Allergen immunotherapy in patients with autoimmune diseases: current of guidelines and emerging controversies

This review examines the use of allergen immunotherapy (AIT) in patients with comorbid autoimmune diseases, addressing ongoing controversies and gaps in current clinical guidelines. The purpose of this article is to explore the complex relationship between allergic and autoimmune diseases and to determine the safety of AIT in this patient population. Historical case reports and recent observational studies were reviewed, highlighting cases in which AIT has been associated with exacerbations of autoimmune diseases. However, these reports often involved older, less purified allergen extracts, raising questions about their relevance to current practice. The review also assessed international guidelines, revealing inconsistencies and a reliance on outdated evidence. The findings suggest the need for more rigorous, large-scale studies to provide clear guidelines for the safe use of AIT in patients with autoimmune diseases. This review underscores the need for updating clinical practices to align with contemporary evidence, ensuring that AIT is applied safely and effectively in patients with autoimmune conditions.