Allergen Extract Selection and Handling Specific Allergens
ÎImmunotherapy is effective for pollen, animal allergens, dust mite, mold/fungi, and Hymenoptera hypersensitivity. Therefore immunotherapy should be considered as part of the management program in patients who have symptoms related to exposure to these allergens, as supported by the presence of specific IgE antibodies. (A)
Cockroach
ÎThere are limited data on the efficacy of cockroach immunotherapy. (B) Multiallergen Immunotherapy
ÎThere are few studies that have investigated the efficacy of multiallergen subcutaneous immunotherapy. These studies have produced conflicting results, with some demonstrating significant clinical improvement compared with placebo and others showing no benefit over optimal pharmacotherapy and environmental control measures. Thus it is important to treat the patients only with relevant allergens. (B)
Basis Of Allergen Extract Selection
ÎThe selection of the components of an allergen immunotherapy extract should be based on a careful history in correlation with positive allergy skin test results or serum specific IgE antibodies. The allergen immunotherapy extract should contain only clinically relevant allergens. In choosing the components for a clinically relevant allergen immunotherapy extract, the physician should be familiar with local and regional aerobiology and indoor and outdoor allergens, paying special attention to potential allergens in the patient's own environment. (D)
Skin Tests And Serum Specific IgE Antibody Tests
ÎSkin testing has been the primary diagnostic tool in clinical studies of allergen immunotherapy. Therefore in most patients skin testing should be used to determine whether the patient has serum specific IgE antibodies. Appropriately interpreted serum specific IgE antibodies can also be used. (C)
Allergen Extract Selection
ÎNonstandardized extracts can vary widely in biologic activity and composition, regardless of a particular weight/volume or protein nitrogen unit (PNU) potency and should not be considered equipotent. (B)
ÎWhen possible, standardized extracts should be used to prepare the allergen immunotherapy extract treatment sets. (A)
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