Subcutaneous and sublingual routes of using allergen-specific immunotherapy. Treatment protocols

Allergen-specific immunotherapy should be carried out by an experienced specialist allergologist because of the possibility of adverse reactions occurring during treatment. The treatment regimen in subcutaneous and sublingual immunotherapy consists of the phase of initial treatment and the phase of maintenance treatment. The initial treatment phase consists of a gradual increase in the dose of the allergen administered until the maximum tolerated dose or the maximum dose recommended by the manufacturer is reached. The maintenance phase is based on systematic administration of the maximal dose from the initial phase. Immunotherapy for perennial allergens can be started at any time, while for seasonal allergens should begin 4–24 weeks before the season of exposure. The recommended duration of immunotherapy sums up to 3–5 years. In the hymenoptera venom immunotherapy, accelerated schemes are used to shorten the initial treatment phase from several weeks (cluster), several days (rush) to several hours (ultra rush). They consist of more than once a week administration of a dose of the vaccine, but they are associated with the frequent occurrence of serious allergic side effects, and should be carried out at the hospital.