A systematic review of allergen immunotherapy, a successful therapy for canine atopic dermatitis and feline atopic skin syndrome

Ralf S. Mueller Centre for Clinical Veterinary Medicine, Faculty of Veterinary Medicine, University of Munich, München, Germany

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Abstract

Canine atopic dermatitis and feline atopic skin syndrome are common presentations in small animal practice. Numerous drugs are used for symptomatic therapy. The only definitive treatment based on the cause of the disease is allergen immunotherapy. Classical allergen immunotherapy (AIT) consists of subcutaneous injections of an extract containing offending allergens, with increasing doses and allergen concentrations at short intervals during the induction phase of several weeks to months followed by a maintenance phase, where a fixed dose is typically given at longer intervals. Dose and interval are tailored to the individual patient. Newer types of AIT include rush immunotherapy, where the induction phase is abbreviated, intralymphatic immunotherapy, and oromucosal or sublingual immunotherapy. AIT aims at inducing a regulatory T-cell response and subsequently downregulating the exaggerated immune response to offending allergens leading to clinical signs. This article reviews the published knowledge about allergen immunotherapy in dogs and cats for small animal practitioners.

Abstract

Canine atopic dermatitis and feline atopic skin syndrome are common presentations in small animal practice. Numerous drugs are used for symptomatic therapy. The only definitive treatment based on the cause of the disease is allergen immunotherapy. Classical allergen immunotherapy (AIT) consists of subcutaneous injections of an extract containing offending allergens, with increasing doses and allergen concentrations at short intervals during the induction phase of several weeks to months followed by a maintenance phase, where a fixed dose is typically given at longer intervals. Dose and interval are tailored to the individual patient. Newer types of AIT include rush immunotherapy, where the induction phase is abbreviated, intralymphatic immunotherapy, and oromucosal or sublingual immunotherapy. AIT aims at inducing a regulatory T-cell response and subsequently downregulating the exaggerated immune response to offending allergens leading to clinical signs. This article reviews the published knowledge about allergen immunotherapy in dogs and cats for small animal practitioners.

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