question: If allergy shots stimulate your immune system to clear up more allergens in your system, what's the point of continuing them? Wouldn't the immune system over time still produce allergy symptoms in the presence of allergens?
comment: Allergy shots contain the actual allergen (eg peanut protein), they are meant to trigger a controlled immune response on purpose. They introduce allergens into the body, not clear them up. The point of allergy shots is to build tolerance. the exact mechanism involves many cells, proteins, antibodies and is not fully understood. The immune system adapts over time to “ignore” or remove the allergen before an allergic reaction occurs. After some time on immunotherapy (allergy shots), your body will no longer respond to the allergen & you will be cured.
passages: Subcutaneous immunotherapy, also known as allergy shots, is the historical route of administration and consists of injections of allergen extract, which must be performed by a medical professional. Subcutaneous immunotherapy protocols generally involve weekly injections during a build-up phase, followed by monthly a maintenance phase that consists of injections for a period of 3–5 years.The build-up phase involves the patient being administered injections which contain increasing amounts of allergens about one to two times per week. The length of the build-up phase is dependent upon how often injections are administered, but normally ranges from three to six months. After the effective dose is reached, the maintenance phase is implemented, which varies depending upon an individual’s response to the build-up phase. When accounting for a person’s age, type of allergen, and severity of allergy, there is a high probability that subcutaneous allergen immunotherapy may provide greater clinical and immunological responses than sublingual allergen immunotherapy. Compared to sublingual allergen immunotherapy, there are no significant differences observed in quality of life. It is possible, but rare (1/2.5 million), that people undergoing subcutaneous allergen immunotherapy may experience a fatal anaphylactic event. Subcutaneous allergen immunotherapy adverse events vary significantly depending on different allergenic extracts and the application of different allergen immunotherapy schedules. Allergen immunotherapy schedules include the "cluster" approach, which involves administering several doses sequentially in a single day; a "conventional" approach, which involves incrementally increasing the dose over approximately 15 weeks; and the "rush" approach, which involves administering incremental doses at intervals of 15–60 minutes over 1–3 days). It is challenging to perform an adequate risk assessment on the use of subcutaneous allergen immunotherapy compared to other forms of allergen immunotherapy administration due to the variability of immunotherapy schedules and further research is required.
   The first dose contain tiny amounts of the allergen or antigen. Dosages increase over time, as the person becomes desensitized. This technique has been tested on infants to prevent peanut allergies.
  
  Section::::Helminthic therapies.
   In order to mitigate these risks, corticosteroid doses are decreased biweekly assuming no further progression of disease after each reduction. When no exacerbations from the disease are seen within three months after discontinuing corticosteroids, the patient is considered to be in complete remission. The exception to this rule is patients who are diagnosed with advanced ABPA; in this case removing corticosteroids almost always results in exacerbation and these patients are continued on low-dose corticosteroids (preferably on an alternate-day schedule).
   Treatment of an allergic transfusion reaction is to immediately stop the transfusion. If the only symptoms are mild (i.e., hives and itching), the patient may be treated with an antihistamine and if the symptoms completely disappear and the patient feels well, the transfusion may be restarted. A mild transfusion reaction during infusion usually does not progress to a more severe anaphlyactic reaction after infusion of additional product from the same unit. If the symptoms are more than mild, the transfusion should not be restarted.
  
  Section::::Prevention.
   Antihistamines may also relieve the symptoms of the allergy by blocking the immune pathway. Persons with a history of severe anaphylactic reaction may carry an injectable emergency dose of epinephrine (such as an EpiPen). Oral steroids may also be helpful. Allergy immunotherapy has been reported to improve or cure OAS in some patients. Immunotherapy with extracts containing birch pollen may benefit OAS sufferers of apple or hazelnut related to birch pollen-allergens. Even so, the increase in the amount of apple/hazelnut tolerated was small (from 12.6 to 32.6 g apple), and as a result, a patient's management of OAS would be limited.
   If the allergen is encountered and the symptoms are mild, a cold compress can be used to provide relief.
  
  Section::::Management.:Mast cell stabilizers.
  
  Mast cell stabilizers can help people with allergic conjunctivitis. They tend to have delayed results, but they have fewer side-effects than the other treatments and last much longer than those of antihistamines. Some people are given an antihistamine at the same time so that there is some relief of symptoms before the mast cell stabilizers becomes effective. Doctors commonly prescribe lodoxamide and nedocromil as mast cell stabilizers, which come as eye drops.
   Although complications during anesthesia are rare, potentially life-threatening consequences may occur if an anaphylactic reaction develops. The severity of the reaction whilst under anesthesia is because the anesthetist is only made aware of the allergy when it is severe enough to compromise the cardiovascular system and the respiratory system. At this stage, there is little time to manage the situation and recognise the severity of the condition.
  
