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Novel Allergen Immunotherapy Routes

  • Specific Immunotherapy (L Cox, Section Editor)
  • Published:
Current Treatment Options in Allergy Aims and scope Submit manuscript

Opinion statement

Allergic diseases are among the most common human diseases of humans. Approximately 33 % of the total population in industrialized countries may be affected. The immune response towards allergens is regulated by T lymphocytes and characterized by an interleukin (IL)-4, IL-5 and IL-13 dominated Th2 cytokine profile. Allergen-specific immunotherapy (AIT) is the only causative treatment option and able to change the natural course of disease, e.g., to prevent the development of asthma and new sensitizations. Classically, the allergen extract has been applied subcutaneously to the patient. New application methods for delivering the allergen to the patient have been developed in recent years. The intralymphatic delivery of allergens named intralymphatic immunotherapy (ILIT) has been evaluated in clinical trials and was demonstrated to be a highly potent application route with low effort and side effects while having equal efficacy if compared with current standard AIT forms. However, large studies that verify important questions like optimal dose, injection intervals, new allergen forms, use of adjuvants, etc. are still missing. Moreover, it has to be evaluated, whether different indications like rhinitis, asthma, or atopic dermatitis are suitable for ILIT and whether it is useful in children. Epicutaneous immunotherapy (EPIT) is a possible alternative application form. EPIT is minimally invasive and basically consists of the affixation of allergen containing patches to the epidermis over 6 weeks. From the studies performed so far, the authors concluded, that EPIT is safe and efficacious in a dose-dependent manner after six patches only. EPIT is increasingly attracting attention because of its capacity to offer a safe, needle-free, and potentially self-administrable treatment option for IgE-mediated allergic diseases. AIT is accepted to be the only causative treatment option for allergies. New application routes in ILIT and EPIT may become more important and allow for different delivery methods in the future, however further clinical studies are required and in preparation.

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Authors and Affiliations

  1. Center for Rhinology and Allergology, An den Quellen 10, 65183, Wiesbaden, Germany

    Ludger Klimek Prof. Dr. med., Annette Sperl, Gabriela Senti PD Dr. med. & Thomas Kündig PD Dr. med.

  2. UniversitätsSpital Zürich, Clinical Trials Center, Zentrum für Klinische Forschung, Rämistraße 100/MOU2, CH-8091, Zürich, Switzerland

    Gabriela Senti PD Dr. med.

  3. UniversitätsSpital Zürich, Rämistraße 100/MOU2, CH-8091, Zürich, Switzerland

    Thomas Kündig PD Dr. med.

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  1. Ludger Klimek Prof. Dr. med.
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Correspondence to Ludger Klimek Prof. Dr. med..

Ethics declarations

The survey was conducted according to the guidelines of the “International Conference on Harmonization on Good Clinical Practice” (ICH-GCP) and the Declaration of Helsinki.

Conflict of interest

L. Klimek (LK) has received research grants for his institution from ALK Abelló (Germany/Denmark), Allergopharma (Germany), Stallergenes (Germany/ France), HAL Allergy (Germany/the Netherlands), Artu Biologicals (the Netherlands), Allergy Therapeutics/Bencard (UK/Germany), Hartington (Spain), Lofarma (Italy), Novartis/Leti (Germany/Spain), GlaxoSmithKline (UK/Germany), Essex Pharma (Germany), Cytos (Switzerland), Curalogic (Denmark), Roxall (Germany), Biomay (Austria), Thermo Fisher (Germany), Circassia (UK), Biotech Tools s.a. (Belgium), and Meda Pharma GmbH (Germany); and/or he has served as an advisor and on speakers’ bureaus for some of the aforementioned companies. LK has received travel grants from HAL Allergy (the Netherlands/Germany), Meda (Germany/Sweden), and Allergopharma (Germany), and he is a consultant for Bencard (Germany), Novartis/Leti (Germany), Meda (Germany), ALK Abelló (Germany/Denmark), Allergopharma (Germany), and Boehringer Ingelheim (Germany).

LK is Board Member of the ENT Section of the European Academy of Allergy and Clinical Immunology (EAACI), Vice-President of the German Academy of Allergology and Clinical Immunology, Vice-President German Union of Allergologists, Member of the Board of Directors of the German Society for Otorhinolaryngology HNS. He is co-editor and author of different chapters of the textbook “Allergien bei Kindern und Jugendlichen” (publisher: Schattauer-Verlag, Germany), author of one chapter in “Allergologie” (publisher: Springer, Germany), and author of different chapters in “Allergologie” (publisher: Schattauer-Verlag).

Annette Sperl declares that she has no conflict of interest.

Thomas Kündig declares that he has no conflict of interest.

Gabriela Senti declares that she has no conflict of interest.

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This article does not contain any original data on studies with human or animal subjects performed by any of the authors. For the cited publications that include original data from previous studies of the authors, human rights declarations have been given in the respective publication.

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Klimek, L., Sperl, A., Senti, G. et al. Novel Allergen Immunotherapy Routes. Curr Treat Options Allergy 3, 102–112 (2016). https://doi.org/10.1007/s40521-016-0071-7

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