective, yet only 2-9% of eligible patients undergo therapy, likely due to the long duration of treatment. As a result, novel, faster forms of AIT are currently under development.



This article provides an overview of AR and summarises the efficacy and mechanisms of established forms of AIT, highlighting the current drawbacks. We discuss novel strategies of AIT that have been developed in an attempt to tackle these limitations, including epicutaneous, intradermal and intralymphatic immunotherapy (ILIT), focusing on ILIT, the treatment that has been most comprehensively assessed.



Current strategies to treat AR suffer from a poor safety profile and, importantly, lack of adherence. ILIT is a faster and safer form of AIT, with a treatment regime of only 12 weeks. Further validation is required, but ILIT, with its short and comparatively inexpensive protocol, has the potential to offer disease-modifying therapy to a larger number of patients.
a Division of ENT Diseases, Department of Clinical Sciences, Intervention and Technology , Karolinska Institutet , Stockholm , Sweden.
Olivia
O
Larsson
a Division of ENT Diseases, Department of Clinical Sciences, Intervention and Technology , Karolinska Institutet , Stockholm , Sweden.
Laila
L
Hellkvist
b Laboratory of Clinical Experimental Allergy Research, Department of Otorhinolaryngology Malmö , Lund University, Skåne University Hospital , Malmö , Sweden.
Ulla
U
Peterson-Westin
a Division of ENT Diseases, Department of Clinical Sciences, Intervention and Technology , Karolinska Institutet , Stockholm , Sweden.|c Department of ENT Diseases , Karolinska University Hospital , Stockholm , Sweden.
Lars Olaf
LO
Cardell
D000485:Allergens / Q000276:immunology; D000818:Animals; D003888:Desensitization, Immunologic / Q000379:methods*; D005060:Europe / Q000453:epidemiology; D006801:Humans; D007272:Injections, Intralymphatic / Q000379:methods; D006109:Poaceae / Q000187:drug effects* / Q000276:immunology; D011058:Pollen / Q000187:drug effects* / Q000276:immunology; D065631:Rhinitis, Allergic / Q000453:epidemiology / Q000276:immunology / Q000628:therapy*; D063729:Sublingual Immunotherapy / Q000379:methods; D013997:Time Factors; D016896:Treatment Outcome; D014481:United States / Q000453:epidemiology
D000485:Allergens
Allergic rhinitis; allergen immunotherapy; allergy; grass pollen; intralymphatic immunotherapy