Immunotherapy

Allergy shots are a form of immunotherapy. They work by exposing the body in stages to an allergen so that the body ‘learns’ not to react to that trigger. The principle is similar to a vaccine, which exposes the body to a small amount of a virus and then allows the body to build its immune response.

Allergy shots are administered by a doctor or allergist regularly, typically once or twice a week, during the build-up stage and then less frequently during a maintenance period.

Allergy shots work well on allergies triggered by inhaled allergens, such as pollen allergies, dust allergies, and pet dander allergies. Allergy shots can also work well in limiting the body’s response to a stinging insect allergy. They are typically not used to treat food allergies.

Sublingual immunotherapy follows the same principles as OIT, but is used more commonly to address allergic rhinitis or asthma related to environmental allergens such as dust mites and ragweed. Studies are ongoing as to its effectiveness with food allergies.

It involves the administration of drops or FDA-approved allergen extract tablets sublingually, or under the tongue. These drops or tablets contain very small amounts of an allergen, allowing the body to adjust to exposure to the allergen over time.

A significant advantage of sublingual immunotherapy is that the patient does not need to undergo a series of shots. It can take time, however. Also, patients typically administer the doses at home without direct medical supervision. As such, patients will need to review and adhere to advice from their allergist on how to manage adverse reactions.

Oral immunotherapy, or OIT, involves the slow and systematic exposure of a patient to a food allergen under medical supervision. The patient ingests amounts of the allergen at first that are far lower than what would typically trigger an allergic reaction. Over time, the dose is increased in the medical setting; the patient also takes a daily dose at home.

OIT offers a number of advantages to those with allergies to common foods, such as peanuts or tree nuts, that can be difficult to avoid. It can take time, however, and requires ongoing adherence to maintenance protocols by the patient.

Patients can reach the maintenance stage of oral immunotherapy in four to six months typically. While OIT can potentially decrease the risk of a severe or fatal allergic reaction in a patient, it does require ongoing maintenance for the duration of the patient’s life.