Skin Patch Immunotherapy for Allergy Cure

Over the years, there have been a variety of systems via which physicians and researchers have attempted to cure patients of their inhalant allergies.

These include (click here for a description of each):

• Allergy shots
• Under the tongue allergy drops (SLIT)
• Intra-Lymphatic Injections (ILIT)
• Allergy Tablets
• Epicutaneous Immunotherapy (EPIT)
• Intra-Nasal Spray
• Bronchial Inhalers

Well... we can now add skin patches to the list.

European researchers conducted a placebo-controlled, double-blinded trial involving 132 patients with grass pollen allergies. The patients were randomly divided into one of four groups: placebo, low-dose, medium-dose or high-dose patches. Patients applied six weekly patches prepared with grass allergens prior to and during the 2008 grass season and ALL reported improvement in their symptoms (30% in 2008) though one year later, there was a dose-dependent improvement with essentially no improvement in low-dose and placebo groups.

Unfortunately, higher-dose patches had higher rates of adverse events including pruritus, erythema, wheal, or eczema leading to an overall drop-out rate of 8.3% from the study.

This all may sound good and promising, but two of the study's authors hold patents on patch-based immunotherapy which may lead to study bias.

My take? More study is needed...

Reference:
Epicutaneous allergen-specific immunotherapy ameliorates grass pollen–induced rhinoconjunctivitis: A double-blind, placebo-controlled dose escalation study. The Journal of Allergy and Clinical Immunology Volume 129, Issue 1 , Pages 128-135, January 2012

Different Types of Immunotherapy for Allergy Cure

Most people are already familiar with allergy shots and even sublingual (under the tongue) allergy drops as treatment to try and achieve cure (or tolerance) to the things they are allergic to.

However, there are other forms of immunotherapy that may one day provide just as good if not better allergy cure rates. These include (most currently under research):

- Intra-Lymphatic Injections (ILIT): Rather than weekly shots in the arm, one research paper reported only 3 injections into a groin lymph node over 2 months provided equivalent results to allergy shots in the arm after 3 years!

- Allergy Tablets: Potentially in the next year or 2, tablets may become available to treat certain allergies. Grazax by Merck which treats grass allergy is the first which is currently undergoing FDA approval.

- Epicutaneous immunotherapy (EPIT) involves lightly scraping a patient’s skin and then applying a patch that delivers the allergens through the bloodstream.

- Intra-Nasal Spray: Declared effective and safe by WHO.

- Bronchial Inhalers: Marginal effectiveness and risky.

At this time, our office only provides allergy shots and allergy drops.

Can A Person Have Allergies Even if Allergy Testing Comes Back Negative?

YES!!! But how can that be?!! Well, here is the simplified answer. When allergy testing is performed whether by skin prick or blood testing (RAST), one is testing to certain specific proteins known to cause allergic reactions in majority but not all patients (these are called major allergen).

Patients need to remember that for a given allergy like CAT (or tree, mold, dust, etc)... there are millions of proteins (minor allergen) that have the potential to cause an allergic reaction in people. Allergy testing to cat ONLY tests for ONE of these proteins called Fel d1 as well as a few other minor allergens. As such, if a patient is CAT allergic, but not to the Fel d1 protein, then the allergy testing will come back normal!

Given this information, that's why skin testing is a bit more "accurate" when it comes to determining whether a patient has allergies or not as there are more "proteins" for a given allergen like CAT being tested than the blood test like RAST which STRICTLY tests for a single protein.

Of course, it is possible that a patient may TRULY not have any allergies. So, how can a person tell? Look at the total IgE serum levels. If it is high, than you most likely have allergies even if everything comes back negative.