One Hundred Ten Years of Allergen Immunotherapy: A Broad Look Into the Future

Allergen immunotherapy (AIT) is the only disease-modifying treatment option for patients with type 1emediated allergic diseases such as allergic rhinitis/rhinoconjunctivitis with/ without allergic asthma. Although many innovations have been developed since the first clinical report of Noon et al in 1911, the improvement of clinical efficacy and tolerability of this treatment is still an important unmet need. Hence, much progress has been made in the characterization of the cell types, cytokines, and intracellular signaling events involved in the development, maintenance, and regulation of allergic reactions, and also in the understanding of the mechanisms of tolerance induction in AIT. This comprehensive review aims to summarize the current innovative approaches in AIT, but also gives an outlook on promising candidates of the future. On the basis of an extensive literature review, integrating a clinical point of view, this article focuses on recent and future innovations regarding biologicals, allergen-derived peptides, recombinant allergens, Toll-like receptor agonists and other adjuvants, and novel application routes being developed for future AIT. (c) 2021 American Academy of Allergy, Asthma & Immunology (J Allergy Clin Immunol Pract 2021;9:1791-803)

Automated summary

Allergen immunotherapy is the only disease-modifying treatment option for type 1-mediated allergic diseases, but there is still a need for improvement in clinical efficacy and tolerability. Current innovative approaches include the development of biologicals, allergen-derived peptides, recombinant allergens, Toll-like receptor agonists, other adjuvants, and novel application routes for future AIT.