Conflict of interest: All authors declare no conflict of interests.
New visions in specific immunotherapy in children: an iPAC summary and future trends
Article first published online: 8 JUL 2008
© 2008 The Authors. Journal compilation © 2008 Blackwell Munksgaard
Pediatric Allergy and Immunology
Special Issue: iPAC, an initiative for the future of research in pediatric allergy, asthma and immunology
Volume 19, Issue Supplement s19, pages 60–70, August 2008
How to Cite
Halken, S., Lau, S. and Valovirta, E. (2008), New visions in specific immunotherapy in children: an iPAC summary and future trends. Pediatric Allergy and Immunology, 19: 60–70. doi: 10.1111/j.1399-3038.2008.00768.x
- Issue published online: 8 JUL 2008
- Article first published online: 8 JUL 2008
- Accepted 3 April 2008
- specific immunotherapy;
- side effects;
- future aspects
Specific immunotherapy is indicated for confirmed immunoglobulin E-mediated airway diseases using standardized allergen products with documented clinical efficacy and safety. For decades the subcutaneous route of administration (SCIT) has been the gold standard. Recently, the sublingual immunotherapy (SLIT) has also been investigated in children. SCIT, especially with grass and birch pollens but also house dust mites, is an effective treatment in children with allergic rhinitis and asthma when a significant part of their symptoms are caused by these allergens. A long-term effect up to 12 yr after discontinuation of SCIT with timothy allergen has been shown. Efficacy and safety of SLIT in pollen allergic rhinoconjunctivitis have been demonstrated in adults. The evidence in children is a little less convincing, and more data is needed. The clinical relevance, long-term results and the size of the effect, as well as the dose, the treatment regimen and duration has not been sufficiently elaborated. It is demonstrated that SCIT has the potential for preventing the development of asthma in children with allergic rhinoconjunctivitis. Also one randomized study indicates a preventive effect of SLIT in children on the development of asthma. At present, there are no studies who clearly demonstrates either a long-term effect or a preventive effect on the development of asthma of SLIT in children. The areas with lack of evidence should be addressed in well performed prospective, randomized long-term studies both with SCIT and SLIT. This review was initiated by iPAC (international Pediatric Allergy and Asthma Consortium) and aims to review current knowledge related to specific immunotherapy in childhood, and to identify needs for future research in this field.