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Allergy. 2011 Jun;66(6):798-809. doi: 10.1111/j.1398-9995.2011.02560.x. Epub 2011 Feb 24.

Epicutaneous allergen administration: is this the future of allergen-specific immunotherapy?

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  • 1Clinical Trials Center, University Hospital of Zürich, Zürich, Switzerland.

Abstract

IgE-mediated allergies, such as allergic rhinoconjunctivitis and asthma, have become highly prevalent, today affecting up to 30% of the population in industrialized countries. Allergen-specific immunotherapy (SIT) either subcutaneously or via the sublingual route is effective, but only few patients (<5%) choose immunotherapy, as treatment takes several years and because allergen administrations are associated with local and, in some cases, even systemic allergic side-effects because of allergen accidentally reaching the circulation. In order to resolve these two major drawbacks, the ideal application site of SIT should have two characteristics. First, it should contain a high number of potent antigen-presenting cells to enhance efficacy and shorten treatment duration. Secondly, it should be nonvascularized in order to minimize inadvertent systemic distribution of the allergen and therefore systemic allergic side-effects. The epidermis, a nonvascularized multilayer epithelium, that contains high numbers of potent antigen-presenting Langerhans cells (LC) could therefore be an interesting administration route. The present review will discuss the immunological rational, history and actual clinical experience with epicutaneous allergen-specific immunotherapy.

© 2011 John Wiley & Sons A/S.

PMID:
21518374
[PubMed - indexed for MEDLINE]
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