Treatment

The best way to prevent allergy is by avoiding the allergen.

Allergen avoidance

Allergen avoidance involves taking adequate measures to reduce the allergenic agent from the environment in which we live and limit contact with it. This is the first step towards improving the symptoms of allergy.

  • Food allergy

There is no cure for food allergy and avoidance of the food allergen is the only way to protect against an allergic reaction1. Identifying “hidden” food requires a high level of attention. People with food allergies should read labels carefully and always carry an epinephrine auto-injector to treat severe allergic reactions.

  • House dust mite allergy

Our home environment must be treated to reduce the development of house dust mites: reduce the room temperature to 18-19° maximum, decrease humidity, air your house regularly, wash linen and duvets at 60°, clean and vacuum upholstery, curtains bedding frequently, dust and vacuum on a regular basis, etc.

  • Pollen allergy

Avoiding allergy to pollen is more complicated since pollen is present everywhere in our environment. Some measures can help reduce exposure to pollen: wash your hair and shower after having been outside, prefer air conditioning to open windows during the pollen season, etc.

  • Allergy to pets

Avoid contact with pets and pet stores, wash your hands after having been in contact with a pet, have your pet brushed and washed regularly by someone who doesn’t have allergies.

 

Symptomatic treatments for respiratory allergy

Symptomatic drugs are often prescribed by healthcare professionals as first-line treatment to reduce the intensity of respiratory allergy symptoms and fight the inflammation caused by the allergy.

Symptomatic drugs are effective and may reduce the severity of allergy symptoms, though these medications have no carry-over effect when treatment ends2. Their effects last as long as they are taken but present no long-term benefits.

Most symptomatic treatments work in different ways to target the different allergy symptoms. They can generally be found over-the-counter. For example:

  • Antihistamines work by blocking the action of histamine, a chemical released by the immune system during an allergic reaction that causes swelling and itching.
  • Decongestants are used to help ease a blocked or stuffy nose (nasal congestion). They may be helpful for congestion caused by various conditions, including allergic rhinitis.
  • Corticosteroids help to reduce inflammation for patients suffering from allergic rhinitis and asthma. Corticosteroids are usually only available with a prescription and their use must be carefully monitored by a healthcare professional2.

 

Allergen immunotherapy

  • Respiratory allergy

Only an allergy specialist can prescribe an allergy immunotherapy treatment after an accurate diagnosis. Allergen immunotherapy is a second line treatment intended for patients (from 5 years of age) with respiratory allergies and for whom symptomatic treatments are insufficient or not well tolerated.

Allergen immunotherapy, also known as desensitisation, uniquely alters the natural course of respiratory allergies. Allergen immunotherapy is the only therapeutic class capable of modifying the disease progression and potentially preventing the onset of the disease by inducing tolerance in the immune system3.

Allergen immunotherapy is a targeted treatment which consists in administering to the patient repeated doses of allergenic extracts, which will reduce the hyper-reactivity of the immune system and the inflammation. An AIT treatment can take between three to five years4 to achieve a carry-over effect.

Once the patient has completed their recommended time on treatment, tolerance to the allergen is improved and progression of the allergic march is contained.

Patients can live a life with fewer symptoms and rescue medication as well as experience better sleep and improved performance at school, work, or recreational activities5.

  • Food allergy

Food avoidance is the only way to prevent an allergic reaction. Total avoidance of food allergens is not possible and allergen immunotherapy is the only causative treatment with the goal of inducing allergen tolerance in individuals with food allergies6.

As in respiratory allergy, food allergen immunotherapy involves the administration of increasing doses of a specific food allergen until maintenance dosage is achieved7. It aims to raise the threshold that may trigger an allergic reaction and protect against accidental exposure of the allergen8. Food allergen immunotherapy is carried out in a medical setting.

People with food allergies should always avoid the food allergen to which they are sensitised, read labels carefully for hidden foods, and always carry an epinephrine auto-injector to treat severe allergic reactions.

 

1. ACAAI. Food allergy. Online: https://acaai.org/allergies/allergic-conditions/food/ Last accessed Febr 2024
2. Allergy UK www.allergyuk.org Last accessed Febr 2024
3. Global Atlas of Allergy, EAACI 2014
4. Penagos M, Durham S. Long-term efficacy of the sublingual and subcutaneous routes in allergen immunotherapy. Allergy Asthma Proc 2022 43(4):292-298
5. Allergen Immunotherapy Guidelines. EAACI 2017
6. AIT: New Avenues in Allergen Immunotherapy.  Wofgang Pfützner, Christian Möbs
7. Jones SM, Burks AW, Dupont C. State of the art on food allergen immunotherapy: oral, sublingual, and epicutaneousJ Allergy Clin Immunol (2014) 133:318–23. doi: 10.1016/j.jaci.2013.12.104
8. AAAAI. The current state of oral immunotherapy. Online: https://www.aaaai.org/tools-for-the-public/conditions-library/allergies/the-current-state-of-oral-immunotherapy Last accessed Febr 2024

Last updated on: 27/05/2024