You may have seen Immunotherapy for allergies being talked about in the media and online, often presented as a life changing treatment for those who suffer with allergies. But what is Immunotherapy for Allergies? And how does one go about accessing it for themselves or their child? In this brief guide on all things Immunotherapy, we hope to answer any questions you may have about this treatment and clear up some common myths and misunderstandings of this transformative treatment for Allergies.
What is Immunotherapy for Allergies?
Immunotherapy or allergen immunotherapy refers to the process by which the body is gradually exposed to increasing doses of a substance which someone is allergic to, to reduce the severity of allergic reactions. This is also known as desensitisation.
This process retrains the immune system by shifting the balance of T cells, increasing regulatory T cells (Tregs) that suppress allergic reactions while reducing allergen-specific helper T cells (Th2) that drive allergy symptoms. Over time, this reduces inflammation and the severity of allergic responses. As exposure continues, the body also produces blocking antibodies, making it safer for individuals to encounter the allergen in daily life.
Immunotherapy has been in existence for many years and is widely used across the world to treat allergies. In the UK, allergen avoidance has been the standard in allergy care in recent years and Immunotherapy as an allergy treatment is not routinely offered – although services and types of immunotherapy treatments are increasing. When administered by someone with the right experience, immunotherapy is considered safe and effective.
How does Immunotherapy work?
There are different types of Immunotherapies for allergies currently offered in the UK, and it depends on the individual patient and their triggers as to which method is most suitable for treating their allergy (or allergies)
- Sublingual immunotherapy (known as SLIT) involves placing allergen-containing tablets or drops under the tongue to gradually desensitise the body to allergens. This is generally offered for environmental allergies such as pet, dust mite and pollen allergies. You may have seen Dr Helen discuss a newly approved SLIT drug for dust mite allergy in the news recently – https://www.bbc.co.uk/news/articles/c5y6lq2yd9zo
- Subcutaneous Immunotherapy (known as SCIT) are injections which are administered to gradually expose the patient to allergens and help to desensitise their immune system to that allergen. This is generally offered for allergies such as pollen and bee and wasp venom. The injections do carry a risk of anaphylaxis, so SLIT is often considered a safer option in community clinics.
- Food Oral Immunotherapy (known as OIT) involves eating or drinking a controlled amount of the allergen containing product and gradually building tolerance to the allergen over time. This builds a tolerance to the allergen and therefore gives protection against accidental exposure – it is hoped that if exposure outside of dosing occurs, a reaction will either not occur or should be milder. In the UK we currently offer Palforzia – a peanut immunotherapy treatment – on the NHS and other OIT treatments for a variety of foods at private allergy clinics only. These include treatments such as milk OIT, sesame OIT, chickpea OIT, pea OIT, egg OIT and others.
Who is suitable for immunotherapy?
The suitability for treatment varies from patient to patient and you must consider a range of factors – in conjunction with an allergy specialist – before starting any immunotherapy treatment.
Food Oral Immunotherapy for allergies is suitable for children (approximately aged ten months to seventeen years old). Any co-existing medical conditions (such as asthma and eosinophilic oesophagitis) will need to be managed to consider starting Immunotherapy treatment and any risk factors (such as anaphylaxis) will need to be discussed in advance of treatment.
Immunotherapy is a life changing treatment for patients and their families, however it can also be a challenging process, so professional advice must be sought to carefully weigh up the treatment options and decide what is right for you and your family.
What Does the Future Hold for Immunotherapy?
It is an exciting time in the allergy world currently with increasing options becoming available for the treatment of food allergies for both children, and adults.
Sublingual immunotherapy. This is a treatment option which will soon be available at Dr Helen Allergy and is currently offered only in other countries. It involves using a diluted amount of the food and placing it under the tongue for a period of one minute, before swallowing.
Over time, using a very small amount of the food protein, the tolerance to the food will begin to build. This is a very safe option and crucially will be a treatment available for adults as well as children. Sublingual immunotherapy for allergies also brings with it the option for multiple foods to be treated at the same time.
Testing to See if Immunotherapy Treatment Has Worked
After one year of treatment, individuals will undergo a food challenge to see if they can tolerate a small amount of the food. This is a low-risk treatment option with a success rate of around 60-70%.
What is EPIT?
Epicutaneous immunotherapy (EPIT) is a treatment approach for allergic conditions, where allergens are applied to the skin using a patch to gradually desensitise the immune system. This method is being studied primarily for food allergies, such as peanut allergy, and aims to improve tolerance while reducing severe allergic reactions.
EPIT is considered a promising, non-invasive alternative to oral immunotherapy, with potentially fewer side effects. There is currently a phase 3 study ongoing looking at the use of EPIT for peanut allergies.
Omalizumab is a medicine that helps prevent allergic reactions by blocking a protein in the body called IgE, which triggers allergies. It was first used for asthma and skin allergies but is has recently been shown that it can help people with food allergies.
The medicine is given as a subcutaneous injection every 4-6 weeks and can make the body less sensitive to foods that usually cause severe reactions. It can be used on its own or with other treatments to make food allergies safer to manage, especially for people with multiple allergies or a high risk of serious reactions.
To find out more about the treatments we offer at our clinics visit Dr Helen Allergy for further information or contact us to find out more.
