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Allergen: A substance that triggers an allergic reaction.

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Allergic Rhinitis: An allergy affecting the mucus membrane of the nose. Seasonal allergic rhinitis is often called "hay fever."

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Allergist: A doctor that diagnoses, treats, and manages allergy-related conditions.

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Ana-Kit: A device used to inject epinephrine during an anaphylaxis attack.

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Anaphylaxis: A life-threatening allergic reaction that involves the entire body. Anaphylaxis may result in shock or death, and thus requires immediate medical attention

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Animal dander: The small scales or pieces of skin, often containing proteins secreted by oil glands, which are shed by an animal. These proteins are the major causes of allergies to pets.

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Antibiotics: A class of medications used to treat bacterial infections. Certain antibiotics, such as penicillin, may cause an allergic reaction in some people.

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Antibody: A protein in the immune system that recognizes and attacks foreign substances in the body.

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Anticonvulsant: A medication used to prevent or treat seizures. Certain anticonvulsants may cause an allergic reaction in some people.

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Antihistamines: A class of medications used to block the action of histamines in the body and prevent the symptoms of an allergic reaction.

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Asthma: An inflammatory disorder of the airways, causing periodic attacks of wheezing, coughing, chest tightness, and shortness of breath.

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Atopic dermatitis: A chronic skin rash, also known as "eczema," that often appears in the first few years of life.

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Basophil: An immune system cell that attaches to antibodies and circulates through out the blood.

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Beta-blockers: A class of blood pressure medications that ease the heart's pumping action and widen the blood vessels. Beta-blockers counteract the effects of epinephrine used for emergency treatment of anaphylactic shock and should not be used during immunotherapy.

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Bronchial tubes: The lower sections of the airway that lead into the lungs.

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Challenge test: A test used to confirm an allergy to specific substance. A doctor will administer small but increasing amounts of a suspected allergen until an allergic response is noticed. Due to the risk of anaphylaxis, this should only be performed under a controlled setting.

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Conjunctivitis: Inflammation of the conjunctiva, or the mucous membrane surrounding the eye. Also known as pinkeye.

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Contact dermatitis: An allergic reaction resulting from skin contact to an allergen.

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Corticosteroid: An anti-inflammatory medication used to treat the itching and swelling associated with some allergic reactions.

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Cromolym sodium: An anti-inflammatory nasal spray used to treat and sometimes prevent allergic rhinitis.

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Decongestants: A class of medications used for nasal congestion. Decongestants are available in oral doses, nasal sprays, or eye drops (for conjunctivitis).

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Dust mites: A microscopic organism that lives in dust.

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Eczema: See Atopic dermatitis.

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Eosinophil: A specific type of immune cell that can cause tissue damage in the late phase of an allergic reaction.

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Epinepherine: A medication used for immediate treatment of anaphylaxis by raising blood pressure and heart rate back to normal levels. Epinepherine is also known as adrenaline.

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EpiPen: A device used to inject epinephrine during an anaphylaxis attack.

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Heparin: A chemical released by basophils and mast cells that causes nearby tissues to become swollen and inflamed.

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Histamine: A chemical released by basophils and mast cells that causes nearby tissues to become swollen and inflamed.

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Hives: See urticaria.

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Hypertension: High blood pressure. When blood pushes against artery walls harder than normal.

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Immunoglobulin E: A type of antibody responsible for most allergic reactions.

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Immunotherapy: A series of shots that help build up the immune system's tolerance to an allergen.

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Insulin: A hormone that regulates blood sugar levels. Diabetics who take insulin derived from animals may have allergic reactions.

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Intradermal test: A test where an allergen is injected just underneath the skin. Intradermal tests are generally used when results from a skin prick test are unclear.

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Late Phase: The period 4 - 24 hours after exposure to an allergen where tissue damage may occur.

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Leukotrienes: Inflammatory substances that are released by mast cells during an allergic response or asthma attack.

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Lymphocyte: A specific type of immune cell that can cause tissue damage in the late phase of an allergic reaction.

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Mast cell: An immune system cell which attaches to antibodies and is located in the tissue that lines the nose, bronchial tubes, gastrointestinal tract, and the skin

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Neocromil sodium: An inhaled medication used to treat inflammation involved with asthma.

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Neutrophil: A specific type of immune cell that can cause tissue damage in the late phase of an allergic reaction.

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Otitis media: A middle ear infection. Otitis media with effusion occurs when fluid builds up within the ear.

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Radioallergosorbant Test (RAST): A blood test that measures the amount of IgE antibody produced when the sample is mixed with a specific allergen.

