23 Mar Immunotherapy for allergies: Treating the causes instead of suppressing the symptoms

Posted at 11:51h in Allergy, ENT, ENT practice by dr-dorothee

Many people with allergies resort to pills or tablets to treat their symptoms. Nasal sprays. The symptoms subside - but only in the short term, as the incorrect reaction of the immune system still remains. This is precisely where immunotherapy for allergies comes in. It tackles the allergic reaction at its source and gradually acclimatises your body to the triggering allergen. We explain below for whom this method is suitable.

Your immune system in alarm mode: what happens in the body when you have an allergy?

An allergy occurs when your immune system categorises harmless substances as a threat. Pollen, house dust mites or certain foods then trigger a defence reaction. Your body reacts hypersensitively - often to even the smallest amounts of the trigger.

When you first come into contact with the allergen, your immune system produces special IgE-type antibodies. These antibodies attach themselves to so-called mast cells. If contact occurs again, the antibodies immediately recognise the allergen. The mast cells then release messenger substances such as histamine.

Histamine dilates the blood vessels, increases mucus production and irritates nerve endings.

Typical consequences are

Allergic rhinitis with constantly running nose and/or impaired nasal breathing
Itchy eyes or skin
Frequent sneezing
Swelling of the mucous membranes
Breathing difficulties
Skin reactions such as wheals

Not every allergy is the same: an overview of the most important forms

Allergies can be differentiated according to their trigger. Common forms are

Inhalation allergies (respiratory allergies)

The triggers enter the body via the air we breathe and irritate the nose, eyes and bronchial tubes in particular.

Typical examples:

Pollen (e.g. grasses, birch, hazel, alder)
House dust mites (more precisely: mite allergens from faecal particles, e.g. in mattresses)
Animal allergens (mainly from cat/dog saliva, dander and urine, not „the hair“ itself)
Mould spores (e.g. Alternaria or Cladosporium)

Food allergies

Certain proteins in food can also trigger an immune reaction. The symptoms often affect the skin, gastrointestinal tract or respiratory tract.

Frequent triggers:

Pulses and nuts such as peanuts, hazelnuts or walnuts
Cow's milk protein
Chicken egg white
Wheat
Fish
Crustaceans and shellfish
Soya
Celery
Apple or stone fruit with existing pollen allergy (cross allergy)

Insect venom allergies

In addition, certain protein components in insect venom can lead to an excessive immune reaction. The symptoms range from localised swelling to severe general reactions.

Typical triggers:

Bee venom
Wasp venom
Hornet venom

It is important to distinguish between a „normal“ local reaction and a genuine allergic general reaction with circulatory involvement. The latter requires immediate medical clarification.

Contact allergies (allergic contact dermatitis)

Direct skin contact with certain substances can be accompanied by a delayed immune reaction. The symptoms usually appear hours to days after contact in the form of redness, itching, blisters or scaly skin.

Frequent triggers:

Nickel (e.g. in jewellery or buttons)
Fragrances in cosmetics or care products
Preservatives in creams or cleaning agents
Latex (e.g. in gloves)

Drug allergies

Active substances or their degradation products can trigger an immunological reaction. The symptoms range from skin rash and itching to shortness of breath or severe general reactions.

Examples:

Antibiotics, especially penicillins
Pain and inflammation inhibitors (e.g. ASA, ibuprofen)
Contrast agent
Certain anaesthetics

It is important to differentiate between a genuine allergy and an intolerance. Careful diagnostics clarify which active ingredient is responsible and which alternatives are possible.

Symptoms under control - but the problem remains: Why do classic anti-allergic drugs not eliminate the cause of symptoms?

Antihistamines, nasal sprays containing cortisone or eye drops usually relieve acute symptoms reliably. They block messenger substances such as histamine or slow down the inflammatory reaction in the mucous membrane. Sneezing, itching and swelling are reduced.

