What Do We Really Know About Intralymphatic Immunotherapy?
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Purpose of review
Allergen-specific immunotherapy (AIT) is the only causal treatment method of IgE-mediated allergies that may lead to long-term symptom amelioration even after the end of treatment, positively interfere with the course of disease, and improve the immunological situation of the patient. While AIT in general requires treatment periods over 3 up to 5 years, intralymphatic immunotherapy (ILIT) needs only three ultrasound-guided injections of low allergen doses into inguinal lymph nodes with 4-week time interval making the entire treatment possible within 2 months.
The number of published ILIT trials is continuously increasing and it has been mainly used for the indication of allergic rhinitis using commercially available grass pollen and birch extracts and Dermatophagoides farinae, Dermatophagoides pteronyssinus, dog or cat allergens, and moreover a recombinant MAT-Fel d 1 vaccine and autologous semen from a patient with post-orgasmic illness syndrome.
ILIT is a very promising AIT technique that could widely improve patient treatment However, there is not enough convincing evidence for a routine use of ILIT and no authorized commercial allergen extracts exist for this approach, so far. Dose-escalation studies and prospective DBPC efficacy trials need to be performed in diverse allergens like insect venom. Moreover, pediatric populations have not been present in former ILIT studies.
KeywordsIntralymphatic immunotherapy ILIT Allergen-specific immunotherapy AIT Allergic rhinitis
Compliance with ethical standards
Conflict of interest
Dr. Kündig reports grants from AlleCure Corp. USA, grants from ImVision AG, during the conduct of the study. In addition, Dr. Kündig has patents on intralymphatic immunotherapy where he is named as inventor. These patents, however, are owned by the University of Zurich. Dr. Klimek reports grants and personal fees from ALK-Abelló, Denmark; personal fees from MEDA, Sweden; grants and personal fees from Novartis, Switzerland; grants and personal fees from Allergopharma, Germany; grants and personal fees from Bionorica, Germany; personal fees from Boehringer Ingelheim, Germany; grants and personal fees from GSK, Great Britain; grants and personal fees from Lofarma, Italy; grants from Biomay, Austria; grants from HAL, Netherlands; grants from LETI, Spain; grants from Roxall, Germany; and grants from Bencard, Great Britain, outside the submitted work. Dr. Senti declares that she has no conflict of interest. Dr. Hoffmann declares that he has no conflict of interest.
Human and animal rights and informed consent
This article does contain studies with human subjects performed by GS, TK and HJH.
These studies have been performed according to the Declaration of Helsinki in its actual version and a positive vote of the responsible Ethical Committee was given before start of the study.
References and Recommended Reading
Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance
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