Immunotherapy for rhinitis.

Allergen-specific immunotherapy in the treatment of allergic rhinitis has a well-documented clinical efficacy that indicates a statistically significant and clinically relevant reduction in symptom scores and the need for pharmacotherapy. The clinical efficacy of recently published studies is equivalent to or superior to the effect of standard anti-allergic drugs. Additional advantages are related to a downregulation of the allergic phenotype with the additional induction of a Th1 cytokine profile. The immunoregulatory capacity and the global downregulation of the allergic inflammation in mucous membranes might be important factors in the capacity to ensure long-term clinical efficacy (after termination of treatment) and the preventive capacity of immunotherapy in reducing the progression of rhinitis to asthma as well as deflowering the development of new sensitizations. Subcutaneous immunotherapy is optimal in severe allergic rhinitis with signs of bronchial hyperreactivity; however, sublingual immunotherapy might be an option for patients with milder disease.