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Subcutaneous Immunotherapy

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Allergen immunotherapy is the only disease-modifying treatment available for several common allergic diseases. Subcutaneous immunotherapy is the best studied form of AIT and is effective for allergic rhinitis and rhinoconjunctivitis, allergic asthma, and Hymenoptera venom allergy. Subcutaneous immunotherapy involves the repeated subcutaneous injection of increasing amounts of allergen beginning with very small doses of allergen and gradually increasing to higher doses. Another popular method of Allergen immunotherapy involves sublingual administration in the form of dissolvable tablets or extracts
Allergen immunotherapy alters the immune system's reaction to causative allergens and induces long-lasting tolerance to these allergens. Subcutaneous immunotherapy has been in …show more content…

Levels may continue to rise over many months of maintenance immunotherapy, and elevated levels may persist for many years after immunotherapy is discontinued. The generation of allergen-specific regulatory T and B cells (Tregs and Bregs) and suppression of allergen-specific effector T cell subsets and innate lymphoid cells (ILCs). During allergen immunotherapy, allergen-specific Treg cells are generated, which produce IL-10 and transforming growth factor-beta (TGF-beta), cytotoxic T lymphocyte antigen 4 (CTLA-4), and program death molecule 1 (PD1). These cytokines suppress proliferative and cytokine responses against major allergens. IL-10 reduces proinflammatory cytokine release from mast cells, eosinophils, and T cells, and elicits tolerance in T cells by means of selective inhibition of the CD28 costimulatory pathway. The transcription factor forkhead box protein 3 (FOXP3) is required for the development and function of naturally occurring T regulatory cells, and its expression is sufficient to convert nonregulatory CD4+CD25+ T cells into T cells with regulatory activity. FOXP3 expression negatively correlates with levels of IgE, eosinophilia,

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