Pollen and dust allergies can be miserable, “like having a continuous bad cold “. When the usual medical treatment doesn’t work, and symptoms are interfering with the patient’s life, then immunotherapy (AIT) might provide an answer.

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At the West Midlands Allergy Centre we can provide AIT for a number of conditions including pollen, dust and animal allergies.  Patients need to be referred for assessment, and not everyone is suitable for this treatment.

What does IT involve?

Immunotherapy works by “re-training” the immune system so that it no longer over-reacts to the pollens or dust (called “allergens”) that trigger the allergic rhinitis. The traditional way of giving AIT  is by injections. These are given weekly, slowly increasing the dose of allergen with each injection, until a full dose is reached without causing any symptoms. This full dose is then given monthly for a total course of 3 years.

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AIT can also be given by tablets or drops under the tongue (sublingual immunotherapy). The first dose is given in clinic and patient then takes them every day at home.

Who is suitable for AIT?

Immunotherapy is considered only in patients whose allergic symptoms are due mainly to a single allergen. This could be dust or grass pollen, for example. AIT only works for one allergen, so if the symptoms are caused by many different allergens then IT  is unlikely to be helpful.

Are there people who cannot have IT?

There are several exclusions, such as severe asthma or some other medical conditions. These will be reviewed by the Allergy team when the patient  is assessed for suitability for treatment.

What are the side effects?

All effective treatments have side effects, and AIT is no exception. As you might expect, it is common to have allergic symptoms to the injection, but these are usually mild (a little swelling or itching). Rarely, more severe allergic reactions happen, such as wheezing or even anaphylaxis. This is why the injections are given in hospital, so that these reactions can be treated promptly.

Sublingual tablets or drops can also cause allergic reactions in the mouth or throat, but these usually stop happening with continued treatment.

How well does AIT work?

Immunotherapy works well for 70-80% of people who are treated. This means that they are able to control their symptoms more easily, although they often still have to use some medication. Many studies have shown that AIT improves patient’s quality of life.

Further information

We have given you a very brief summary of AIT. For more detailed information, and tips for managing allergic rhinitis, see Allergy UK’s website.

You can find an allergy clinic near you from the BSACI website. It also contains more detailed guidance on immunotherapy in the UK, mainly for medical professionals.

For referral to the West Midlands Allergy Centre at Birmingham Heartlands Hospital, see the Trust’s main website