Allergen-Specific Immunotherapy Approaches in Allergy Treatment

Allergen-specific immunotherapy (AIT) is the only disease-modifying treatment for IgE-mediated allergic disorders and aims to restore immune tolerance to otherwise harmless environmental or food proteins. Conventional regimens include subcutaneous immunotherapy (SCIT) and sublingual immunotherapy (SLIT), both of which rely on repeated exposure to defined allergen extracts over several years. These approaches induce a progressive shift from T helper 2 (Th2)-driven inflammation towards regulatory and T helper 1 (Th1)-biased responses, underpinned by expansion of regulatory T (Treg) cells and increased production of blocking IgG4 antibodies. Limitations of SCIT and SLIT include long treatment durations, risk of systemic reactions and variable patient adherence. In response, novel delivery routes—such as intralymphatic, epicutaneous and intratonsillar immunotherapy—have been explored to reduce dosing frequency and improve safety. Molecular strategies employ recombinant hypoallergenic proteins or peptide fragments to focus T-cell recognition while minimising IgE cross-linking. Adjuvant development has progressed from aluminium salts and microcrystalline tyrosine to include toll-like receptor agonists, virus-like particles and carbohydrate‐based formulations, all designed to enhance immunogenicity and tailor immune deviation. Combining AIT with targeted biologics against key cytokines or cell populations offers further potential to accelerate tolerance induction and broaden applicability to food, venom and respiratory allergies. Together, these innovations seek to deliver more effective, personalised and patient-friendly immunotherapies with sustained clinical benefit.

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Allergen-Specific Immunotherapy Approaches in Allergy Treatment publication trend

The graph below shows the total number of articles in allergen-specific immunotherapy approaches in allergy treatment across all publications each year (not limited to Nature Index journals).

Technical terms

Allergen-specific immunotherapy (AIT): Treatment that exposes patients to increasing doses of allergen to induce immune tolerance.

Subcutaneous immunotherapy (SCIT): AIT administered by injections beneath the skin at regular intervals.

Sublingual immunotherapy (SLIT): AIT delivered by placing allergen extract under the tongue for mucosal absorption.

Regulatory T cells (Treg cells): A subset of T lymphocytes that suppress allergic inflammation and promote immune tolerance.

Toll-like receptor (TLR): A pattern-recognition receptor on immune cells; used as a target for novel adjuvants to modulate immune responses.

Adjuvant: A substance co-administered with an antigen to enhance the strength and quality of the immune response.

References

1. Intratonsillar Immunotherapy: A Convenient and Effective Alternative to Subcutaneous Immunotherapy for Allergic Rhinitis. Research (2025).
2. Novel adjuvants in allergen-specific immunotherapy: where do we stand?. Frontiers in Immunology (2024).
3. Novel Approaches to Allergen Immunotherapy for Respiratory Allergies. Pharmaceuticals (2024).
4. Peripheral blood mononuclear cell transcriptome profile in a clinical trial with subcutaneous, grass pollen allergoid immunotherapy. Clinical & Experimental Allergy (2024).