Allergen immunotherapy is a proven and effective treatment for seasonal pollinosis. Three years of therapy provides long-term benefits by downregulating allergen-specific Th2 responses and inducing IgE-blocking activity associated with specific IgG and IgA. In children with seasonal rhinitis, both subcutaneous and sublingual pollen immunotherapy have been shown to reduce asthma symptoms and medication needs. Additionally, house dust mite tablet immunotherapy has demonstrated effectiveness for perennial rhinitis in both adults and children and may help prevent asthma exacerbations, though its long-term effects remain unconfirmed.
The success of early peanut introduction in preventing peanut allergy highlights the potential for primary prevention of inhalant allergies and asthma. House dust mite allergy, a significant asthma risk factor, could be addressed through early intervention. Preliminary evidence suggests that sublingual house dust mite immunotherapy initiated in infancy may reduce sensitization to multiple allergens and lower asthma risk by age six. Further research, including robust randomized controlled trials, is needed to confirm its preventive potential.
Reference: Arshad H, Lack G, Durham SR, et al. Prevention Is Better than Cure: Impact of Allergen Immunotherapy on the Progression of Airway Disease. J Allergy Clin Immunol Pract. 2024 Jan;12(1):45-56. doi: 10.1016/j.jaip.2023.10.013. Epub 2023 Oct 14. PMID: 37844847.
Link: https://pubmed.ncbi.nlm.nih.gov/37844847/