Skip to main content
SpringerLink
Log in

Subcutaneous Immunotherapy for Allergic Rhinitis and Asthma

  • Reference work entry
  • First Online:
Allergy and Asthma

  • 1423 Accesses

Abstract

Subcutaneous immunotherapy, a type of allergen immunotherapy, is an effective and disease-modifying treatment in patients who have suffered from allergic rhinitis with or without conjunctivitis and/or asthma and who demonstrate specific IgE antibodies to the relevant allergens. Indications of subcutaneous immunotherapy for respiratory allergies include patients who are poorly responsive to pharmacotherapies, not tolerable to medications because of side effects, and sometimes even considered for primary allergy prevention. Subcutaneous immunotherapy requires a buildup phase as the allergen content is increased until a therapeutic “desensitization” level is achieved and usually continues for 3 to 5 years. Randomized, double-blind, placebo-controlled studies have shown that subcutaneous immunotherapy is an effective treatment for allergic rhinitis and/or asthma. Even with newer therapies on the horizon, subcutaneous immunotherapy will continue to have an important role in the management of allergic diseases.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 599.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Hardcover Book
USD 799.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  • Aimmune Therapeutics’ Pivotal Phase 3 PALISADE Trial of AR101 Meets Primary Endpoint in Patients With Peanut Allergy. Available at http://ir.aimmune.com/news-releases/news-release-details/aimmune-therapeutics-pivotal-phase-3-palisade-trial-ar101-meets

  • Akdis CA, Akdis M. Mechanisms of allergen-specific immunotherapy and immune tolerance to allergens. World Allergy Organ J. 2015;8(1):17.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  • Amar SM, Harbeck RJ, Sills M, Silveira LJ, O’Brien H, Nelson HS. Response to sublingual immunotherapy with grass pollen extract: monotherapy versus combination in a multiallergen extract. J Allergy Clin Immunol. 2009;124:150–6.

    Article  CAS  PubMed  Google Scholar 

  • American Pet Products Association's 2017–2018 National Pet Owners Survey. Available at http://www.americanpetproducts.org/pubs_survey.asp

  • Amin HS, Liss GM, Bernstein DI. Evaluation of near-fatal reactions to allergen immunotherapy injections. J Allergy Clin Immunol. 2006;117(1):169–75.

    Article  PubMed  Google Scholar 

  • Baldrick P, Richardson D, Wheeler AW. Safety evaluation of a glutaraldehyde modified tyrosine adsorbed housedust mite extract containing monophosphoryl lipid a (MPL) adjuvant: a new allergy vaccine for dust mite allergy. Vaccine. 2001;20:737–43.

    Article  CAS  PubMed  Google Scholar 

  • Baxi SN, Portnoy JM, Larenas-linnemann D, Phipatanakul W. Exposure and health effects of Fungi on humans. J Allergy Clin Immunol Pract. 2016;4(3):396–404.

    Article  PubMed  PubMed Central  Google Scholar 

  • Berchtold E, Maibach R, Muller U. Reduction of side effects from rushimmunotherapy with honey bee venom by pretreatment with terfenadine. Clin Exp Allergy. 1992;22:59–65.

    Article  CAS  PubMed  Google Scholar 

  • Bernstein DI, Wanner M, Borish L, Liss GM. Twelve-year survey of fatal reactions to allergen injections and skin testing: 1990-2001. J Allergy Clin Immunol. 2004;113(6):1129–36.

    Article  PubMed  Google Scholar 

  • Bernstein IL, Li JT, Bernstein DI, Hamilton R, Spector SL, Tan R, et al. Allergy diagnostic testing: an updated practice parameter. Ann Allergy Asthma Immuno. 2008;100(3 Suppl 3):S1–148.

    CAS  Google Scholar 

  • Blumberga G, Groes L, Haugaard L, Dahl R. Steroid-sparing effect of subcutaneous SQ-standardised specific immunotherapy in moderate and severe house dust mite allergic asthmatics. Allergy. 2006;61(7):843–8.

    Article  CAS  PubMed  Google Scholar 

  • Blumenthal MN, Fine L. Definition of an allergen (Immunobiology). In: Lockey RF, Ledford DK, editors. Allergens and allergen immunotherapy: subcutaneous, sublingual and Oral. 5th ed. New York: CRC Press (Taylor & Francis Group); 2014. p. 1–525.

    Google Scholar 

  • Bodtger U. Prognostic value of asymptomatic skin sensitization to aeroallergens. Curr Opin Allergy Clin Immunol. 2004;4(1):5–10.

    Article  PubMed  Google Scholar 

  • Bousquet J, Lockey R, Malling HJ. Allergen immunotherapy: therapeutic vaccines for allergic diseases. A WHO position paper. J Allergy Clin Immunol. 1998;102(4 Pt 1):558–62.

    Article  CAS  PubMed  Google Scholar 

  • Bousquet J, Khaltaev N, Cruz AA, Denburg J, Fokkens WJ, Togias A, et al. Allergic rhinitis and its impact on asthma (ARIA) 2008 update (in collaboration with the World Health Organization, GA(2)LEN and AllerGen). Allergy. 2008;63(Suppl 86):8–160.

    Article  PubMed  Google Scholar 

  • Branco-ferreira M, Clode MH, Palma-carlos AG. Distal digital vasculitis induced by specific immunotherapy. Allergy. 1998;53(1):102–3.

    Article  CAS  PubMed  Google Scholar 

  • Brockow K, Kiehn M, Riethmuller C, Vieluf D, Berger J, Ring J. Efficacy of antihistamine pretreatment in the prevention of adverse reactions to Hymenoptera immunotherapy: a prospective, randomized, placebo-controlled trial. J Allergy Clin Immunol. 1997;100:458–63.

    Article  CAS  PubMed  Google Scholar 

  • Bunnag C, Dhorranintra B. A preliminary study of circulating immune complexes during allergen immunotherapy in Thai patients. Asian Pac J Allergy Immunol. 1989;7(1):15–21.

    CAS  PubMed  Google Scholar 

  • Burks AW, Calderon MA, Casale T, Cox L, Demoly P, Jutel M, et al. Update on allergy immunotherapy: American Academy of Allergy, Asthma & Immunology/European academy of allergy and clinical immunology/PRACTALL consensus report. J Allergy Clin Immunol. 2013;131(5):1288–96.e3.

