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Allergen immunotherapy paper

Allergen immunotherapy paper

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Published by Ashley Tobalsky
Reviews research done on allergen immunotherapy. Demonstrates ability to review research and writing skills.
Reviews research done on allergen immunotherapy. Demonstrates ability to review research and writing skills.

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Published by: Ashley Tobalsky on Nov 03, 2008
Copyright:Attribution Non-commercial


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Ashley Tobalsky
Allergen Immunotherapy
Allergen immunotherapy is established through a series of shots that contain certain pureallergens at an increasing level in order to desensitize the patient and achieve life-long relief of allergy symptoms. Patients eligible for this treatment are those who suffer from year-roundallergies, have controlled allergy-induced asthma, are allergic to bee stings, or can’t find relief for seasonal allergies through prescription medications.The practice of allergy-specific immunotherapy of desensitization dates back to 1911. Atthe St. Mary’s Hospital in London, England, two doctors, Noon and Freeman, successfullytreated hay-fever sufferers by injecting them with pollen extracts. The practice continued to beused even thought it was very controversial and unpopular. In 1986 the
 British Medical Journal 
 published a report cautioning against the use of immunotherapy in general practice and cited 26anaphylactic deaths over 30 years. The deaths were a result of inappropriate treatment in patientswith uncontrolled asthma. The newly introduced risks of death led to even more controversy andhigher need for regulation of the practice. New regulations were soon introduced calling for careful patient selection along with stricter observation periods, greatly reducing all risks of death.The recent episodes of death related to allergen immunotherapy include the death of a 13-year old girl who received her last allergy injection in May of 1998. She died from anaphylacticshock within 20 minutes after her injection because no one had stopped in to check on her.Shortly after that case a 41-year old mother died, also from severe anaphylaxis reaction.However, she was checked on, but the tiny clinic just didn’t have the correct treatment optionsavailable (Putman and Badzek, 2005).
These episodes, along with others, pushed for higher guidelines to be set by the AmericanAcademy of Allergy, Asthma and Immunology (AAAAI) and the American College of Allergy,Asthma and Immunology (ACAAI). These guidelines are established by board-certifiedspecialists in allergy and asthma treatment, and also other personnel who practice under thedirect supervision of allergists (ed. Cox, 2007).The revised and currently used procedure begins when the patient finds an allergyspecialist that will recommend the treatment. Qualified patients with asthma should havesymptoms under control. Allergy tests are given to determine what the patient is allergic to andwhich allergens will need to be included in the vile for each shot. This is done through either askin prick test or a blood test. The next step involves the patient’s insurance company’swillingness to cover the cost of the treatment; whether they see it as necessary or experimental.Once all is settled, treatment may begin. Depending on the clinic, the patient may receive“traditional” treatment (conventional allergen vaccination) or “rush” treatment (rush allergenvaccination). Rush treatment completes the first nine months of traditional treatment in one day. Numerous shots are given in increasing doses while time is taken between each to supervise.After the initial day it takes about two additional months to build up to the maintenance level. Itmakes for a long day and a lot of exposure to allergens, but it saves money, about nine months toa year of shots with the traditional treatment, and some studies prove that it’s safer.A study of rush allergen vaccination (RAV) was presented at the annual meeting of theAmerican College of Allergy, Asthma and Immunology, Nov. 19, 2001 in Orlando, Florida. Itwas done by several doctors, led by Dr. Smits, of allergy and asthma clinics in Indiana. Rushtreatment was tested on 137 patients, male and female ranging from ages 2-68 years old. They allhad a history of allergies and/or asthma, and patients with a history of anaphylaxis were
excluded. They were pretreated with prednisone and antihistamines up to two days before theRAV.The results showed some mild systemic reactions such as headache, abdominal pain,dizziness, itchiness, chest/throat tightness, cough and shortness of breath; all of which areconsistent with the Conventional Allergy Vaccination (CAV) and easily treated with epinephrine, prednisone, or other medications (Smits et al., 2003). Overall RAV proved more efficient andalso safer than CAV because of the pretreatment. The extended observation periods allow anyreactions to be recognized and treated immediately. A time period ranging from half an hour to afull hour are taken in between sets of injections in order to watch for local (swelling around areaof injection) and general (itchiness, runny nose, tightness of chest/troublesome breathing)reactions. If a significant reaction is noticed, treatment is given, injections may be stopped or thedosage of the injection may be steadied instead of increased.There is a wide range of costs for prescription drugs for the treatment of asthma andallergies. The price of a daily dose generic antihistamine for one month, without a deductablefrom insurance, is about $70. For a corticosteroid nasal spray, used everyday for a month, would be $102 without a deductable from insurance. And if you have asthma along with your allergies,you will also need a daily inhaler that can cost about $184 for a months worth of daily doseswithout a deductable from insurance. This adds up to $356 per month; $4,272 per year, and don’tthink you won’t need it for the rest of your life. In fact, you may need to increase your doses astime goes by.Allergen Immunotherapy takes between three and five years to complete. After the firstor second year the majority of patients are able to wean off of their prescription allergy andasthma medications. The first year of allergy immunotherapy injections has been estimated to

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