Immunotherapy for Allergy Relief

We continue to develop treatments for many illnesses by harnessing the immune system’s power and adaptability. Immunotherapy is an exciting yet well-established method to treat allergies by utilizing the immune system to “trick” itself. Immunotherapy is meant to prevent allergic reactions in the future by desensitizing a patient to the allergens that cause a reaction. Immunotherapy can be effective for dust mites, pollens, grasses, and other common allergens but is typically not used for food allergies. However, novel oral immunotherapies may be changing that.

While there is still more to learn about immunotherapy generally, it is believed that it may stimulate the production of a protein or antibody that blocks the allergen’s associated symptoms. While immunotherapy can take a while to show results, it is the most “natural” and arguably the most effective long-term way to manage specific allergies in carefully selected patients.

Immunotherapy gradually reduces symptoms of allergic reactions, thus helping patients live more comfortably. Moreover, it also assists asthma and even eczema (which are highly correlated with the degree of allergy) by reducing the inflammatory response that causes these conditions.

First Steps in Immunotherapy

Of course, the most critical first step is for your doctor to fully understand the allergies that trigger symptoms. This can be done using skin or blood tests that tell us precisely what sensitivities individual patients have. Allergy tests are minimally invasive and relatively quick, with skin tests and blood draws typically performed in the office or at a lab, respectively.

  • Skin tests are usually performed in the office either by dropping small amounts of the allergen onto the skin and making a scratch or a prick to allow the allergen to react or sometimes by injecting small amounts superficially. Within 20 minutes, most patients will have developed a red bump at the site if they are allergic.
  • On the other hand, allergy blood tests measure the amount of Immunoglobulin E or IgE in the blood (an indirect and somewhat less accurate measure of allergy). When a patient suffers from an allergy, this antibody presents in higher quantities than usual. Sometimes blood testing is necessary when skin testing doesn’t work or is too dangerous.

The Ideal Patient for Allergy Immunotherapy

Typically, a good candidate for immunotherapy:

  • Is sensitive to multiple allergens
  • Has symptoms not controlled by medication (or doesn’t tolerate it)
  • Suffers from allergies year-round (or several seasons) and
  • Finds it relatively difficult to avoid the allergen in daily life

People Who Typically Do Not Qualify for Immunotherapy

Food may or may not be treated using immunotherapy. Instead, patients and their caregivers will often be directed to avoid the food that causes the allergic symptoms. However, newer treatments, including sublingual immunotherapy (SLIT), especially in peanut allergies, show excellent results.¹ Patients with severe or uncontrolled asthma, or COPD, may not be suitable for allergy skin testing or immunotherapy. Anything that restricts the airways can make immunotherapy riskier. Patients on specific medications, those who are pregnant or immunocompromised, some of those with autoimmune disorders, and some patients with significant cardiovascular concerns may also be contraindicated for allergy immunotherapy. We discuss these contraindications further here.

Effectiveness of Allergy Immunotherapy

Fortunately, we have more allergy relief options than ever, giving most patients a path toward relief. Immunotherapy has been very successful, and in our practice, about 80% or more of patients experience significant relief from their symptoms with immunotherapy. Of course, the success rate highly depends on the individual’s immune system and the frequency and severity of symptoms. It’s also worth noting that success is subjective. As such, Dr. Boger will consult with each patient to help them understand what should be expected and what would be considered successful based on the therapeutic modality we agree on and pursue.


  1. Jones SM, Kim EH, Nadeau KC, Nowak-Wegrzyn A, Wood RA, Sampson HA, Scurlock AM, Chinthrajah S, Wang J, Pesek RD, Sindher SB, Kulis M, Johnson J, Spain K, Babineau DC, Chin H, Laurienzo-Panza J, Yan R, Larson D, Qin T, Whitehouse D, Sever ML, Sanda S, Plaut M, Wheatley LM, Burks AW; Immune Tolerance Network. Efficacy and safety of oral immunotherapy in children aged 1-3 years with peanut allergy (the Immune Tolerance Network IMPACT trial): a randomised placebo-controlled study. Lancet. 2022 Jan 22;399(10322):359-371. doi: 10.1016/S0140-6736(21)02390-4. PMID: 35065784; PMCID: PMC9119642.