    Article  PubMed  Google Scholar 

  • Calabria CW, Coop CA, Tankersley MS. The GILL study: glycerin-induced local reactions in immunotherapy. J Allergy Clin Immunol. 2008;121(1):222–6.

    Article  CAS  PubMed  Google Scholar 

  • Carnés J, Iraola V, Cho SH, Esch RE. Mite allergen extracts and clinical practice. Ann Allergy Asthma Immunol. 2017;118(3):249–56.

    Article  PubMed  CAS  Google Scholar 

  • Carter MC, Ruiz-esteves KN, Workman L, Lieberman P, Platts-mills TAE, Metcalfe DD. Identification of alpha-gal sensitivity in patients with a diagnosis of idiopathic anaphylaxis. Allergy. 2017. https://doi.org/10.1111/all.13366.

    Article  PubMed  CAS  Google Scholar 

  • Casale TB, Stokes JR. Future forms of immunotherapy. J Allergy Clin Immunol. 2011;127(1):8–15.

    Article  PubMed  Google Scholar 

  • Casale TB, Busse WW, Kline JN, Ballas ZK, Moss MH, Townley RG, et al. Omalizumab pretreatment decreases acute reactions after rush immunotherapy for ragweed-induced seasonal allergic rhinitis. J Allergy Clin Immunol. 2006;117(1):134–40.

    Article  CAS  PubMed  Google Scholar 

  • Casale TB, Cole J, Beck E, Vogelmeier CF, Willers J, Lassen C, et al. CYT003, a TLR9 agonist, in persistent allergic asthma - a randomized placebo-controlled phase 2b study. Allergy. 2015;70(9):1160–8.

    Article  CAS  PubMed  Google Scholar 

  • Circassia Announces Top-Line Results from Cat Allergy Phase III Study, available at http://www.circassia.com/media/press-releases/circassia-announces-top-line-results-from-cat-allergy-phase-iii-study/

  • Circassia Announces Top-Line Results from House Dust Mite Allergy Field Study, available at http://www.circassia.com/media/press-releases/circassia-announces-top-line-results-from-house-dust-mite-allergy-field-study/

  • Codina R, Lockey RF. Pollen used to produce allergen extracts. Ann Allergy Asthma Immunol. 2017;118(2):148–53.

    Article  CAS  PubMed  Google Scholar 

  • Coop CA, Tankersley MS. Patient perceptions regarding local reactions from allergen immunotherapy injections. Ann Allergy Asthma Immunol. 2008;101(1):96–100.

    Article  PubMed  Google Scholar 

  • Cox L, Larenas-linnemann D, Lockey RF, Passalacqua G. Speaking the same language: the world allergy organization subcutaneous immunotherapy systemic reaction grading system. J Allergy Clin Immunol. 2010;125(3):569–74, 574.e1–574.e7.

    Article  PubMed  Google Scholar 

  • Cox L, Nelson H, Lockey R, Calabria C, Chacko T, Finegold I, et al. Allergen immunotherapy: a practice parameter third update. J Allergy Clin Immunol. 2011;127(1 Suppl):S1–55.

    Article  PubMed  Google Scholar 

  • Cox LS, Sanchez-borges M, Lockey RF. World allergy organization systemic allergic reaction grading system: is a modification needed? J Allergy Clin Immunol Pract. 2017;5(1):58–62.e5.

    Article  PubMed  Google Scholar 

  • Cox LS, Hankin C, Lockey R. Allergy immunotherapy adherence and delivery route: location does not matter. J Allergy Clin Immunol Pract. 2(2):156–60.

    Google Scholar 

  • Craig T, Sawyer AM, Fornadley JA. Use of immunotherapy in a primary care office. Am Fam Physician. 1998;57(8):1888–94, 1897–1898.

    CAS  PubMed  Google Scholar 

  • Crobach MJ, Hermans J, Kaptein AA, Ridderikhoff J, Petri H, Mulder JD. The diagnosis of allergic rhinitis: how to combine the medical history with the results of radioallergosorbent tests and skin prick tests. Scand J Prim Health Care. 1998;16(1):30–6.

    Article  CAS  PubMed  Google Scholar 

  • DaVeiga SP, Caruso K, Golubski S, Lang DM. A retrospective survey of systemic reaction from allergen immunotherapy. J Allergy Clin Immunol. 2008;121(suppl):S124.

    Article  Google Scholar 

  • DBV Technologies Announces Topline Results of Phase III Clinical Trial in PeanutAllergic Patients Four to 11 Years of Age. Available at https://media.dbv-technologies.com/d286/ressources/_pdf/5/4257-PR-PEPITES-topline-results-FINAL.pdf

  • Dhami S, Kakourou A, Asamoah F, Agache I, Lau S, Jutel M, et al. Allergen immunotherapy for allergic asthma: a systematic review and meta-analysis. Allergy. 2017;72(12):1825–48.

    Article  CAS  PubMed  Google Scholar 

  • Dominicus R. 3-years’ long-term effect of subcutaneous immunotherapy (SCIT) with a high-dose hypoallergenic 6-grass pollen preparation in adults. Eur Ann Allergy Clin Immunol. 2012;44:135–40.

    CAS  PubMed  Google Scholar 

  • Drachenberg KJ, Wheeler AW, Stuebner P, Horak F. A well-tolerated grass pollen-specific allergy vaccine containing a novel adjuvant, monophosphoryl lipid a, reduces allergic symptoms after only four preseasonal injections. Allergy. 2001;56(6):498–505.

    Article  CAS  PubMed  Google Scholar 

  • Ellis AK, Frankish CW, O'hehir RE, Armstrong K, Steacy L, Larché M, et al. Treatment with grass allergen peptides improves symptoms of grass pollen-induced allergic rhinoconjunctivitis. J Allergy Clin Immunol. 2017;140(2):486–96.

    Article  CAS  PubMed  Google Scholar 

  • Epstein TG, Liss GM, Murphy-berendts K, Bernstein DI. AAAAI/ACAAI surveillance study of subcutaneous immunotherapy, years 2008-2012: an update on fatal and nonfatal systemic allergic reactions. J Allergy Clin Immunol Pract. 2014;2(2):161–7.

    Article  PubMed  Google Scholar 

  • Epstein TG, Liss GM, Murphy-berendts K, Bernstein DI. Risk factors for fatal and nonfatal reactions to subcutaneous immunotherapy: national surveillance study on allergen immunotherapy (2008-2013). Ann Allergy Asthma Immunol. 2016;116(4):354–359.e2.

