Depending on the type of allergy the child has, we can train the body to become less responsive to that allergen. Immunotherapy is a treatment option in allergic children where

• symptoms are difficult to control with medications and/or
• the allergy-causing allergen cannot be avoided.

In this therapy, the culprit allergens are given to the patient in gradually increasing doses. The regime of incremental increases is decided by the allergy specialist. By administering allergens in this way, the immune system becomes less sensistive to the substance, probably by causing production of a “blocking” antibody, which reduces the inflammatory response of the body to this substance in future encounters. As a result, the troubling symptoms of allergies subside over time. Immunotherapy is an effective treatment modality and holds potential to cure allergies in future.

Immunotherapy is given in which type of allergies?

Immunotherapy is given to children suffering from allergic rhinitis, asthma, food allergy and bee-venom allergy. It is now recommended by all international guidelines for these allergic diseases. Allergens responsible for causing symptoms are identified and then immunotherapy is planned for these allergens by an allergy specialist. Tests that help determine these allergens are

• Skin prick test
• Blood test for specific allergens

Do all children with allergies require Immunotherapy?

• In children who suffer from severe allergies where the symptoms affect the daily routine activities of the child, the allergy specialist may recommend immunotherapy to improve quality of life.
• Poor response to medications or over-dependence of medications is another situation to start immunotherapy.
• When symptom causing allergens are hard to avoid, for example pollens, weeds, trees or house dust mites, immunotherapy is advised.

Immunotherapy is not advised to all children with allergies. The allergy specialists decide on starting this treatment depending on the child’s age, response to medical treatment, allergens responsible etc.

How is Immunotherapy given?

Immunotherapy, previously known as allergy shots, can be given as injections in the superficial layers of the skin. This type of immunotherapy is called SCIT (Subcutaneous Immunotherapy). These injections are given frequently at the beginning but gradually reduce to once a week and then once a month over the course of the therapy. Sublingual immunotherapy (SLIT) is another form of therapy where the medicine is placed under the tongue. This medicine is initially administered under supervision of the doctor, but later can be taken by the child at home. Duration of complete course of immunotherapy is usually 2-3 years. During this time regular follow up visits with the treating doctor who keeps a record of child’s improvement is very important. Both the methods of immunotherapy are safe and do not have much practical adverse effects on the child. Dr Ritika Goyal has been giving immunotherapy to children with allergic rhinitis and asthma for 3 years.