Allergen immunotherapy practice parameter update.

In 1911 Leonard Noon proposed a theory that patients suffering from hay fever were overly sensitive to toxins from grass pollen. As a trial treatment, he began inoculating patients with increasing strengths of grass pollen vaccines. By clinical observation standards, this treatment was found to be successful. By the 1920s it was found that vaccines could be given for other allergens. Perennial allergen therapy required perennial treatment, unlike the original pre-season treatment for pollens. It was empirically appreciated that immunotherapy was effective but not scientifically proven until the early 1960s. Since then, the immunologic evidence continues to encourage broadened use of immunotherapy for inhalant sensitivities. As the employment of this immune modulation has advanced, guidelines have been adopted to promote the most appropriate, consistently safe, and efficacious methods of application. This summary article is intended as a guide for Kentucky Physicians to the current state of the art for immunotherapy vaccinations in the treatment of allergic disorders, as set forth in Allergy, Asthma, and Immunology Practice Parameters published in January 2003.