    Article  PubMed  Google Scholar 

  • Esch RE. Manufacturing and standardizing fungal allergen products. J Allergy Clin Immunol. 2004;113(2):210–5.

    Article  PubMed  Google Scholar 

  • Esch RE. Allergen immunotherapy: what can and cannot be mixed? J Allergy Clin Immunol. 2008;122:659–60.

    Article  PubMed  Google Scholar 

  • Esch RE, Codina R. Fungal raw materials used to produce allergen extracts. Ann Allergy Asthma Immunol. 2017;118(4):399–405.

    Article  CAS  PubMed  Google Scholar 

  • European Medicines Agency. Guideline on allergen products: production and quality issues. London;2008. EMEA/CHMP/BWP/304831/2007. Available at http://www.ema.europa.eu/docs/en_GB/document_library/Scientific_guideline/2009/09/WC500003333.pdf

  • Fernández-caldas E, Fox RW, Bucholtz GA, Trudeau WL, Ledford DK, Lockey RF. House dust mite allergy in Florida. Mite survey in households of mite-sensitive individuals in Tampa, Florida. Allergy Proc. 1990;11(6):263–7.

    Article  PubMed  Google Scholar 

  • Fernández-caldas E, Cases B, El-qutob D, Cantillo JF. Mammalian raw materials used to produce allergen extracts. Ann Allergy Asthma Immunol. 2017;119(1):1–8.

    Article  PubMed  CAS  Google Scholar 

  • Finegold I. Immunotherapy: when to initiate treatment in children. Allergy Asthma Proc. 2007;28:698–705.

    Article  PubMed  Google Scholar 

  • Flicker S, Marth K, Kofler H, Valenta R. Placental transfer of allergen-specific IgG but not IgE from a specific immunotherapy-treated mother. J Allergy Clin Immunol. 2009;124:1358–60.e1.

    Article  CAS  PubMed  Google Scholar 

  • Fox RW, Lockey RF. Allergen immunotherapy. In: Lieberman P, Anderson JA, editors. Allergic diseases. Current clinical practice. Totowa: Humana Press; 2007.

    Google Scholar 

  • Frew AJ, Smith HE. Allergen-specific immunotherapy. In: O'Hehir RE, Holgate ST, Sheikh A, editors. Middleton's allergy essentials: Elsevier; 2016.

    Google Scholar 

  • Frew AJ, Powell RJ, Corrigan CJ. Durham systemic reaction. Efficacy and safety of specific immunotherapy with SQ allergen extract in treatment-resistant seasonal allergic rhinoconjunctivitis. J Allergy Clin Immunol. 2006;117:319–25.

    Article  CAS  PubMed  Google Scholar 

  • Galera C, Soohun N, Zankar N, Caimmi S, Gallen C, Demoly P. Severe anaphylaxis to bee venom immunotherapy: efficacy of pretreatment and concurrent treatment with omalizumab. J Investig Allergol Clin Immunol. 2009;19:225–9.

    CAS  PubMed  Google Scholar 

  • Garcia BE, Gonzalez-Mancebo E, Barber D, Martin S, Tabar AI, Diaz de Durana AM, et al. Sublingual immunotherapy in peach allergy: monitoring molecular sensitizations and reactivity to apple fruit and Platanus pollen. J Investig Allergol Clin Immunol. 2010;20:514–20.

    CAS  PubMed  Google Scholar 

  • Gawchik SM, Saccar CL. Pollinex Quattro Tree: allergy vaccine. Expert Opin Biol Ther. 2009;9(3):377–82.

    Article  CAS  PubMed  Google Scholar 

  • 2018 GINA Report. Global Strategy for Asthma Management and Prevention. Available at http://ginasthma.org/2018-gina-report-global-strategy-for-asthma-management-and-prevention/

  • Glovsky MM, Ghekiere L, Rejzek E. Effect of maternal immunotherapy on immediate skin test reactivity, specific rye I IgG and IgE antibody, and total IgE of the children. Ann Allergy. 1991;67:21–4.

    CAS  PubMed  Google Scholar 

  • Golden DB, Demain J, Freeman T, Graft D, Tankersley M, Tracy J, et al. Stinging insect hypersensitivity: a practice parameter update 2016. Annals of allergy, asthma & immunology : official publication of the American College of Allergy, Asthma, & Immunology. 2017;118(1):28–54.

    Article  Google Scholar 

  • Grant T, Aloe C, Perzanowski M, Phipatanakul W, Bollinger ME, Miller R, et al. Mouse sensitization and exposure are associated with asthma severity in urban children. J Allergy Clin Immunol Pract. 2017;5(4):1008–1014.e1.

    Article  PubMed  Google Scholar 

  • Grastek [Prescribing Information] Whitehouse Station, NJ: Merck & Co., Inc.; September 2016.

    Google Scholar 

  • Greenhawt M, Oppenheimer J, Nelson M, Nelson H, Lockey R, Lieberman P, et al. Sublingual immunotherapy: a focused allergen immunotherapy practice parameter update. Ann Allergy Asthma Immunol. 2017;118(3):276–282.e2.

    Article  PubMed  Google Scholar 

  • Grier TJ, LeFevre DM, Duncan EA, Esch RE. Stability of standardized grass, dust mite, cat, and short ragweed allergens after mixing with mold or cockroach extracts. Ann Allergy Asthma Immunol. 2007;99:151–60.

    Article  CAS  PubMed  Google Scholar 

  • Grinn-gofroń A, Strzelczak A. Changes in concentration of Alternaria and Cladosporium spores during summer storms. Int J Biometeorol. 2013;57(5):759–68.

    Article  PubMed  Google Scholar 

  • Halken S, Larenas-Linnemann D, Roberts G, Calderón MA, Angier E, Pfaar O, et al. EAACI GUIDELINES ON ALLERGEN IMMUNOTHERAPY PREVENTION OF ALLERGY. In: Muraro A, Roberts G, editors. Allergen immunotherapy guidelines part 2: recommendations. Zurich: European Academy of Allergy and Clinical Immunology.

    Google Scholar 

  • Hankin CS, Cox L, Lang D, Levin A, Gross G, Eavy G, et al. Allergy immunotherapy among Medicaid-enrolled children with allergic rhinitis: patterns of care, resource use, and costs. J Allergy Clin Immunol. 2008;121(1):227–32.

