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

Giovanni Battista Pajno, Roberto Bernardini, Diego Peroni, Stefania Arasi, Alberto Martelli, Massimo Landi, Giovanni Passalacqua, Antonella Muraro, Stefania La Grutta, Alessandro Fiocchi, Luciana Indinnimeo, Carlo Caffarelli, Elisabetta Calamelli, Pasquale Comberiati, Marzia Duse

Research output: Contribution to journalReview articlepeer-review

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.

Original languageEnglish
Pages (from-to)1-18
Number of pages18
JournalItalian Journal of Pediatrics
Volume43
DOIs
Publication statusPublished - Jan 23 2017

Keywords

  • Allergen-specific immunotherapy
  • Allergy
  • Asthma
  • Atopic dermatitis
  • Children
  • Food allergy
  • Sub-lingual immunotherapy
  • Subcutaneous immunotherapy

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

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