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. 2003 Nov 22;327(7425):1229. doi: 10.1136/bmj.327.7425.1229

Treatment of seasonal allergic rhinitis

Desensitisation for hay fever works

Stephen R Durham 1
PMCID: PMC274072  PMID: 14630778

Editor—Desensitisation for hay fever, using conventional high dose extracts, does work1 and does modify allergy, as reflected by long term remission of disease for at least three years after treatment, and data indicating reduced progression of hay fever to asthma in children.2,3 On the other hand, the negative results of the study by Radcliffe et al concerning enzyme-potentiated desensitisation using low dose extracts are convincing and seriously question the use of this alternative treatment.4

Figure 1.

Figure 1

It is unfortunate that your journal cover banner heading did not distinguish the two forms of treatment, with the likely result that general practitioners will be discouraged from referring the small but significant proportion of patients with severe hay fever, unresponsive to nasal corticosteroids and antihistamines, to NHS allergy clinics for consideration of high dose desensitisation.

Equally upsetting was the depiction of a “stargazer,” I presume a type of lily, as a cause of hay fever. Hay fever is caused by wind pollinated plants, which include grasses, trees, and weeds. Lilies are insect pollinated. They look nice and smell nice, and they attract insects, but they don't cause hay fever.

Competing interests: SRD has received research funding, and consultancy and lecture fees from ALK Abello, Horsholm, Denmark, a manufacturer of high-dose vaccines for hay fever.

References

  • 1.Varney V, Gaga M, Frew AJ, Aber VA, Kay AB, Durham SR. Usefulness of immunotherapy in patients with severe summer hay fever uncontrolled by anti-allergic drugs. BMJ 1991;302: 265-9. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 2.Durham SR, Walker SM, Varga EM, Jacobson MR, O'Brien F, Noble W, et al. Long term clinical efficacy of grass pollen immunotherapy. N Engl J Med 1999;341: 468-75. [DOI] [PubMed] [Google Scholar]
  • 3.Moller C, Dreborg S, Ferdousi HA, Halken S Host A, Koivikko A, et al. Pollen immunotherapy reduces the development of asthma in children with allergic rhinoconjunctivitis (The PAT study). J Allergy Clin Immunol 2002;109: 251-6. [DOI] [PubMed] [Google Scholar]
  • 4.Radcliffe MJ, Lewith GT, Turner RG, Prescott P, Church MK, Holgate ST. Enzyme potentiated desensitisation in treatment of seasonal allergic rhinitis: double blind randomised controlled study. BMJ 2003;327: 251-4. (2 August.) [DOI] [PMC free article] [PubMed] [Google Scholar]

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