However, the actual malfunction of the immune system remains. Your body continues to categorise the allergen as a threat and reacts again the next time it comes into contact with it. The medication therefore controls the symptoms, but does not change the underlying immune response.

What's more, those who treat exclusively symptomatically over a longer period of time often experience an increase in symptoms. From a Hay fever can, for example, lead to the development of allergic asthma (keyword: Floor change).

Not just slowing down, but reprogramming: Why does immunotherapy work for allergies?

Specific immunotherapy starts where the allergic reaction arises: in the misguided learning process of your immune system. Instead of blocking the messenger substances released, it changes the way your body evaluates the allergen.

Repeated, controlled administration of the triggering substance gradually acclimatises your immune system to it. The excessive IgE-mediated defence reaction decreases. At the same time, regulatory mechanisms that support the development of tolerance are promoted. As a result, your body reacts less violently or, ideally, remains symptom-free.

This approach influences the course of the disease in the long term. Many patients require less acute medication over time. It also reduces the risk of a change of stage and the allergy spreading.

Immunotherapy for allergies: What options are there?

Different treatment models are available depending on the allergen, symptoms and individual situation.

In our ENT clinic in Frankfurt we offer you the following measures:

Conventional subcutaneous immunotherapy

In this form, you receive the allergen in the form of an injection under the skin. Treatment begins with a top-up phase. During this time, we gradually increase the dose until we have reached the individually appropriate maintenance dose.
We then continue the therapy at regular intervals over several years.

The injections are usually given every four to six weeks. This continuous immune stimulation promotes stable tolerance development and has a lasting effect on the course of the disease.

This variant is particularly suitable for pollen, house dust mite, animal hair or insect venom allergies.

Short-term immunisation (pre-seasonal therapy)

With short-term immunisation, we concentrate the dosing on a shorter period of time. You will receive several injections in increasing doses within a few weeks.

This approach is particularly suitable for seasonal allergies such as hay fever.

The aim is to build up sufficient protection before the start of the pollen season. Despite the compressed treatment phase, the principle remains the same: your immune system should develop a different way of reacting.

Cluster therapy

This form of specific immunotherapy additionally accelerates the dosing phase. On individual treatment days, you will receive several injections at short intervals in succession.

This bundling allows us to reach the maintenance dose more quickly than with the classic approach. This does not necessarily shorten the overall duration of treatment, but it does significantly reduce the time it takes to reach a stable dose.

Typical indications are pollen allergies (e.g. grass, birch or herb pollen), house dust mite allergies and sometimes also animal hair allergies.

Oral immunotherapy

Tablet preparations are available for certain pollen allergies, particularly against grass and rye pollen. There are also authorised preparations for birch and related tree pollen. This sublingual therapy can also be used for house dust mite allergies.

Place the tablet under the tongue every day. The oral mucosa absorbs the allergen and activates mechanisms that promote immunological tolerance. After the first dose under medical supervision, you continue the treatment independently at home.

This form of therapy is particularly suitable for patients with:

seasonal allergic rhinitis caused by grass or tree pollen
Year-round house dust mite allergy
mild to moderate symptoms without unstable asthma

Specific immunotherapy in Frankfurt: treatment for allergies for a better quality of life

Immunotherapy retrains your immune system - it not only alleviates the symptoms, but also changes the way it reacts. For many sufferers, this opens up the possibility of reducing symptoms in the long term and reducing the need for acute medication.

Whether it's pollen, house dust mites or insect venom: a careful Diagnostics forms the basis for a customised therapy concept. We check whether specific immunotherapy makes sense for you, clarify any unanswered questions and provide you with structured support throughout the entire course of treatment.

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Our news articles are prepared for you to the best of our knowledge and belief and are intended for general education. They are in no way a substitute for medical advice, diagnosis and treatment and are not intended to encourage self-diagnosis or self-treatment. Please always contact your ENT specialist in Frankfurt directly if you have any health complaints!