This literature review assessed the effectiveness of two approaches:
- specific immunotherapy (SIT) with aeroallergens in patients with immunoglobulin E (IgE) mediated atopic dermatitis (AD)
- oral immunotherapy (OIT) with food allergens as "active" treatment to achieving tolerance for foods in patients with IgE mediated food allergy
Mechanisms of allergen-specific immunotherapy (click to enlarge the image):
32 studies were included that used subcutaneous immunotherapy (SCIT) or sublingual immunotherapy (SLIT) or OIT with placebo.
36-92% of patients treated with OIT reached tolerance to cow's milk or egg. 8-53% reached partial tolerance.
Regarding SIT for AD: 72% of patients treated with house dust mite SCIT and 54% treated with SLIT had a significant improvement of SCORAD-Index.
This review found that OIT with cow's milk or egg is effective in achieving full tolerance or partial tolerance in the majority of patients with IgE mediated food allergy.
Editor's note: 36% is hardly called "majority". More studies are needed, especially trials evaluating the incidence of adverse reactions and eosinophilic esophagitis. OIT is not yet ready for prime time.
SIT may represent an additional therapeutic tool for the treatment of extrinsic AD in properly selected patients.
SIT beyond respiratory diseases. Pajno GB, Finegold I. Ann Allergy Asthma Immunol. 2011 Nov;107(5):395-400.
The place of oral desensitization in the practice of allergy at this time is in flux - see why: http://goo.gl/gNKLD
Robert Silge - 36-96%. A nice tight grouping there.