ABSTRACT
[This corrects the article DOI: 10.1186/s13601-016-0095-x.].
ABSTRACT
BACKGROUND: The European Academy of Allergy and Clinical Immunology (EAACI) is in the process of developing the EAACI Guidelines for Allergen Immunotherapy (AIT) for the Management of Insect Venom Allergy. We seek to critically assess the effectiveness, cost-effectiveness and safety of AIT in the management of insect venom allergy. METHODS: We will undertake a systematic review, which will involve searching international biomedical databases for published, in progress and unpublished evidence. Studies will be independently screened against pre-defined eligibility criteria and critically appraised using established instruments. Data will be descriptively and, if possible and appropriate, quantitatively synthesised. DISCUSSION: The findings from this review will be used to inform the development of recomendations for EAACI's Guidelines on AIT.
ABSTRACT
The only method aiming to permanently cure allergic disorders is allergen immunotherapy. Over the last 20 years there has been great progress in understanding the mechanisms that govern allergen immunotherapy in order to meet three basic prerequisites: safety, effectiveness and compliance. In the present summary report from the European Academy of Allergology and Clinical Immunology-World Allergy Organization Congress held last June in Milan, we review key points concerning the main axes as diagnosis, novel modalities, routes and protocols, as well as two important immunotherapy fields: food and insect venom allergy.
Subject(s)
Allergy and Immunology , Desensitization, Immunologic/methods , Hypersensitivity/immunology , Hypersensitivity/therapy , Allergens/adverse effects , Allergens/immunology , Animals , Cost-Benefit Analysis , Desensitization, Immunologic/trends , Food/adverse effects , Humans , Hypersensitivity/diagnosis , Insecta , Italy , Medication Adherence , Venoms/adverse effectsABSTRACT
The mechanisms governing the induction of peripheral tolerance as a result of specific immunotherapy are far from being clearly characterized. In the last 15 years, a number of studies have highlighted the tolerogenic role of regulatory T cells, blocking antibodies and anti-inflammatory cytokines such as IL-10 and TGF-ß; however, the best part of our knowledge is mostly limited to mechanisms underlying the maintenance phase. By contrast, little is known regarding the very early effects seen in rush and ultrarush immunotherapy protocols. In this article, Bussmann et al. provide evidence on the possible role, first, of inhibitory receptors of the leukocyte immunoglobulin-like receptor family and, second, of the upregulation of indoleamine 2,3-dioxygenase and subsequent tryptophan starvation on the induction of specific tolerance within a few hours after the initial doses. They also suggest that the observed changes reflect the activation of protective mechanisms, which we are just beginning to understand.
