Future Developments - Looking Ahead: Allergies

Content provided by the Faculty of the Harvard Medical School

Future developments

Future developments

New treatments for allergies and asthma are likely to emerge as a direct result of increased understanding of immunology and inflammation. In the short term, the use of anti-IgE drugs is being explored for treating food allergies. The same approach can be effective in treating seasonal allergic rhinitis, although so far the cost is prohibitive. Anti-IgE use is also being explored to reduce the allergic reactions that can occur as a result of allergy shots. However, it is important to note that anti-IgE has not yet been approved by the FDA for any of these uses.

One of the current problems with allergy shots is that about 5% of people receiving them have an allergic reaction more severe than redness and swelling at the injection site at some time in the course of treatment. These systemic reactions can be as mild as a runny nose, or more severe, with hives, asthma, or even full-blown anaphylaxis. Allergy shots work in part by targeting the T cell, changing the allergic response from one that is dominated by Th2 cells to one in which Th1 cells are more prominent. The parts of the allergenic protein that work on the T cell are often different from the parts of the protein that are recognized by IgE. So, researchers have tried to develop allergy vaccines that contain only the parts of the protein that target the T cell and not those parts of the protein that are seen by IgE on mast cells, thereby triggering an allergic reaction.

Various ways of doing this have been tried, and it is hoped that one or more of them will result in new forms of allergy shots that are even more effective and safer than those in use today.

New and expanded diagnostic techniques are also under development. Research is under way to expand the use of blood tests for allergy diagnosis to help physicians differentiate between people who are allergic from those who are not. One problem with diagnosing allergies is determining whether a person’s symptoms are caused by allergy or something completely different. Advanced blood testing techniques are under development which would help physicians do specific IgE testing to determine whether an allergic response is the cause of the symptoms.

All in all, physicians now have a far more sophisticated understanding of the immunologic response in allergic disease, from the “big picture” of environmental influences, to the genes that predispose people to allergies. They know much more about the microscopic level of the cells that regulate allergies, and the molecular level of the substances involved. Already this increased knowledge has yielded new medicines such as the leukotriene modifiers, new immunomodulators (pimecrolimus and tacrolimus), and IgE modifiers. Scientists expect that as understanding of the immune response and its role in allergies increases, new treatments will continue to emerge as a direct result of these complementary research approaches.

Last updated:	August 21, 2006
Reviewed By:	Faculty of Harvard Medical School