Authors: Pål Johansen, Seraina von Moos, Deepa Mohanan, Thomas M. Kündig and Gabriela Senti

Pål Johansen

Department of Dermatology; University Hospital Zurich; Zurich, Switzerland

Seraina von Moos

Clinical Trials Center; University Hospital Zurich; Zurich, Switzerland
Current affiliation: Division of Internal Medicine, University Hospital Zurich; Zurich, Switzerland

Deepa Mohanan

Department of Dermatology; University Hospital Zurich; Zurich, Switzerland

Thomas M. Kündig

Department of Dermatology; University Hospital Zurich; Zurich, Switzerland

Gabriela Senti

Corresponding author: Gabriela.Senti@usz.ch
Clinical Trials Center; University Hospital Zurich; Zurich, Switzerland

Abstract:
IgE-mediated allergy is a highly prevalent disease in the industrialized world. Allergen-specific immunotherapy (SIT) should be the preferred treatment, as it has long lasting protective effects and can stop the progression of the disease. However, few allergic patients choose to undergo SIT, due to the long treatment time and potential allergic adverse events. Since the beneficial effects of SIT are mediated by antigen presenting cells inducing Th1, Treg and antibody responses, whereas the adverse events are caused by mast cells and basophils, the therapeutic window of SIT may be widened by targeting tissues rich in antigen presenting cells. Lymph nodes and the epidermis contain high density of dendritic cells and low numbers of mast cells and basophils. The epidermis has the added benefit of not being vascularised thereby reducing the chances of anaphylactic shock due to leakage of allergen. Hence, both these tissues represent highly promising routes for SIT and are the focus of discussion in this review.

Received: July 5, 2012; Accepted: August 23, 2012; Published Online: October 1, 2012

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