References

Effectiveness of regionally-specific immunotherapy for the management of canine atopic dermatitis

Canine atopic dermatitis is a common pruritic skin disease often treated with allergen immunotherapy (AIT). AIT in dogs traditionally begins with attempting to identify clinically relevant environmental allergens. Current allergen testing methodologies and immunotherapy techniques in dogs are not standardized. Immunotherapy with a mixture of allergenic extracts selected based on regional aerobiology rather than intradermal tests or serum IgE assays has been described. The objective of this study was to evaluate the effectiveness of regionally-specific immunotherapy in dogs with atopic dermatitis.

Successful replacement of allergen-specific immunotherapy with premixed extracts

This case series describes 20 people that were switched from allergen-specific immunotherapy to premixed extracts containing both skin reactive and non-reactive allergens. The authors concluded that allergen-mixture immunotherapy is equally effective and did not find evidence of increased adverse clinical reactions.

Effects of sublingual immunotherapy for multiple or single allergens in polysensitized patients

Birch and grass pollen sensitive patients were treated with SLIT. Those treated with only birch also improved during the grass pollen season; those treated with only grass also improved during the birch season; those treated with both improved by the greatest degree.

Poor agreement between four serum allergy test assays and treatment recommendations

This study concluded that “the choice of IgE assay may have a major influence on the positive/negative results and ensuing treatment recommendations.”

Disagreement between allergen-specific IgE and intradermal tests

“It is well established that there is only partial correlation between the serological and intradermal tests; however, the significance of discrepant results is unknown and unstudied.”

Similar response to ASIT is seen whether based on IDT or serology

“…veterinarians can use either allergen-specific intradermal or IgE serological tests to identify hypersensitivity to common environmental allergens as there is no clear evidence that the response to ASIT is superior using allergens selected by IDT or serology.”

Allergen-specific immunotherapy (ASIT) is often discussed as though it represents a uniform treatment option. In fact, the process of customizing an allergen prescription for a pet is not standardized and there is a great deal of subjectivity involved, even when veterinarians are presented with identical test results.

In an informal survey, 11 veterinary dermatologists were given the same patient history and allergy test results and asked for their immunotherapy recommendations. Among the findings:

• each dermatologist prescribed a unique allergen formulation
• only 2 allergens were prescribed by every participant
• the number of allergens included ranged from 10 to 20
• 28/50 allergens were prescribed by at least one dermatologist
• 16/50 allergens were prescribed by >50% of dermatologists