title: Clinical practice recommendations for allergen-specific immunotherapy in children: the Italian consensus report.
abstract: Allergen-specific immunotherapy (AIT) is currently recognized as a clinically effective treatment for allergic diseases, with a unique disease-modifying effect. AIT was introduced in clinical practice one century ago, and performed in the early years with allergenic extracts of poor quality and definition. After the mechanism of allergic reaction were recognized, the practice of AIT was refined, leading to remarkable improvement in the efficacy and safety profile of the treatment. Currently AIT is accepted and routinely prescribed worldwide for respiratory allergies and hymenoptera venom allergy. Both the subcutaneous (SCIT) and sublingual (SLIT) routes of administration are used in the pediatric population.AIT is recommended in allergic rhinitis/conjunctivitis with/without allergic asthma, with an evidence of specific IgE-sensitization towards clinically relevant inhalant allergens. Long-term studies provided evidence that AIT can also prevent the onset of asthma and of new sensitizations. The favorable response to AIT is strictly linked to adherence to treatment, that lasts 3-5 years. Therefore, several factors should be carefully evaluated before starting this intervention, including the severity of symptoms, pharmacotherapy requirements and children and caregivers' preference and compliance.In recent years, there have been increasing interest in the role of AIT for the treatment of IgE-associated food allergy and extrinsic atopic dermatitis. A growing body of evidence shows that oral immunotherapy represents a promising treatment option for IgE-associated food allergy. On the contrary, there are still controversies on the effectiveness of AIT for patients with atopic dermatitis.This consensus document was promoted by the Italian Society of Pediatric Allergy and Immunology (SIAIP) to provide evidence-based recommendations on AIT in order to implement and optimize current prescription practices of this treatment for allergic children.
authors.affiliation: Department of Pediatrics, Allergy Unit, University of Messina, Via Consolare Valeria-Gazzi, Messina, 98124, Italy. giovanni.pajno@unime.it.
authors.forename: Giovanni Battista
authors.initials: GB
authors.lastname: Pajno
authors.affiliation: Pediatric Unit, Hospital "Nuovo Ospedale S. Giuseppe", Empoli, Italy.
authors.forename: Roberto
authors.initials: R
authors.lastname: Bernardini
authors.affiliation: Pediatric Unit, University of Pisa, Pisa, Italy.
authors.forename: Diego
authors.initials: D
authors.lastname: Peroni
authors.affiliation: Department of Pediatrics, Allergy Unit, University of Messina, Via Consolare Valeria-Gazzi, Messina, 98124, Italy.|Molecular Allergology and Immunomodulation- Department of Pediatric Pneumology and Immunology, Charité Medical University Berlin, Berlin, Germany.
authors.forename: Stefania
authors.initials: S
authors.lastname: Arasi
authors.affiliation: Pediatric Unit, Hospital "G. Salvini", Garbagnate Milanese, Italy.
authors.forename: Alberto
authors.initials: A
authors.lastname: Martelli
authors.affiliation: National Pediatric Healthcare System, Turin, Italy.|National Research Council of Italy, Institute of Biomedicine and Molecular Immunology, Palermo, Italy.
authors.forename: Massimo
authors.initials: M
authors.lastname: Landi
authors.affiliation: Allergy and Respiratory Diseases, IRCCS San Martino-IST-University of Genoa, Genoa, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Passalacqua
authors.affiliation: Food Allergy Referral Centre Veneto Region, Department of Women and Child Health, Padua General University Hospital, Padua, Italy.
authors.forename: Antonella
authors.initials: A
authors.lastname: Muraro
authors.affiliation: National Research Council of Italy, Institute of Biomedicine and Molecular Immunology, Palermo, Italy.
authors.forename: Stefania
authors.initials: S
authors.lastname: La Grutta
authors.affiliation: Bambino Gesù Pediatric Hospital, Rome, Italy.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Fiocchi
authors.affiliation: Department of Pediatrics, University "La Sapienza", Rome, Italy.
authors.forename: Luciana
authors.initials: L
authors.lastname: Indinnimeo
authors.affiliation: Pediatric Unit, Department of Clinical and Experimental Medicine, University of Parma, Parma, Italy.
authors.forename: Carlo
authors.initials: C
authors.lastname: Caffarelli
authors.affiliation: Pediatric Unit, University of Bologna, Bologna, Italy.
authors.forename: Elisabetta
authors.initials: E
authors.lastname: Calamelli
authors.affiliation: Pediatric Unit, University of Verona, Verona, Italy.
authors.forename: Pasquale
authors.initials: P
authors.lastname: Comberiati
authors.affiliation: Department of Pediatrics, University "La Sapienza", Rome, Italy.
authors.forename: Marzia
authors.initials: M
authors.lastname: Duse
mesh_terms: D000284:Administration, Oral; D002648:Child; D002986:Clinical Trials as Topic; D003876:Dermatitis, Atopic / Q000276:immunology / Q000628:therapy*; D003888:Desensitization, Immunologic / Q000379:methods; D005512:Food Hypersensitivity / Q000628:therapy*; D006801:Humans; D007279:Injections, Subcutaneous; D007558:Italy; D010372:Pediatrics; D017410:Practice Guidelines as Topic; D016032:Randomized Controlled Trials as Topic; D012955:Societies, Medical; D016896:Treatment Outcome
keywords: Allergen-specific immunotherapy; Allergy; Asthma; Atopic dermatitis; Children; Food allergy; Sub-lingual immunotherapy; Subcutaneous immunotherapy