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There have been enormous improvments in mainstream medical treatments developed by allergists. Recently advances in anaphylaxis and hypersensitivity reactions to foods, drugs, and insects and in allergic skin disease include identification of food proteins to which IgE binding is associated with severe reactions, improvements in skin prick test predictions; evaluation of the atopy patch test; and advances in yellow jacket sting outcomes predictions and a rapidly disintegrating epinephrine tablet and development of low-allergen foods, and anti-IL-5 for eosinophilic diseases.
Immunotherapy
Hyposensitization is a form of immunotherapy where the patient is gradually vaccinated with progressively larger doses of the allergen in question. This can either reduce the severity or eliminate hypersensitivity altogether. It relies on the progressive skewing of IgG ("the blocking antibody") production, as opposed to the excessive IgE production seen in hypersensitivity type I cases.
The Allergic Rhinitis and its Impact on Asthma guidelines, first published in 2001 and revised in 2007, confirm the clinical efficacy of injection immunotherapy in rhinitis and asthma, as well as the safety, provided that recommendations are followed.
Studies have demonstrated the long-term efficacy and the preventive effect of immunotherapy in reducing the development of new allergy.
A randomized trial demonstrated that injection immunotherapy reduces the risk of developing asthma.
Recent meta-analyses confirm its efficacy in allergic rhinitis in children and in asthma.
A second form of immunotherapy involves the intravenous injection of monoclonal anti-IgE antibodies. These bind to free and B-cell IgE, signalling such sources for destruction. They do not bind to IgE already bound to the Fc receptor on basophils and mast cells as this would stimulate the allergic inflammatory response. The first agent in this class is omalizumab.
Unproven or Ineffective Treatments
An experimental treatment, enzyme potentiated desensitization (EPD), has been tried for decades but is not generally accepted as effective. EPD uses dilutions of allergen and an enzyme, beta-glucuronidase, to which T-regulatory lymphocytes are supposed to respond by favouring desensitization, or down-regulation, rather than sensitization. EPD has also been tried for the treatment of autoimmune diseases but again is not FDA approved or of proven effectiveness.
Chemotherapy
Several antagonistic drugs are used to block the action of allergic mediators, preventing activation of cells and degranulation processes. They include antihistamines, cortisone, dexamethasone, hydrocortisone, epinephrine (adrenaline), theophylline and Cromolyn sodium. Antileukotrienes, such as montelukast (Singulair) or zafirlukast (Accolate), have also been FDA approved for allergic diseases. Anticholinergics, decongestants, mast cell stabilizers, and other compounds (some of which might impair eosinophil chemotaxis) are also commonly used. These drugs help alleviate the symptoms of allergy but play little role in chronic alleviation of the disorder. They can play an imperative role in the acute recovery of someone suffering from anaphylaxis, which is why those allergic to bee stings, peanuts, nuts, and shellfish often carry an adrenaline needle with them at all times.
Alternative therapies
In alternative medicine, a number of treatment modalities are considered effective by its practitioners in the treatment of allergies, particularly naturopathic, herbal medicine, homeopathy, traditional Chinese medicine and kinesiology, despite the lack of approval by the United States Food and Drug Administration. These modalities are frequently offered as treatment for those seeking additional help when mainstream medicine has failed to provide adequate relief from allergy symptoms[citation needed]. However, mainstream physicians[attribution needed] maintain that these claims lack a scientific basis and warn that the efficacy of such treatments is only supported by anecdotal evidence.
Systematic literature searches conducted by the Mayo Clnic through 2006 in hundreds of articles studying mutliple conditions including asthma, and upper respiratory tract infection showed no effectiveness, and no difference compared with placebo and stated that based on rigorous clinical trials of all types of homeopathy for childhood and adolescence ailments there is no convincing evidence.
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Important notice:
The content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other
qualified health provider with any questions you may have regarding a medical condition.
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