Immunotherapy in the Prevention of Allergic Disease

Abstract

In response to lay and medical urgings for physicians to apply more effort in the prevention of disease rather than prescribing palliative symptomatic forms of treatment, immunotherapy offers a good setting for preventive medicine. Immunotherapy takes place primarily in an outpatient or private practice setting rather than in academic institutions. Only a small minority of the millions of atopic children receive appropriate immunotherapy. It has been clearly demonstrated that immunotherapy is clinically effective in the treatment of pollinosis, asthma, and perennial allergic rhinitis. Based on what is known about the natural history of respiratory allergy in children with and without immunotherapy, perhaps the situation requires more education of the lay public in order to give parents some voice in the decision-making about when and whether immunotherapy is indicated. Because the chances of a child's "outgrowing" his asthma without immunotherapy are slim and because early institution of immunotherapy may prevent complications of untreated hay fever, a closer consideration of the appropriate application of this form of therapy seems indicated.