ABSTRACT
Allergen immunotherapy has been a key therapeutic intervention for both the prevention and treatment of environmental allergies. This chapter reviews novel approaches to improve both the efficacy and safety of allergen immunotherapy. In addition to traditional subcutaneous injection of a single or multiple allergens, different modes of administration have been examined including sublingual, oral, and intralymphatic which are reviewed. Furthermore, we discuss modifications of the allergen extracts that have been developed to improve the safety and efficacy of allergen immunotherapy. Finally, the utility of recombinant allergens, peptides, and the addition of immunologic adjuvants to immunotherapy are reviewed. Although many attempts have been made to improve immunotherapy, a number of these efforts have failed to show either improved effectiveness or safety. Nonetheless, as we learn more about the immune system, newer and better ways of both diagnosing and treating allergies will likely be forthcoming.
