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. 1989;67(3):263–272.

Current status of allergen immunotherapy (hyposensitization): memorandum from a WHO/IUIS meeting.

PMCID: PMC2491247  PMID: 2670296

Abstract

This Memorandum reviews the present status of allergen immunotherapy, its scientific basis, and the clinical evidence of its efficacy. It also makes recommendations on both indications and contraindications, the most appropriate allergens and treatment regimens, and on prevention and management of adverse reactions. Finally, it indicates future developments in this form of treatment.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Aalberse R. C., Dieges P. H., Knul-Bretlova V., Vooren P., Aalbers M., van Leeuwen J. IgG4 as a blocking antibody. Clin Rev Allergy. 1983 Jun;1(2):289–302. doi: 10.1007/BF02991163. [DOI] [PubMed] [Google Scholar]
  2. Aas K., Backman A., Belin L., Weeke B. Standardization of allergen extracts with appropriate methods. The combined use of skin prick testing and radio-allergosorbent tests. Allergy. 1978 Jun;33(3):130–137. doi: 10.1111/j.1398-9995.1978.tb01522.x. [DOI] [PubMed] [Google Scholar]
  3. Aas K. Hyposensitization in house dust allergy asthma. A double-blind controlled study with evaluation of the effect on bronchial sensitivity to house dust. Acta Paediatr Scand. 1971 May;60(3):264–268. doi: 10.1111/j.1651-2227.1971.tb06655.x. [DOI] [PubMed] [Google Scholar]
  4. Arntzen F. C., Wilhelmsen T. W., Løwenstein H., Gjesing B., Maasch H. J., Strömberg R., Einarsson R., Backman A., Mäkinen-Kiljunen S., Ford A. The international collaborative study on the first international standard of birch (Betula verrucosa)-pollen extract. J Allergy Clin Immunol. 1989 Jan;83(1):66–82. doi: 10.1016/0091-6749(89)90479-x. [DOI] [PubMed] [Google Scholar]
  5. Baer H., Anderson M. C., Helm R. M., Yunginger J. W., Lowenstein H., Gjesing B., White W., Jr, Douglass G., Phillips P. R., Schumacher M. The preparation and testing of the proposed International Reference (IRP) Bermuda grass (Cynodon dactylon)-pollen extract. J Allergy Clin Immunol. 1986 Oct;78(4 Pt 1):624–631. doi: 10.1016/0091-6749(86)90080-1. [DOI] [PubMed] [Google Scholar]
  6. Baer H., Godfrey H., Maloney C. J., Norman P. S., Lichtenstein L. M. The potency and antigen E content of commercially prepared ragweed extracts. J Allergy. 1970 Jun;45(6):347–354. doi: 10.1016/0021-8707(70)90043-2. [DOI] [PubMed] [Google Scholar]
  7. Baer H., Maloney C. J., Norman P. S., Marsh D. G. The potency and Group I antigen content of six commercially prepared grass pollen extracts. J Allergy Clin Immunol. 1974 Sep;54(3):157–164. doi: 10.1016/0091-6749(74)90052-9. [DOI] [PubMed] [Google Scholar]
  8. Bousquet J., Fontez A., Aznar R., Robinet-Levy M., Michel F. B. Combination of passive and active immunization in honeybee venom immunotherapy. J Allergy Clin Immunol. 1987 Jun;79(6):947–954. doi: 10.1016/0091-6749(87)90245-4. [DOI] [PubMed] [Google Scholar]
  9. Bousquet J., Müller U. R., Dreborg S., Jarisch R., Malling H. J., Mosbech H., Urbanek R., Youlten L. Immunotherapy with Hymenoptera venoms. Position paper of the Working Group on Immunotherapy of the European Academy of Allergy and Clinical Immunology. Allergy. 1987 Aug;42(6):401–413. doi: 10.1111/j.1398-9995.1987.tb00355.x. [DOI] [PubMed] [Google Scholar]
  10. Chapman M. D., Platts-Mills T. A., Gabriel M., Ng H. K., Allan W. G., Hill L. E., Nunn A. J. Antibody response following prolonged hyposensitization with Dermatophagoides pteronyssinus extract. Int Arch Allergy Appl Immunol. 1980;61(4):431–440. doi: 10.1159/000232471. [DOI] [PubMed] [Google Scholar]
  11. Creticos P. S., Van Metre T. E., Mardiney M. R., Rosenberg G. L., Norman P. S., Adkinson N. F., Jr Dose response of IgE and IgG antibodies during ragweed immunotherapy. J Allergy Clin Immunol. 1984 Jan;73(1 Pt 1):94–104. doi: 10.1016/0091-6749(84)90490-1. [DOI] [PubMed] [Google Scholar]