    Article  PubMed  Google Scholar 

  • Haugaard L, Dahl R. Immunotherapy in patients allergic to cat and dog dander. I Clinical results Allergy. 1992;47(3):249–54.

    CAS  PubMed  Google Scholar 

  • Heinzerling L, Mari A, Bergmann KC, Bresciani M, Burbach G, Darsow U, et al. The skin prick test - European standards. Clinical and translational allergy. 2013;3(1):3.

    Article  PubMed  PubMed Central  Google Scholar 

  • Hejjaoui A, Ferrando R, Dhivert H, Michel FB, Bousquet J. Systemic reactions occurring during immunotherapy with standardized pollen extracts. J Allergy Clin Immunol. 1992;89:925–33.

    Article  CAS  PubMed  Google Scholar 

  • Helbling A, Reimers A. Immunotherapy in fungal allergy. Curr Allergy Asthma Rep. 2003;3(5):447–53.

    Article  PubMed  Google Scholar 

  • Horst M, Hejjaoui A, Horst V, Michel FB, Bousquet J. Double-blind, placebo-controlled rush immunotherapy with a standardized Alternaria extract. J Allergy Clin Immunol. 1990;85(2):460–72.

    Article  CAS  PubMed  Google Scholar 

  • Hylander T, Latif L, Petersson-Westin U, Cardell LO. Intralymphatic allergen-specific immunotherapy: an effective and safe alternative treatment route for pollen-induced allergic rhinitis. J Allergy Clin Immunol. 2013;131:412–20.

    Article  CAS  PubMed  Google Scholar 

  • Johansson SG, Bieber T, Dahl R, Friedmann PS, Lanier BQ, Lockey RF, et al. Revised nomenclature for allergy for global use: report of the nomenclature review Committee of the World Allergy Organization, October 2003. J Allergy Clin Immunol. 2004;113(5):832–6.

    Article  CAS  PubMed  Google Scholar 

  • Jutel M, Akdis M, Budak F, Aebischer-Casaulta C, Wrzyszcz M, Blaser K, et al. IL-10 and TGF-beta cooperate in the regulatory T cell response to mucosal allergens in normal immunity and specific immunotherapy. Eur J Immunol. 2003;33(5):1205–14.

    Article  CAS  PubMed  Google Scholar 

  • Jutel M, Agache I, Bonini S, Burks AW, Calderon M, Canonica W, et al. International consensus on allergy immunotherapy. J Allergy Clin Immunol. 2015;136(3):556–68.

    Article  PubMed  Google Scholar 

  • Kelso JM. The rate of systemic reactions to immunotherapy injections is the same whether or not the dose is reduced after a local reaction. Ann Allergy Asthma Immunol. 2004;92(2):225–7.

    Article  PubMed  Google Scholar 

  • Kim SH, Ye YM, Palikhe NS, Kim JE, Park HS. Genetic and ethnic risk factors associated with drug hypersensitivity. Curr Opin Allergy Clin Immunol. 2010;10(4):280–90.

    Article  PubMed  Google Scholar 

  • Kohno Y, Minoguchi K, Oda N, Yokoe T, Yamashita N, Sakane T, et al. Effect of rush immunotherapy on airway inflammation and airway hyperresponsiveness after bronchoprovocation with allergen in asthma. J Allergy Clin Immunol. 1998;102:927–34.

    Article  CAS  PubMed  Google Scholar 

  • Konradsen JR, Fujisawa T, Van Hage M, Hedlin G, Hilger C, Kleine-Tebbe J, et al. Allergy to furry animals: new insights, diagnostic approaches, and challenges. J Allergy Clin Immunol. 2015;135(3):616–25.

    Article  PubMed  Google Scholar 

  • Kopp MV, Brauburger J, Riedinger F, Beischer D, Ihorst G, Kamin W, et al. The effect of anti-IgE treatment on in vitro leukotriene release in children with seasonal allergic rhinitis. J Allergy Clin Immunol. 2002;110:728–35.

    Article  CAS  PubMed  Google Scholar 

  • Kuehr J, Brauburger J, Zielen S, Schauer U, Kamin W, Von Berg A, et al. Efficacy of combination treatment with anti-IgE plus specific immunotherapy in polysensitized children and adolescents with seasonal allergic rhinitis. J Allergy Clin Immunol. 2002;109:274–80.

    Article  CAS  PubMed  Google Scholar 

  • Larché M. Update on the current status of peptide immunotherapy. J Allergy Clin Immunol. 2007;119:906–9.

    Article  PubMed  CAS  Google Scholar 

  • Larsen JN, Broge L, Jacobi H. Allergy immunotherapy: the future of allergy treatment. Drug Discov Today. 2016;21(1):26–37.

    Article  CAS  PubMed  Google Scholar 

  • Levetin E, Horner WE, Scott JA. Taxonomy of allergenic Fungi. J Allergy Clin Immunol Pract. 2016;4(3):375–385.e1.

    Article  PubMed  Google Scholar 

  • Lieberman P, Nicklas RA, Randolph C, Oppenheimer J, Bernstein D, Bernstein J, et al. Anaphylaxis–a practice parameter update 2015. Ann Allergy Asthma Immunol. 2015;115(5):341–84.

    Article  PubMed  Google Scholar 

  • Limb SL, Brown KC, Wood RA, Eggleston PA, Hamilton RG, Adkinson NF Jr. Long-term immunologic effects of broad-spectrum aeroallergen immunotherapy. Int Arch Allergy Immunol. 2006;140:245–51.

    Article  CAS  PubMed  Google Scholar 

  • Lin MS, Tanner E, Lynn J, Friday GA Jr. Nonfatal systemic allergic reactions induced by skin testing and immunotherapy. Ann Allergy. 1993;71:557–62.

    CAS  PubMed  Google Scholar 

  • Lin CH, Alandijani S, Lockey RF. Subcutaneous versus sublingual immunotherapy. Expert Rev Clin Immunol. 2016;12(8):801–3.

