International consensus on allergy immunotherapy

Marek Jutel¹, Ioana Agache², Sergio Bonini³, A Wesley Burks⁴, Moises Calderon⁵, Walter Canonica⁶, Linda Cox⁷, Pascal Demoly⁸, Antony J Frew⁹, Robin O'Hehir¹⁰, Jörg Kleine-Tebbe¹¹, Antonella Muraro¹², Gideon Lack¹³, Désirée Larenas¹⁴, Michael Levin¹⁵, Harald Nelson¹⁶, Ruby Pawankar¹⁷, Oliver Pfaar¹⁸, Ronald van Ree¹⁹, Hugh Sampson²⁰, Alexandra F Santos²¹, George Du Toit²¹, Thomas Werfel²², Roy Gerth van Wijk²³, Luo Zhang²⁴, Cezmi A Akdis²⁵

Affiliations

¹ Department of Clinical Immunology, Wrocław Medical University, and "ALL-MED" Medical Research Institute, Wrocław, Poland. Electronic address: marek.jutel@umed.wroc.pl.
² Faculty of Medicine, Transylvania University, Brasov, Romania.
³ Second University of Naples and IFT-CNR, Rome, and Expert-on-Secondment European Medicines Agency, London, United Kingdom.
⁴ Department of Pediatrics, University of North Carolina, Chapel Hill, NC.
⁵ Section of Allergy and Clinical Immunology, Imperial College London, National Heart and Lung Institute, Royal Brompton Hospital, London, United Kingdom.
⁶ Allergy & Respiratory Diseases Clinic, DIMI-University of Genoa, IRCCS AOU S. Martino, Genoa, Italy.
⁷ Allergy and Asthma Center, Ft Lauderdale, Fla.
⁸ University Hospital of Montpellier-INSERM U657, Montpellier, France.
⁹ Department of Respiratory Medicine, Royal Sussex County Hospital, Brighton, United Kingdom.
¹⁰ Department of Immunology, AMREP, Monash University, Melbourne, Australia.
¹¹ Allergy & Asthma Center Westend, Berlin, Germany.
¹² Department of Mother and Child Health, Padua General University Hospital, Padua, Italy.
¹³ Division of Asthma, Allergy and Lung Biology, MRC and Asthma UK Centre in Allergic Mechanisms of Asthma, King's College London, and the Children's Allergy Unit, Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom.
¹⁴ Hospital Médica Sur, Mexico City, Mexico.
¹⁵ Division of Allergy, School of Child and Adolescent Health, Red Cross War Memorial Children's Hospital, Cape Town, South Africa.
¹⁶ National Jewish Health, Denver, Colo.
¹⁷ Department of Pediatrics, Nippon Medical School, Tokyo, Japan.
¹⁸ Center for Rhinology and Allergology, Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Mannheim, Mannheim, Germany.
¹⁹ Academic Medical Center, Departments of Experimental Immunology and of Otorhinolaryngology, University of Amsterdam, Amsterdam, The Netherlands.
²⁰ Department of Pediatrics, Division of Allergy-Immunology, and the Jaffe Food Allergy Institute at the Icahn School of Medicine at Mount Sinai, New York, NY.
²¹ Department of Pediatric Allergy, Division of Asthma, Allergy & Lung Biology, King's College London, and MRC & Asthma UK Centre in Allergic Mechanisms of Asthma, London, United Kingdom.
²² Department of Dermatology and Allergy, Division of Immunodermatology and Allergy Research, Hannover Medical School, Hannover, Germany.
²³ Erasmus Medical Center, Rotterdam, The Netherlands.
²⁴ Beijing Institute of Otolaryngology, Beijing, China.
²⁵ Swiss Institute for Allergy and Asthma Research, University of Zurich, Christine Kühne-Center for Allergy Research and Education, Davos, Switzerland.

PMID:26162571
DOI: 10.1016/j.jaci.2015.04.047

Review

International consensus on allergy immunotherapy

Marek Jutel et al. J Allergy Clin Immunol.2015 Sep.

.2015 Sep;136(3):556-68.

doi: 10.1016/j.jaci.2015.04.047. Epub 2015 Jul 7.