  12. D'Souza M. F., Pepys J., Wells I. D., Tai E., Palmer F., Overell B. G., McGrath I. T., Megson M. Hyposensitization with Dermatophagoides pteronyssinus in house dust allergy: a controlled study of clinical and immunological effects. Clin Allergy. 1973 Jun;3(2):177–193. doi: 10.1111/j.1365-2222.1973.tb01320.x. [DOI] [PubMed] [Google Scholar]
  13. Ford A., Seagroatt V., Platts-Mills T. A., Løwenstein H. A collaborative study on the first international standard of Dermatophagoides pteronyssinus (house dust mite) extract. J Allergy Clin Immunol. 1985 Jun;75(6):676–686. doi: 10.1016/0091-6749(85)90093-4. [DOI] [PubMed] [Google Scholar]
  14. Gleich G. J., Larson J. B., Jones R. T., Baer H. Measurement of the potency of allergy extracts by their inhibitory capacities in the radioallergosorbent test. J Allergy Clin Immunol. 1974 Mar;53(3):158–169. doi: 10.1016/0091-6749(74)90004-9. [DOI] [PubMed] [Google Scholar]
  15. Graft D. F., Schuberth K. C., Kagey-Sobotka A., Kwiterovich K. A., Niv Y., Lichtenstein L. M., Valentine M. D. Assessment of prolonged venom immunotherapy in children. J Allergy Clin Immunol. 1987 Aug;80(2):162–169. doi: 10.1016/0091-6749(87)90125-4. [DOI] [PubMed] [Google Scholar]
  16. Helm R. M., Gauerke M. B., Baer H., Løwenstein H., Ford A., Levy D. A., Norman P. S., Yunginger J. W. Production and testing of an international reference standard of short ragweed pollen extract. J Allergy Clin Immunol. 1984 Jun;73(6):790–800. doi: 10.1016/0091-6749(84)90449-4. [DOI] [PubMed] [Google Scholar]
  17. Holt P. G., Reid M., Britten D., Sedgwick J., Bazin H. Suppression of IgE responses by passive antigen inhalation: dissociation of local (mucosal) and systemic immunity. Cell Immunol. 1987 Feb;104(2):434–439. doi: 10.1016/0008-8749(87)90045-1. [DOI] [PubMed] [Google Scholar]
  18. Ishizaka K. IgE-binding factors and regulation of the IgE antibody response. Annu Rev Immunol. 1988;6:513–534. doi: 10.1146/annurev.iy.06.040188.002501. [DOI] [PubMed] [Google Scholar]
  19. Juniper E. F., O'Connor J., Roberts R. S., Evans S., Hargreave F. E., Dolovich J. Polyethylene glycol-modified ragweed extract: comparison of two treatment regimens. J Allergy Clin Immunol. 1986 Nov;78(5 Pt 1):851–856. doi: 10.1016/0091-6749(86)90229-0. [DOI] [PubMed] [Google Scholar]
  20. Kemeny D. M., MacKenzie-Mills M., Harries M. G., Youlten L. J., Lessof M. H. Antibodies to purified bee venom proteins and peptides. II. A detailed study of changes in IgE and IgG antibodies to individual bee venom antigens. J Allergy Clin Immunol. 1983 Oct;72(4):376–385. doi: 10.1016/0091-6749(83)90503-1. [DOI] [PubMed] [Google Scholar]
  21. Kishimoto T. IgE class-specific suppressor T cells and regulation of the IgE response. Prog Allergy. 1982;32:265–317. [PubMed] [Google Scholar]
  22. Leavengood D. C., Renard R. L., Martin B. G., Nelson H. S. Cross allergenicity among grasses determined by tissue threshold changes. J Allergy Clin Immunol. 1985 Dec;76(6):789–794. doi: 10.1016/0091-6749(85)90749-3. [DOI] [PubMed] [Google Scholar]
  23. Lichtenstein L. M., MacGlashan D. W., Jr The concept of basophil releasability. J Allergy Clin Immunol. 1986 Feb;77(2):291–294. doi: 10.1016/s0091-6749(86)80106-3. [DOI] [PubMed] [Google Scholar]
  24. Ljungström K. G., Renck H., Hedin H., Richter W., Rosberg B. Prevention of dextran-induced anaphylactic reactions by hapten inhibition. I. A Scandinavian multicenter study on the effects of 10 ml dextran 1, 15% administered before dextran 70 or dextran 40. Acta Chir Scand. 1983;149(4):341–348. [PubMed] [Google Scholar]
  25. Lockey R. F., Benedict L. M., Turkeltaub P. C., Bukantz S. C. Fatalities from immunotherapy (IT) and skin testing (ST) J Allergy Clin Immunol. 1987 Apr;79(4):660–677. doi: 10.1016/s0091-6749(87)80164-1. [DOI] [PubMed] [Google Scholar]