    Article  CAS  PubMed  Google Scholar 

  • Lin SY, Azar A, Suarez-Cuervo C, Diette GB, Brigham E, Rice J, et al. The Role of Immunotherapy in the Treatment of Asthma. Comparative Effectiveness Review No. 196 (Prepared by the Johns Hopkins University Evidence-based Practice Center under Contract No.290–2015-00006-I). AHRQ Publication No. 17(18)-EHC029-EF. Rockville, MD: Agency for Healthcare Research and Quality. March 2018. Posted final reports are located on the Effective Health Care Program search page. https://doi.org/10.23970/AHRQEPCCER196

  • Lockey RF. The myth of hypoallergenic dogs (and cats). J Allergy Clin Immunol. 2012;130(4):910–1.

    Article  PubMed  Google Scholar 

  • Lockey RF, Benedict LM, Turkeltaub PC, Bukantz SC. Fatalities from immunotherapy (IT) and skin testing (ST). J Allergy Clin Immunol. 1987;79(4):660–77.

    Article  CAS  PubMed  Google Scholar 

  • Malling HJ, Bousquet J. Subcutaneous immunotherapy for allergic Rhinoconjunctivitis, allergic asthma, and prevention of allergic diseases. In: Lockey RF, Ledford DK, editors. Allergens and allergen immunotherapy: subcutaneous, sublingual and Oral. 5th ed. New York: CRC Press (Taylor & Francis Group); 2014. p. 1–525.

    Google Scholar 

  • Malling HJ, Dreborg S, Weeke B. Diagnosis and immunotherapy of mould allergy. V. Clinical efficacy and side effects of immunotherapy with Cladosporium herbarum. Allergy. 1986;41(7):507–19.

    Article  CAS  PubMed  Google Scholar 

  • Maloney J, Berman G, Gagnon R, Bernstein DI, Nelson HS, Kleine-Tebbe J, et al. Sequential treatment initiation with timothy grass and ragweed sublingual immunotherapy tablets followed by simultaneous treatment is well tolerated. J Allergy Clin Immunol Pract. 2016;4:301–309.e2.

    Article  PubMed  Google Scholar 

  • Marogna M, Spadolini I, Massolo A, Canonica GW, Passalacqua G. Randomized controlled open study of sublingual immunotherapy for respiratory allergy in real life: clinical efficacy and more. Allergy. 2004;59:1205–10.

    Article  CAS  PubMed  Google Scholar 

  • Marogna M, Spadolini I, Massolo A, Zanon P, Berra D, Chiodini E, et al. Effects of sublingual immunotherapy for multiple or single allergens in polysensitized patients. Ann Allergy Asthma Immunol. 2007;98:274–80.

    Article  CAS  PubMed  Google Scholar 

  • Massanari M, Nelson H, Casale T, Busse W, Kianifard F, Geba GP, et al. Effect of pretreatment with omalizumab on the tolerability of specific immunotherapy in allergic asthma. J Allergy Clin Immunol. 2010;125(2):383–9.

    Article  CAS  PubMed  Google Scholar 

  • Mccormack PL, Wagstaff AJ. Ultra-short-course seasonal allergy vaccine (Pollinex Quattro). Drugs. 2006;66(7):931–8.

    Article  CAS  PubMed  Google Scholar 

  • Metzger WJ, Turner E, Patterson R. The safety of immunotherapy during pregnancy. J Allergy Clin Immunol. 1978;61:268–72.

    Article  CAS  PubMed  Google Scholar 

  • Moller C, Dreborg S, Ferdousi HA, Halken S, Host A, Jacobsen L, et al. Pollen immunotherapy reduces the development of asthma in children with seasonal rhinoconjunctivitis (the PAT-study). J Allergy Clin Immunol. 2002;109:251–6.

    Article  PubMed  Google Scholar 

  • Moreno-Ancillo A, Moreno C, Ojeda P, Domínguez C, Barasona MJ, García-Cubillana A, et al. Efficacy and quality of life with once-daily sublingual immunotherapy with grasses plus olive pollen extract without updosing. J Investig Allergol Clin Immunol. 2007;17:399–405.

    CAS  PubMed  Google Scholar 

  • Nelson HS. Injection immunotherapy for inhalant allergens. In: Adkinson N Jr, Bochner B, Burks A, et al., editors. Middleton's Allergy, Principles and Practice. Elsevier Health Sciences; 2013.

    Google Scholar 

  • Nelson HS. Allergen immunotherapy now and in the future. Allergy Asthma Proc. 2016;37(4):268–72.

    Article  CAS  PubMed  Google Scholar 

  • Nelson BL, Dupont LA, Reid MJ. Prospective survey of local and systemic reactions to immunotherapy with pollen extracts. Ann Allergy. 1986;56:331–4.

    CAS  PubMed  Google Scholar 

  • Nielsen L, Johnsen CR, Mosbech H, Poulsen LK, Malling HJ. Antihistamine premedication in specific cluster immunotherapy: a double-blind, placebo-controlled study. J Allergy Clin Immunol. 1996a;97:1207–13.

    Article  CAS  PubMed  Google Scholar 

  • Nielsen L, Johnsen CR, Mosbech H, Poulsen LK, Malling HJ. Antihistamine premedication in specific cluster immunotherapy: a double-blind, placebo-controlled study. J Allergy Clin Immunol. 1996b;97(6):1207–13.

    Article  CAS  PubMed  Google Scholar 

  • O’connor GT, Lynch SV, Bloomberg GR, Kattan M, Wood RA, Gergen PJ, et al. Early-life home environment and risk of asthma among inner-city children. J Allergy Clin Immunol. 2018;141(4):1468–1475.

    Article  Google Scholar 

  • Odactra [Prescribing Information]. Whitehouse Station, NJ: Merck & Co., Inc.; March 2017.

    Google Scholar 

  • Oralair [Prescribing Information] Antony, France: Stallergenes S.A; October 2014.

    Google Scholar 

  • Passalacqua G, Albano M, Ruffoni S, Pronzato C, Riccio AM, Di Berardino L, et al. Nasal immunotherapy to Parietaria: evidence of reduction of local allergic inflammation. Am J Respir Crit Care Med. 1995;152:461–6.

    Article  CAS  PubMed  Google Scholar 

  • Phanuphak P, Kohler PF. Onset of polyarteritis nodosa during allergic hyposensitization treatment. Am J Med. 1980;68(4):479–85.

    Article  CAS  PubMed  Google Scholar 

  • Phipatanakul W, Matsui E, Portnoy J, Williams PB, Barnes C, Kennedy K, et al. Environmental assessment and exposure reduction of rodents: a practice parameter. Ann Allergy Asthma Immunol. 2012;109(6):375–87.