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Rhinitis: An inflammation of the nasal passageways, particularly with discharge.

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Sinusitis: An inflammation or infection of one or more sinuses. The sinuses are hollow air spaces located around the nose and eyes.

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Skin prick test: A test where a needle is used to scratch the skin with a small amount of allergen. A response can usually be seen within 15 - 20 minutes.

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Urticaria: Raised areas of the skin that are often red, warm, and itchy. Urticaria is also known as hives.

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Urushiol: An oil found on poison ivy, oak, and sumac.

Immunotherapy is like a vaccination against your allergies. Vaccines shots are to prevent infections; immunotherapy shots are to prevent allergies. However, the two work in opposite ways. Vaccinations prime the immune system to help the body react swiftly if the disease is encountered again, whereas immunotherapy dulls the reaction to allergens.

In the long term, allergy shots can minimize the need for antihistamines or other allergy medications. Immunotherapy builds up your tolerance to specific allergens, so your body won't overreact to them.

Immunotherapy shots are used for most airborne allergens, including tree, grass, and weed pollens, mold spores, dust mites, and animal allergens. Immunotherapy shots can also be used to prevent severe sting reactions from honeybees, yellow jackets, hornets, wasps, or fire ants.

How does it work?

Your allergist will first confirm what you're allergic to with allergy testing. Next, the allergist will inject small amounts of allergens over the course of many months, periodically increasing the amount of allergens injected. After receiving each shot, you will need to stay in the doctor's office for 20 - 30 minutes to see if you react adversely. Also, your allergist will ask you how you felt after getting the previous shot.

The injection schedule depends on the individual. Generally, 1 - 2 shots are given weekly in the beginning during the "dose building" stage. They eventually taper off to monthly "maintenance" shots. For some people, it may take up to 12 months to reach the maintenance dose.

Immunotherapy treatment can last for 3 - 5 years, but you may start feeling relief from symptoms within 6 - 12 months of starting the therapy. After stopping immunotherapy, the benefits can last for more than 3 years.

If you are considering immunotherapy and have not visited an allergist, ask your primary care physician for a referral. Also, if you have health insurance, find out if immunotherapy is covered.

"Everyone in my family has allergies, and we would all get our shots together. It was like a family outing; we would all get our shots, and afterwards we'd get pizza."

-- Sharon, age 29

Who can benefit?

With the advice of your allergist, you can decide if immunotherapy is right for you. Do the benefits of immunotherapy outweigh the time commitment, risks, and costs involved? Consider immunotherapy if:

  • You do not like the side effects of allergy medication.
  • Allergy medications have not been effective.
  • You need multiple allergy medications.
  • You cannot avoid the allergen in your environment.
  • You experience allergy symptoms year-round.
  • Your allergy symptoms interfere with your daily life (e.g., lack of sleep, missing work or school).

Immunotherapy has proven to be effective at reducing symptoms of:

  • Allergic rhinitis
  • Allergic conjunctivitis
  • Allergic asthma
  • Stinging insect allergy

It may also prevent the development of asthma in children who have allergic rhinitis.

Risks involved with immunotherapy

Since immunotherapy involves the injection of something that you are allergic to, there is a small risk of anaphylaxis for some people. Immunotherapy must be performed in a medical setting, where epinephrine and other emergency allergy treatments are easily accessible -- this minimizes the risk of anaphylactic shock.

You should not receive immunotherapy if you are taking beta-blocker medication. Beta-blockers counteract the effects of epinephrine used for emergency treatment of anaphylactic shock.

You should also not receive immunotherapy if you have:

  • Acute or chronic lung disorders
  • Uncontrolled asthma
  • History of recent heart attack or other current heart problems
  • Uncontrolled hypertension
  • Kidney or other main organ failure

Immunotherapy during pregnancy

Make sure you inform your allergist if you are pregnant. It is not advisable to start immunotherapy shots for the first time during pregnancy. If you become pregnant after you have already started, you may be able to continue if:

  • You find that immunotherapy reduces your allergy symptoms.
  • You're not prone to reactions after the shots.
  • You maintain the same dose during the entire pregnancy.

You should be able to continue immunotherapy while you're breastfeeding.

Reference

Allergen immunotherapy: a practice parameter. American Academy of Allergy, Asthma & Immunology. Ann Allergy Asthma Immunol. 2003;90(1):1-40.

 

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Review Date: 4/4/2007

Reviewed By: Alan Greene, M.D., F.A.A.P., Department of Pediatrics, Packard Children's Hospital, Stanford University School of Medicine; Chief Medical Officer, A.D.A.M., Inc.


The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.

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