  26. Müller U. R., Morris T., Bischof M., Friedli H., Skarvil F. Combined active and passive immunotherapy in honeybee-sting allergy. J Allergy Clin Immunol. 1986 Jul;78(1 Pt 1):115–122. doi: 10.1016/0091-6749(86)90123-5. [DOI] [PubMed] [Google Scholar]
  27. Norman P. S., Lichtenstein L. M. The clinical and immunologic specificity of immunotherapy. J Allergy Clin Immunol. 1978 Jun;61(6):370–377. doi: 10.1016/0091-6749(78)90116-1. [DOI] [PubMed] [Google Scholar]
  28. Ohman J. L., Jr, Findlay S. R., Leitermann K. M. Immunotherapy in cat-induced asthma. Double-blind trial with evaluation of in vivo and in vitro responses. J Allergy Clin Immunol. 1984 Sep;74(3 Pt 1):230–239. doi: 10.1016/0091-6749(84)90251-3. [DOI] [PubMed] [Google Scholar]
  29. Patterson R., Grammer L. C., Shaughnessy M. A. Immunotherapy: parameters of assessment. J Allergy Clin Immunol. 1985 Aug;76(2 Pt 2):394–397. doi: 10.1016/0091-6749(85)90660-8. [DOI] [PubMed] [Google Scholar]
  30. Pence H. L., Mitchell D. Q., Greely R. L., Updegraff B. R., Selfridge H. A. Immunotherapy for mountain cedar pollinosis. A double-blind controlled study. J Allergy Clin Immunol. 1976 Jul;58(1 Pt 1):39–50. doi: 10.1016/0091-6749(76)90105-6. [DOI] [PubMed] [Google Scholar]
  31. Phanuphak P., Kohler P. F. Onset of polyarteritis nodosa during allergic hyposensitization treatment. Am J Med. 1980 Apr;68(4):479–485. doi: 10.1016/0002-9343(80)90285-5. [DOI] [PubMed] [Google Scholar]
  32. Price J. F., Warner J. O., Hey E. N., Turner M. W., Soothill J. F. A controlled trial of hyposensitization with adsorbed tyrosine Dermatophagoides pteronyssinus antigen in childhood asthma: in vivo aspects. Clin Allergy. 1984 May;14(3):209–219. doi: 10.1111/j.1365-2222.1984.tb02200.x. [DOI] [PubMed] [Google Scholar]
  33. Rocklin R. E., Sheffer A. L., Greineder D. K., Melmon K. L. Generation of antigen-specific suppressor cells during allergy desensitization. N Engl J Med. 1980 May 29;302(22):1213–1219. doi: 10.1056/NEJM198005293022201. [DOI] [PubMed] [Google Scholar]
  34. Saxon A., Morrow C., Stevens R. H. Subpopulations of circulating B cells and regulatory T cells involved in in vitro immunoglobulin E production in atopic patients with elevted serum immunoglobulin E. J Clin Invest. 1980 Jun;65(6):1457–1468. doi: 10.1172/JCI109810. [DOI] [PMC free article] [PubMed] [Google Scholar]
  35. Tamir R., Castracane J. M., Rocklin R. E. Generation of suppressor cells in atopic patients during immunotherapy that modulate IgE synthesis. J Allergy Clin Immunol. 1987 Apr;79(4):591–598. doi: 10.1016/s0091-6749(87)80154-9. [DOI] [PubMed] [Google Scholar]
  36. Taylor W. W., Ohman J. L., Jr, Lowell F. C. Immunotherapy in cat-induced asthma. Double-blind trial with evaluation of bronchial responses to cat allergen and histamine. J Allergy Clin Immunol. 1978 May;61(5):283–287. doi: 10.1016/0091-6749(78)90048-9. [DOI] [PubMed] [Google Scholar]
  37. Turkeltaub P. C., Rastogi S. C., Baer H., Anderson M. C., Norman P. S. A standardized quantitative skin-test assay of allergen potency and stability: studies on the allergen dose-response curve and effect of wheal, erythema, and patient selection on assay results. J Allergy Clin Immunol. 1982 Nov;70(5):343–352. doi: 10.1016/0091-6749(82)90023-9. [DOI] [PubMed] [Google Scholar]
  38. Urbanek R., Kemeny D. M., Richards D. Sub-class of IgG anti-bee venom antibody produced during bee venom immunotherapy and its relationship to long-term protection from bee stings and following termination of venom immunotherapy. Clin Allergy. 1986 Jul;16(4):317–322. doi: 10.1111/j.1365-2222.1986.tb01963.x. [DOI] [PubMed] [Google Scholar]
  39. Viander M., Koivikko A. The seasonal symptoms of hyposensitized and untreated hay fever patients in relation to birch pollen counts: correlations with nasal sensitivity, prick tests and RAST. Clin Allergy. 1978 Jul;8(4):387–396. doi: 10.1111/j.1365-2222.1978.tb00474.x. [DOI] [PubMed] [Google Scholar]

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