2011 Volume 25 Issue 1 Pages 10-15
Thirty years ago there were few good anti-asthma medication such as inhaled corticosteroids or leukotriene receptor antagonists. From that time we have conducted allergen specific immunotherapy to treat patients with asthma or allergic rhinitis who have been sensitized specific allergens. Because of the quick effects, rush immunotherapy is more favorable than conventional method. We found that house dust-mite specific IgG4 antibody increases and house dust-mite specific IgE antibody decreases after successful immunotherapy. We also revealed that one of the mechanisms of immunotherapy is sift of Th1/Th2 cytokine balance and increase in regulatory cytokine IL-10.
Rush immunotherapy has several disadvantage such that patients need to be admitted in the hospital during rapid antigen escalation phase. However, recently cluster methods has been developed by Nagata which makes it possible to treat patients on the outpatients basis.
Now, in Japan, there are two big problems about immunotherapy. First, standardized allergens are not available except mite and Japanese ceder pollen. Second, sublingual immunotherapy is not available in Japan, while it has been approved by governments in Europe and the United States.
Since immunotherapy is the only way to lead patients to natural remission, we hope many allergen extracts for immunotherapy including sublingual will be available soon in Japan.
