Allergen Immunotherapy for Atopic Dermatitis

Abstract

Clinical efficacies of current medical therapies for atopic dermatitis are transient and incomplete. There is an unmet need for a treatment inducing a long-term clinical remission of atopic dermatitis. Allergen immunotherapy is the treatment method of administering increasing doses of clinically relevant allergen to a patient with allergic diseases to reduce the clinical symptom induced by exposure to the allergen. Allergen immunotherapy is proven as a disease-modifying therapy that can change a long-term clinical course in patients with allergic asthma, allergic rhinitis, and bee venom hypersensitivity. Allergen immunotherapy is usually performed by either subcutaneous injection or sublingual administration. A meta-analysis of randomized clinical trials on allergen immunotherapy in patients with atopic dermatitis provided a moderate-level evidence of the clinical efficacy for atopic dermatitis. Currently available evidences suggest: (1) allergen immunotherapy can provide a clinical improvement in patient with atopic dermatitis sensitized to inhalant allergens, (2) subcutaneous allergen immunotherapy is effective in patient with severe atopic dermatitis, (3) sublingual allergen immunotherapy is effective in patients with mild-to-moderate atopic dermatitis. Personalized immunomodulatory therapy combining allergen immunotherapy with other immunomodulatory modalities including monoclonal antibody therapy and/or immunomodulating small molecule drugs might provide a rapid-onset long-lasting clinical improvement in patient with atopic dermatitis.