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Review
. 2017 Jan 23;43(1):13.
doi: 10.1186/s13052-016-0315-y.

Clinical practice recommendations for allergen-specific immunotherapy in children: the Italian consensus report

Giovanni Battista Pajno  1 , Roberto Bernardini  2 , Diego Peroni  3 , Stefania Arasi  4   5 , Alberto Martelli  6 , Massimo Landi  7   8 , Giovanni Passalacqua  9 , Antonella Muraro  10 , Stefania La Grutta  8 , Alessandro Fiocchi  11 , Luciana Indinnimeo  12 , Carlo Caffarelli  13 , Elisabetta Calamelli  14 , Pasquale Comberiati  15 , Marzia Duse  12 ; Allergen-specific Immunotherapy panel of the Italian Society of Pediatric Allergy and Immunology (SIAIP)
Collaborators, Affiliations
Review

Clinical practice recommendations for allergen-specific immunotherapy in children: the Italian consensus report

Giovanni Battista Pajno et al. Ital J Pediatr. .

Abstract

Allergen-specific immunotherapy (AIT) is currently recognized as a clinically effective treatment for allergic diseases, with a unique disease-modifying effect. AIT was introduced in clinical practice one century ago, and performed in the early years with allergenic extracts of poor quality and definition. After the mechanism of allergic reaction were recognized, the practice of AIT was refined, leading to remarkable improvement in the efficacy and safety profile of the treatment. Currently AIT is accepted and routinely prescribed worldwide for respiratory allergies and hymenoptera venom allergy. Both the subcutaneous (SCIT) and sublingual (SLIT) routes of administration are used in the pediatric population.AIT is recommended in allergic rhinitis/conjunctivitis with/without allergic asthma, with an evidence of specific IgE-sensitization towards clinically relevant inhalant allergens. Long-term studies provided evidence that AIT can also prevent the onset of asthma and of new sensitizations. The favorable response to AIT is strictly linked to adherence to treatment, that lasts 3-5 years. Therefore, several factors should be carefully evaluated before starting this intervention, including the severity of symptoms, pharmacotherapy requirements and children and caregivers' preference and compliance.In recent years, there have been increasing interest in the role of AIT for the treatment of IgE-associated food allergy and extrinsic atopic dermatitis. A growing body of evidence shows that oral immunotherapy represents a promising treatment option for IgE-associated food allergy. On the contrary, there are still controversies on the effectiveness of AIT for patients with atopic dermatitis.This consensus document was promoted by the Italian Society of Pediatric Allergy and Immunology (SIAIP) to provide evidence-based recommendations on AIT in order to implement and optimize current prescription practices of this treatment for allergic children.

Keywords: Allergen-specific immunotherapy; Allergy; Asthma; Atopic dermatitis; Children; Food allergy; Sub-lingual immunotherapy; Subcutaneous immunotherapy.

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Figures

Fig. 1
Fig. 1
Proposed algorithm
See this image and copyright information in PMC

References

    1. Pajno G, Bernardini R, Terracciano L, Duse M, Indinnimeo L, Calamelli E, et al. L’immunoterapia in età pediatrica. Rivista di Immunologia e Allergologia Pediatrica. 2014;4(Suppl 4):1–19.
    1. Duse M, Minasi D, Pajno G, Pifferi M, Scala G, Terracciano L, et al. Immunoterapia allergene specifica: se, quando, come eseguirla. Revisione della letteratura ed Indicazioni. Documento della Commissione ITS della SIAIP. Rivista di Immunologia Allergologia Pediatrica. 2010;1(Suppl 2):1–29.
    1. Jutel M, Agache I, Bonini S, Burks AW, Calderon M, Canonica W, et al. International consensus on allergy immunotherapy. J Allergy Clin Immunol. 2015;136:556–568. doi: 10.1016/j.jaci.2015.04.047. - DOI - PubMed
    1. Canonica GW, Cox L, Pawankar R, Baena-Cagnani CE, Blaiss M, Bonini S, et al. Sublingual immunotherapy: World Allergy Organization position paper 2013 update. World Allergy Organ J. 2014;7:6. doi: 10.1186/1939-4551-7-6. - DOI - PMC - PubMed
    1. 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(Suppl 1):S1–S55. doi: 10.1016/j.jaci.2010.09.034. - DOI - PubMed