History of Allergology: Allergen-specific Immunotherapy (AIT) the Identity Therapy of Allergology

Abstract

Aim: The aim of this review is to walk through the evolution of the art and science of allergic immunotherapy (AIT). Data sources: Original reports related to the evolution of the concept of respiratory allergy and its specific treatment were identified by following references in journal articles, review articles, and allergy textbooks from the mid-19th century to the present. Study selections: Studies highlighting milestones in the evolution of allergy immunotherapy practice were included. Results: The history of AIT begins with the recognition of hay fever (hay fever) as a distinct entity and subsequent studies that established grass pollen as one of the causes. This knowledge led Noon, an English researcher, to induce tolerance toward pollen by administering phleum pratense pollen extract with subcutaneous injections (SCIT) to patients with hay fever. After the publication of Noon and Freeman's work in 1911, the practice of AIT spread rapidly and was used for many other allergens for the treatment of seasonal and perennial rhinitis, and asthma. The success of AIT was due, in large part, to the lack of drugs. Early studies were anecdotal, but over the past 60e70 years, studies on AIT have been conducted with increasingly sophisticated scientific methods. Nowadays, AIT is based on solid immunological basis and controlled trials (RCTs), while the clinical response of patients to AIT has not yet been established with certainty. Conclusion: Both the art and science of AIT have been supported by clinical and immunologic studies, yet its current role in clinical practice is debated because AIT is still a niche treatment, used only by some allergists.