Immunotherapy for allergic rhinitis – a United Kingdom survey and short review

Subcutaneous specific immunotherapy for seasonal allergic rhinitis: a review of treatment practices in the US and Europe

BACKGROUND

Subcutaneous specific immunotherapy (SCIT) is claimed to be successful both in the US and Europe, yet treatment methodology differs.

METHODS

The authors review current literature surrounding guidelines and clinical trials in Europe and the US and contrast the treatment approach to SCIT for allergic rhinitis. Search methodology employs MEDLINE and PubMed, selecting articles on SCIT and allergic rhinitis, limited between 1990-2009. They focus on the safety and efficacy of vaccines, and the differences in formulations. Also mentioned are: standardization, new approaches in SCIT and sublingual immunotherapy (SLIT).

RESULTS

SCIT treatment differs in many respects regarding availability of SCIT products, regulatory controls, guidelines (e.g. multiple allergen vaccines in US, single allergen vaccines in Europe) and in location of formulation (US, clinician's office; Europe, manufacturers).

CONCLUSIONS

SCIT is an effective and safe therapy, but major evidence for efficacy is provided from European studies of single allergen extract vaccines; these vaccines may gain more acceptance because of increasing regulatory approval and lower numbers of injections. The potential impact upon public health (e.g. arrest of the 'allergic march') should not be overlooked.

The love-hate relationship between bacterial polysaccharides and the host immune system

This article explores the fascinating relationship between the mammalian immune system and the bacteria that are present in the mammalian gut. Every human is an ecosystem that hosts 10(13)-10(14) bacteria. We review the evidence that immunomodulatory molecules produced by commensal bacteria in the gut have a beneficial influence on the development of certain immune responses, through eliciting the clonal expansion of CD4(+) T-cell populations. This process seems to contribute to the overall health of the host by offering protection against various diseases and might provide supporting evidence at a molecular level for the 'hygiene hypothesis' of allergic immune disorders.