    Article  PubMed  PubMed Central  Google Scholar 

  • Pifferi M, Baldini G, Marrazzini G, Baldini M, Ragazzo V, Pietrobelli A, et al. Benefits of immunotherapy with a standardized Dermatophagoides pteronyssinus extract in asthmatic children: a three-year prospective study. Allergy. 2002;57:785–90.

    Article  CAS  PubMed  Google Scholar 

  • Platts-Mills TAE. Indoor Allergens. In: Jr. NF, Bochner BS, Burks W et al. Middleton's Allergy, Principles and Practice. Elsevier Health Sciences; 2013.

    Google Scholar 

  • Pongracic JA, Visness CM, Gruchalla RS, Evans R, Mitchell HE. Effect of mouse allergen and rodent environmental intervention on asthma in inner-city children. Ann Allergy Asthma Immunol. 2008;101(1):35–41.

    Article  PubMed  Google Scholar 

  • Portnoy J, Bagstad K, Kanarek H, Pacheco F, Hall B, Barnes C. Premedication reduces the incidence of systemic reactions during inhalant rush immunotherapy with mixtures of allergenic extracts. Ann Allergy. 1994;73:409–18.

    CAS  PubMed  Google Scholar 

  • Portnoy J, Kennedy K, Sublett J, Phipatanakul W, Matsui E, Barnes C, et al. Environmental assessment and exposure control: a practice parameter–furry animals. Ann Allergy Asthma Immunol. 2012;108(4):223.e1–15.

    Article  Google Scholar 

  • Portnoy J, Miller JD, Williams PB, Chew GL, Miller JD, Zaitoun F, et al. Environmental assessment and exposure control of dust mites: a practice parameter. Ann Allergy Asthma Immunol. 2013;111(6):465–507.

    Article  PubMed  PubMed Central  Google Scholar 

  • Prigal SJ. A ten-year study of repository injections of allergens: local reactions and their management. Ann Allergy. 1972;30:529–35.

    CAS  PubMed  Google Scholar 

  • Pulimood TB, Corden JM, Bryden C, Sharples L, Nasser SM. Epidemic asthma and the role of the fungal mold Alternaria alternata. J Allergy Clin Immunol. 2007;120(3):610–7.

    Article  PubMed  Google Scholar 

  • Racila DM, Kline JN. Perspectives in asthma: molecular use of microbial products in asthma prevention and treatment. J Allergy Clin Immunol. 2005;116(6):1202–5.

    Article  CAS  PubMed  Google Scholar 

  • Ragwitek [Prescribing Information] Whitehouse Station, NJ: Merck & Co., Inc.; September 2016.

    Google Scholar 

  • Ramachandran M, Aronson JK. John Bostock's first description of hay fever. J R Soc Med. 2011;104(6):237–40.

    Article  PubMed  PubMed Central  Google Scholar 

  • Randhawa IS, Junaid I, Klaustermeyer WB. Allergen immunotherapy in a patient with human immunodeficiency virus: effect on T-cell activation and viral replication. Ann Allergy Asthma Immunol. 2007;98(5):495–7.

    Article  PubMed  Google Scholar 

  • Rank MA, Oslie CL, Krogman JL, Park MA, Li JT. Allergen immunotherapy safety: characterizing systemic reactions and identifying risk factors. Allergy Asthma Proc. 2008;29:400–5.

    Article  CAS  PubMed  Google Scholar 

  • Reid MJ, Lockey RF, Turkeltaub PC, Platts-mills TA. Survey of fatalities from skin testing and immunotherapy 1985-1989. J Allergy Clin Immunol. 1993;92(1 Pt 1):6–15.

    Article  CAS  PubMed  Google Scholar 

  • Reimers A, Hari Y, Muller U. Reduction of side-effects from ultrarush immunotherapy with honeybee venom by pretreatment with fexofenadine: a double-blind, placebo-controlled trial. Allergy. 2000;55:484–8.

    Article  CAS  PubMed  Google Scholar 

  • Renand A, Archila LD, Mcginty J, Wambre E, Robinson D, Hales BJ, et al. Chronic cat allergen exposure induces a TH2 cell-dependent IgG4 response related to low sensitization. J Allergy Clin Immunol. 2015;136(6):1627–1635.e13.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Ricketti PA, Alandijani S, Lin CH, Casale TB. Investigational new drugs for allergic rhinitis. Expert Opin Investig Drugs. 2017;26(3):279–92.

    Article  CAS  PubMed  Google Scholar 

  • Roberts G, Hurley C, Turcanu V, Lack G. Grass pollen immunotherapy as an effective therapy for childhood seasonal allergic asthma. J Allergy Clin Immunol. 2006;117:263–8.

    Article  PubMed  Google Scholar 

  • Roberts G, Pfaar O, Akdis CA, Ansotegui IJ, Durham SR, van Wijk RG, et al. EAACI GUIDELINES ON ALLERGEN IMMUNOTHERAPY ALLERGIC RHINOCONJUNCTIVITIS. In: Muraro A, Roberts G, editors. Allergen immunotherapy guidelines part 2: recommendations. Zurich: European Academy of Allergy and Clinical Immunology; 2017.

    Google Scholar 

  • Rodriguez Perez N, Ambriz Moreno Mde J. Safety of immunotherapy and skin tests with allergens in children younger than five years. Rev Alerg Mex. 2006;53:47–51.

    PubMed  Google Scholar 

  • Ross RN, Nelson HS, Finegold I. Effectiveness of specific immunotherapy in the treatment of allergic rhinitis: an analysis of randomized, prospective, single- or double-blind, placebo-controlled studies. Clin Ther. 2000;22(3):342–50.

    Article  CAS  PubMed  Google Scholar 

  • Roy SR, Sigmon JR, Olivier J, Moffitt JE, Brown DA, Marshall GD. Increased frequency of large local reactions among systemic reactors during subcutaneous allergen immunotherapy. Ann Allergy Asthma Immunol. 2007;99(1):82–6.

    Article  PubMed  Google Scholar 

  • Sampath V, Sindher SB, Zhang W, Nadeau KC. New treatment directions in food allergy. Ann Allergy Asthma Immunol. 2018;120(3):254–62.