Authors

Affiliations

¹ Department of Clinical Immunology, Wrocław Medical University, and "ALL-MED" Medical Research Institute, Wrocław, Poland. Electronic address: marek.jutel@umed.wroc.pl.
² Faculty of Medicine, Transylvania University, Brasov, Romania.
³ Second University of Naples and IFT-CNR, Rome, and Expert-on-Secondment European Medicines Agency, London, United Kingdom.
⁴ Department of Pediatrics, University of North Carolina, Chapel Hill, NC.
⁵ Section of Allergy and Clinical Immunology, Imperial College London, National Heart and Lung Institute, Royal Brompton Hospital, London, United Kingdom.
⁶ Allergy & Respiratory Diseases Clinic, DIMI-University of Genoa, IRCCS AOU S. Martino, Genoa, Italy.
⁷ Allergy and Asthma Center, Ft Lauderdale, Fla.
⁸ University Hospital of Montpellier-INSERM U657, Montpellier, France.
⁹ Department of Respiratory Medicine, Royal Sussex County Hospital, Brighton, United Kingdom.
¹⁰ Department of Immunology, AMREP, Monash University, Melbourne, Australia.
¹¹ Allergy & Asthma Center Westend, Berlin, Germany.
¹² Department of Mother and Child Health, Padua General University Hospital, Padua, Italy.
¹³ Division of Asthma, Allergy and Lung Biology, MRC and Asthma UK Centre in Allergic Mechanisms of Asthma, King's College London, and the Children's Allergy Unit, Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom.
¹⁴ Hospital Médica Sur, Mexico City, Mexico.
¹⁵ Division of Allergy, School of Child and Adolescent Health, Red Cross War Memorial Children's Hospital, Cape Town, South Africa.
¹⁶ National Jewish Health, Denver, Colo.
¹⁷ Department of Pediatrics, Nippon Medical School, Tokyo, Japan.
¹⁸ Center for Rhinology and Allergology, Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Mannheim, Mannheim, Germany.
¹⁹ Academic Medical Center, Departments of Experimental Immunology and of Otorhinolaryngology, University of Amsterdam, Amsterdam, The Netherlands.
²⁰ Department of Pediatrics, Division of Allergy-Immunology, and the Jaffe Food Allergy Institute at the Icahn School of Medicine at Mount Sinai, New York, NY.
²¹ Department of Pediatric Allergy, Division of Asthma, Allergy & Lung Biology, King's College London, and MRC & Asthma UK Centre in Allergic Mechanisms of Asthma, London, United Kingdom.
²² Department of Dermatology and Allergy, Division of Immunodermatology and Allergy Research, Hannover Medical School, Hannover, Germany.
²³ Erasmus Medical Center, Rotterdam, The Netherlands.
²⁴ Beijing Institute of Otolaryngology, Beijing, China.
²⁵ Swiss Institute for Allergy and Asthma Research, University of Zurich, Christine Kühne-Center for Allergy Research and Education, Davos, Switzerland.

PMID:26162571
DOI: 10.1016/j.jaci.2015.04.047

Abstract

Allergen immunotherapy (AIT) has been used to treat allergic disease since the early 1900s. Despite numerous clinical trials and meta-analyses proving AIT efficacious, it remains underused and is estimated to be used in less than 10% of patients with allergic rhinitis or asthma worldwide. In addition, there are large differences between regions, which are not only due to socioeconomic status. There is practically no controversy about the use of AIT in the treatment of allergic rhinitis and allergic asthma, but for atopic dermatitis or food allergy, the indications for AIT are not well defined. The elaboration of a wider consensus is of utmost importance because AIT is the only treatment that can change the course of allergic disease by preventing the development of asthma and new allergen sensitizations and by inducing allergen-specific immune tolerance. Safer and more effective AIT strategies are being continuously developed both through elaboration of new allergen preparations and adjuvants and alternate routes of administration. A number of guidelines, consensus documents, or both are available on both the international and national levels. The international community of allergy specialists recognizes the need to develop a comprehensive consensus report to harmonize, disseminate, and implement the best AIT practice. Consequently, the International Collaboration in Asthma, Allergy and Immunology, formed by the European Academy of Allergy and Clinical Immunology; the American Academy of Allergy, Asthma & Immunology; the American College of Allergy, Asthma & Immunology; and the World Allergy Organization, has decided to issue an international consensus on AIT.

Keywords: International consensus; allergen vaccine; allergic rhinitis; allergy; asthma; atopic dermatitis; food allergy; immunotherapy.

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