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Review
. 2021 Sep;72(9):776-783.
doi: 10.1007/s00105-021-04869-3. Epub 2021 Aug 13.

[The route is the destination-novel forms of application of allergen immunotherapy]

[Article in German]
Wolfgang Pfützner  1
Affiliations
Review

[The route is the destination-novel forms of application of allergen immunotherapy]

[Article in German]
Wolfgang Pfützner. Hautarzt. 2021 Sep.

Abstract
in English, German

Allergen immunotherapy (AIT) is the only causal therapy of IgE-mediated allergies if allergen avoidance is not feasible. Already well established are subcutaneous (SCIT) and sublingual (SLIT) allergen application, and recently the first oral immunotherapy (OIT) for treating peanut allergy was approved. Interesting and promising new forms of allergen administration are intralymphatic (ILIT) and epicutaneous (EPIT) immunotherapy. Immunologic and clinical efficiency in terms of tolerance induction have been investigated in animal and clinical studies, including the first phase 3 studies. The findings as well as advantages and disadvantages, potential risks and challenges that still have to be addressed before routine clinical application can be envisioned will be comprehensively presented and discussed.

Die Allergenimmuntherapie (AIT) ist die einzig kausale Form der Behandlung Ig(Immunglobulin)E-vermittelter Allergien, sofern keine Allergenmeidung möglich ist. Bereits lange und gut etabliert sind subkutane (SCIT) und sublinguale (SLIT) Allergenapplikation, vor Kurzem wurde zudem die erste orale Immuntherapie (OIT) zur Behandlung der Erdnussallergie zugelassen. Interessante und vielversprechende weitere Administrationsformen sind die intralymphatische (ILIT) und epikutane (EPIT) Immuntherapie, deren immunologische und klinische Wirksamkeit bezüglich einer Toleranzinduktion sowohl in tierexperimentellen als auch klinischen Studien untersucht worden ist, Letztere auch bereits in ersten Phase-3-Studien. Die Ergebnisse der Prüfungen sowie Vor- und Nachteile dieser neuen Verfahren, auch im Hinblick auf mögliche Risiken und noch zu adressierende Herausforderungen vor einem zukünftigen routinemäßigen klinischen Einsatz sollen im Folgenden ausführlich dargelegt und diskutiert werden.

Keywords: Epicutaneous immunotherapy; Immunoglobulin E; Intralymphatic immunotherapy; Specific immunotherapy; Tolerance induction.

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References

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