    Article  PubMed  PubMed Central  Google Scholar 

  • Sampson HA, Muñoz-furlong A, Campbell RL, Adkinson NF Jr, Bock SA, Branum A, et al. Second symposium on the definition and management of anaphylaxis: summary report–second National Institute of allergy and infectious disease/Food Allergy and Anaphylaxis Network symposium. J Allergy Clin Immunol. 2006;117(2):391–7.

    Article  PubMed  Google Scholar 

  • Sánchez-morillas L, Reaño Martos M, Iglesias Cadarso A, Pérez Pimiento A, Rodríguez Mosquera M, Domínguez Lázaro AR. Vasculitis during immunotherapy treatment in a patient with allergy to Cupressus arizonica. Allergol Immunopathol (Madr). 2005;33(6):333–4.

    Article  Google Scholar 

  • Scadding GW, Calderon MA, Shamji MH, Eifan AO, Penagos M, Dumitru F, et al. Effect of 2 years of treatment with sublingual grass pollen immunotherapy on nasal response to allergen challenge at 3 years among patients with moderate to severe seasonal allergic rhinitis: the GRASS randomized clinical trial. JAMA. 2017;317(6):615–25.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Schulze J, Rose M, Zielen S. Beekeepers anaphylaxis: successful immunotherapy covered by omalizumab. Allergy. 2007;62:963–4.

    Article  CAS  PubMed  Google Scholar 

  • Schwartz HJ, Golden DB, Lockey RF. Venom immunotherapy in the Hymenoptera-allergic pregnant patient. J Allergy Clin Immunol. 1990;85:709–12.

    Article  CAS  PubMed  Google Scholar 

  • Scranton SE, Gonzalez EG, Waibel KH. Incidence and characteristics of biphasic reactions after allergen immunotherapy. J Allergy Clin Immunol. 2009;123(2):493–8.

    Article  CAS  PubMed  Google Scholar 

  • Senti G, Prinz Vavricka BM, Erdmann I, Diaz MI, Markus R, McCormack SJ, et al. Intralymphatic allergen administration renders specific immunotherapy faster and safer: a randomized controlled trial. Proc Natl Acad Sci U S A. 2008;105:17908–12.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Senti G, Graf N, Haug S, Graf N, Sonderegger T, Johansen P, et al. Epicutaneous allergen administration as a novel method of allergen-specific immunotherapy. J Allergy Clin Immunol. 2009;124:997–1002.

    Article  CAS  PubMed  Google Scholar 

  • Senti G, Crameri R, Kuster D, Johansen P, Martinez-Gomez JM, Graf N, et al. Intralymphatic immunotherapy for cat allergy induces tolerance after only 3 injections. J Allergy Clin Immunol. 2012;129:1290–6.

    Article  CAS  PubMed  Google Scholar 

  • Shaikh WA. A retrospective study on the safety of immunotherapy in pregnancy. Clin Exp Allergy. 1993;23:857–60.

    Article  CAS  PubMed  Google Scholar 

  • Soeria-atmadja D, Onell A, Borgå A. IgE sensitization to fungi mirrors fungal phylogenetic systematics. J Allergy Clin Immunol. 2010;125(6):1379–1386.e1.

    Article  CAS  PubMed  Google Scholar 

  • Sporik R, Holgate ST, Platts-mills TA, Cogswell JJ. Exposure to house-dust mite allergen (Der p I) and the development of asthma in childhood. A prospective study. N Engl J Med. 1990;323(8):502–7.

    Article  CAS  PubMed  Google Scholar 

  • Stanaland BE, Fernández-caldas E, Jacinto CM, Trudeau WL, Lockey RF. Positive nasal challenge responses to Blomia tropicalis. J Allergy Clin Immunol. 1996;97(5):1045–9.

    Article  CAS  PubMed  Google Scholar 

  • Stokes JR, Casale TB. Novel approaches of immunotherapy. Current Treatment Options in Allergy. 2014;1(1):58–67.

    Article  Google Scholar 

  • Summary Health Statistics for Asthma: National Health Interview Survey (2015) Available at https://www.cdc.gov/nchs/fastats/asthma.htm

  • Summary Health Statistics for Hay Fever: National Health Interview Survey (2015) Available at https://www.cdc.gov/nchs/fastats/allergies.htm

  • Swamy RS, Reshamwala N, Hunter T, Vissamsetti S, Santos CB, Baroody FM, et al. Epigenetic modifications and improved regulatory T-cell function in subjects undergoing dual sublingual immunotherapy. J Allergy Clin Immunol. 2012;130:215–224.e7.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Szepfalusi Z, Bannert C, Ronceray L, Mayer E, Hassler M, Wissmann E, et al. Preventive sublingual immunotherapy in preschool children: first evidence for safety and protolerogenic effects. Pediatr Allergy Immunol. 2014;25:788–95.

    Article  PubMed  PubMed Central  Google Scholar 

  • Takahashi M, Soejima K, Taniuchi S, Hatano Y, Yamanouchi S, Ishikawa H, et al. Oral immunotherapy combined with omalizumab for high-risk cow's milk allergy: a randomized controlled trial. Sci Rep. 2017;7(1):17453.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  • Tankersley MS, Butler KK, Butler WK, Goetz DW. Local reactions during allergen immunotherapy do not require dose adjustment. J Allergy Clin Immunol. 2000a;106:840–3.

    Article  CAS  PubMed  Google Scholar 

  • Tankersley MS, Butler KK, Butler WK, Goetz DW. Local reactions during allergen immunotherapy do not require dose adjustment. J Allergy Clin Immunol. 2000b;106(5):840–3.

    Article  CAS  PubMed  Google Scholar 

  • Tari MG, Mancino M, Monti G. Immunotherapy by inhalation of allergen in powder in house dust allergic asthma – a double-blind study. J Investig Allergol Clin Immunol. 1992;2:59–67.

    CAS  PubMed  Google Scholar 

  • Taudorf E, Laursen LC, Lanner A, Björksten B, Dreborg S, Søborg M, et al. Oral immunotherapy in birch pollen hay fever. J Allergy Clin Immunol. 1987;80:153–61.

    Article  CAS  PubMed  Google Scholar 

  • Teplitsky V, Mumcuoglu KY, Babai I, Dalal I, Cohen R, Tanay A. House dust mites on skin, clothes, and bedding of atopic dermatitis patients. Int J Dermatol. 2008;47(8):790–5.

