| Abstract [eng] |
Master's thesis of Elas Aidukas. Allergen-Specific Immunotherapy: Literature review. Research aim: to analyze literature sources and provide a review of scientific articles on allergen- specific immunotherapy, its types, indications and contraindications, mechanisms of action, safety and efficacy. Objectives: 1. To review the indications and contraindications of allergen-specific immunotherapy. 2. To review the types of allergen-specific immunotherapy, their mechanisms of action, and their differences. 3. To review the safety and efficacy of allergen-specific immunotherapy. 4. To review the latest scientific advances, innovations, and future perspectives in the field of allergen-specific immunotherapy. Research methods: a literature review was conducted using the PubMed biomedical bibliographic database. Scientific articles included were those first published no earlier than five years before the completion of the thesis, in order to present a contemporary overview of allergen-specific immunotherapy. The selected studies investigated different types of allergen specific immunotherapy, their indications and contraindications, mechanisms of action, efficacy, safety and the most recent clinical and experimental developments in this area. The search was performed in English, and only articles with abstract and full-text availability were selected. The following English keyword combinations were used to identify relevant literature: "allergen specific immunotherapy", "types of administration of allergen specific immunotherapy", "future of allergen immunotherapy", and "advances in allergen specific immunotherapy". Applying the search criteria yielded 1370 results, of which 84 articles met the inclusion criteria for this systematic review. The articles excluded from the literature review were ones published in a different language than English (e.g. Chinese). Conclusions: The reviewed literature confirms the importance of allergen-specific immunotherapy as the only currently available personalized treatment option capable of modifying the course of allergic disorders. Among the main therapeutic approaches, subcutaneous and sublingual immunotherapy remain the most widely used and well-studied modalities, demonstrating strong clinical efficacy, sustained long-term benefits after the cessation of treatment, and acceptable safety profiles. 5 Studies indicate that the primary mechanism of allergen-specific immunotherapy involves the induction of immune tolerance through the activation of Type 1 regulatory T cell (Tr1), T regulatory (T reg) and B regulatory (B reg) cells, enhanced production of cytokines such as interleukin 10 (IL-10) and transforming growth factor beta (TGF-β), suppression of Type 2 helper T cell (Th2)- mediated responses, and inhibition of immunoglobulin E (IgE) synthesis via induction of blocking antibodies, including immunoglobulin G (IgG) and immunoglobulin A (IgA). These mechanisms collectively contribute to a long-term reduction in allergen sensitivity. Recent publications highlight significant advances in the development of novel allergen immunotherapy approaches – use of probiotics, recombinant allergens, adjuvant vaccines and combinations of allergen immunotherapy with monoclonal antibodies, aiming to improve specificity, minimise adverse effects, enhance tolerability, and, most importantly, achieve superior therapeutic outcomes. Allergen-specific immunotherapy is an effective, personalised, safe and scientifically grounded treatment modality. Ongoing research and innovation in this field enables the pursuit of even more precise and individualized therapeutic approaches. |