    Article  PubMed  Google Scholar 

  • Thommen AA. Which plants cause hayfever? In: Coca AF, Walzer M, Thommen AA, editors. Asthma and hay fever in theory and practice. Springfield: Charles C Thomas; 1931. p. 546–54.

    Google Scholar 

  • Tsabouri S, Mavroudi A, Feketea G, Guibas GV. Subcutaneous and sublingual immunotherapy in allergic asthma in children. Front Pediatr. 2017;5:82.

    Article  PubMed  PubMed Central  Google Scholar 

  • Vailes L, Sridhara S, Cromwell O, Weber B, Breitenbach M, Chapman M. Quantitation of the major fungal allergens, alt a 1 and asp f 1, in commercial allergenic products. J Allergy Clin Immunol. 2001;107(4):641–6.

    Article  CAS  PubMed  Google Scholar 

  • Valovirta E, Berstad AK, de Blic J, Bufe A, Eng P, Halken S, et al. Design and recruitment for the GAP trial, investigating the preventive effect on asthma development of an SQ-standardized grass allergy immunotherapy tablet in children with grass pollen-induced allergic rhinoconjunctivitis. Clin Ther. 2011;33:1537–46.

    Article  CAS  PubMed  Google Scholar 

  • Valovirta E, Petersen TH, Piotrowska T, Laursen MK, Andersen JS, Sorensen HF, et al. Results from the 5-year SQ grass SLIT-tablet asthma prevention (GAP) trial in children with grass pollen allergy. J Allergy Clin Immunol. 2017; https://doi.org/10.1016/j.jaci.2017.06.014.

    Article  CAS  Google Scholar 

  • Van Metre TE Jr, Rosenberg GL, Vaswani SK, Ziegler SR, Adkinson NF. Pain and dermal reaction caused by injected glycerin in immunotherapy solutions. J Allergy Clin Immunol. 1996;97:1033–9.

    Article  PubMed  Google Scholar 

  • Varney VA, Edwards J, Tabbah K, Brewster H, Mavroleon G, Frew AJ. Clinical efficacy of specific immunotherapy to cat dander: a double-blind placebo-controlled trial. Clin Exp Allergy. 1997;27(8):860–7.

    Article  CAS  PubMed  Google Scholar 

  • Vredegoor DW, Willemse T, Chapman MD, Heederik DJ, Krop EJ. Can f 1 levels in hair and homes of different dog breeds: lack of evidence to describe any dog breed as hypoallergenic. J Allergy Clin Immunol. 2012;130(4):904–9.e7.

    Article  CAS  PubMed  Google Scholar 

  • Weber RW. Aerobiology of outdoor allergens. Adkinson N Jr, Bochner B, Burks A, et al., editors., Middleton's allergy, principles and practice. Elsevier Health Sciences; 2013.

    Google Scholar 

  • Weber RW. Aeroallergen botany. Ann Allergy Asthma Immunol. 2014;112(2):102–7.

    Article  PubMed  Google Scholar 

  • Werfel T, Breuer K, Ruéff F, Przybilla B, Worm M, Grewe M, et al. Usefulness of specific immunotherapy in patients with atopic dermatitis and allergic sensitization to house dust mites: a multi-Centre, randomized, dose-response study. Allergy. 2006;61(2):202–5.

    Article  CAS  PubMed  Google Scholar 

  • WHO Guidelines for Indoor Air Quality: Dampness and Mould. WHO Regional Office Europe; 2009.

    Google Scholar 

  • Witten M, Malling HJ, Blom L, Poulsen BC, Poulsen LK. Is intralymphatic immunotherapy ready for clinical use in patients with grass pollen allergy? J Allergy Clin Immunol. 2013;132:1248–1252.e5.

    Article  PubMed  Google Scholar 

  • Wohrl S, Gamper S, Hemmer W, Heinze G, Stingl G, Kinaciyan T. Premedication with montelukast reduces local reactions of allergen immunotherapy. Int Arch Allergy Immunol. 2007;144:137–42.

    Article  PubMed  CAS  Google Scholar 

  • Wood RA, Chapman MD, Adkinson NF, Eggleston PA. The effect of cat removal on allergen content in household-dust samples. J Allergy Clin Immunol. 1989;83(4):730–4.

    Article  CAS  PubMed  Google Scholar 

  • Woodfolk JA. High-dose allergen exposure leads to tolerance. Clin Rev Allergy Immunol. 2005;28(1):43–58.

    Article  CAS  PubMed  Google Scholar 

  • Zahradnik E, Raulf M. Animal allergens and their presence in the environment. Front Immunol. 2014;5:76.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  • Zolkipli Z, Roberts G, Cornelius V, Clayton B, Pearson S, Michaelis L, et al. Randomized controlled trial of primary prevention of atopy using house dust mite allergen oral immunotherapy in early childhood. J Allergy Clin Immunol. 2015;136:1541–7.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Medicine, Division of Allergy and Immunology, Houston Methodist Hospital, Houston, TX, USA

    Chen Hsing Lin

Authors
  1. Chen Hsing Lin
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Chen Hsing Lin .

Section Editor information

  1. Division of Allergy & Immunology, University of South Florida, Tampa, FL, USA

    Dennis K. Ledford

  2. Milton S Hershey Med Ctr, Penn State University, Hershey, PA, USA

    Timothy Craig

  3. Department of Medicine and Pediatrics, Penn State College of Medicine, Hershey, PA, USA

    Timothy Craig

  4. Division of Allergy & Immunology, Dept. of Internal Medicine, University of South Florida Morsani College of Medicine, James A Haley Veterans' Hospital, Asthma and Immunology Associates of Tampa Bay, Tampa, Florida, USA

    Dennis K. Ledford

Rights and permissions

Reprints and permissions

Copyright information

© 2019 Springer Nature Switzerland AG

About this entry

Check for updates. Verify currency and authenticity via CrossMark

Cite this entry

Lin, C.H. (2019). Subcutaneous Immunotherapy for Allergic Rhinitis and Asthma. In: Allergy and Asthma. Springer, Cham. https://doi.org/10.1007/978-3-030-05147-1_40

Download citation

  • DOI: https://doi.org/10.1007/978-3-030-05147-1_40

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-05146-4

  • Online ISBN: 978-3-030-05147-1

  • eBook Packages: MedicineReference Module Medicine

Publish with us

Policies and ethics

Search

Navigation