  The immediate management of the issue consists of three processes:
  
  BULLET::::- The withdrawal of the substances
  
  BULLET::::- Interrupting the effects of the preformed substances released in response to toxin presentation
   While some fruits and a few vegetables are eliminated in the first weeks of the Program, they are replaced by others. Often, some or all of these items can be returned to the diet, once the level of tolerance is determined.
  
  Section::::History.
  
  Feingold was Chief of Pediatrics at Cedars of Lebanon Hospital in Los Angeles, CA, until 1951,
  
  when he became Chief of Allergy at Kaiser-Permanente Medical Center in San Francisco.
  
  He
  
  continued his work with children and adults with hyperactivity and allergy until his death at the age of 82, in 1982.
   Side effects during sublingual immunotherapy treatment are usually local and mild and can often be eliminated by adjusting the dosage. Anaphylaxis during sublingual immunotherapy treatment has occurred on rare occasions.
  
  Potential side effects related to subcutaneous immunotherapy treatment for asthma and allergic rhinoconjunctivitis include mild or moderate skin or respiratory reactions. Severe side effects such as anaphylaxis during subcutaneous immunotherapy treatment is relatively uncommon.
   One approach being studied is in altering the protein structure of the allergen to decrease immune response but still induce tolerance. Extensive heating of some foods can change the conformation of epitopes recognized by IgE antibodies. In fact, studies show that regular consumption of heated food allergens can speed up allergy resolution. In one study, subjects allergic to milk were 16x more likely to develop complete milk tolerance compared to complete milk avoidance. Another approach regarding changes in protein is to change specific amino acids in the protein to decrease recognition of the allergen by allergen-specific antibodies.
   BULLET::::- Autologen, an injectable dermal material made from the patient's own skin. No risk of allergy exists but the results are very temporary because the body quickly absorbs the material.
  
  BULLET::::- Collagen requires an allergy test because the material is extracted from bovine hides. It lasts anywhere from four weeks to three months because it is also absorbed into the body. However, the allergy test must be observed for four weeks.
   A temporary desensitization method involves the administration of small doses of an allergen to produces an IgE-mediated response in a setting where an individual can be resuscitated in the event of anaphylaxis; this approach, through uncharacterized mechanisms, eventually overrides the hypersensitive IgE response.
  
  Desensitization approaches for food allergies are generally at the research stage. They include:
  
  BULLET::::- oral immunotherapy, which involves building up tolerance by eating a small amount of (usually baked) food;
  
  BULLET::::- sublingual immunotherapy, which involves placing a small drop of milk or egg white under the tongue;
   Sublingual immunotherapy is used to treat allergic rhinitis, often from seasonal allergies, and is typically given in several doses over a 12 week period. It works best when given 12 weeks before the start of the pollen season. The first dose is given by a physician to monitor for any rare reactions or anaphylaxis. Subsequent doses can be taken at home which makes this a convenient alternative to subcutaneous immunotherapy.
   There is active research on trying oral immunotherapy (OIT) to desensitize people to egg allergens. A Cochrane Review concluded that OIT can desensitize people, but it remains unclear whether long-term tolerance develops after treatment ceases, and 69% of the people enrolled in the trials had adverse effects. They concluded there was a need for standardized protocols and guidelines prior to incorporating OIT into clinical practice. A second review noted that allergic reactions, up to anaphylaxis, can occur during OIT, and recommends this treatment not be routine medical practice. A third review limited its scope to trials of baked egg-containing goods such as bread or cake as a means of resolving egg allergy. Again, there were some successes, but also some severe allergic reactions, and the authors came down on the side of not recommending this as treatment.
   BULLET::::- 1965: Production of the first standard series of allergens for epicutaneous testing
  
  BULLET::::- 1966: Introduction of the first commercially available house-dust mite extract by HAL Introduction of the biological standardization for allergen activity determination for each batch
  
  BULLET::::- 1969: Introduction of aluminium hydroxide depot extracts
  
  BULLET::::- 1974: Introduction of HAL ORAL
  
  BULLET::::- 1977: Introduction of product for the diagnosis of type III-allergies; Start operations of HAL Allergy in Germany
  
  BULLET::::- 1980: HALISA - the HAL-ELISA for type III-allergy diagnosis - is introduced
  
  BULLET::::- 1982: HAL allergen extracts are stabilized by epsilon amino caproic acid (EACA)
   Epinephrine (adrenaline) is the primary treatment for anaphylaxis with no absolute contraindication to its use. It is recommended that an epinephrine solution be given intramuscularly into the mid anterolateral thigh as soon as the diagnosis is suspected. The injection may be repeated every 5 to 15 minutes if there is insufficient response. A second dose is needed in 16-35% of episodes with more than two doses rarely required. The intramuscular route is preferred over subcutaneous administration because the latter may have delayed absorption. Minor adverse effects from epinephrine include tremors, anxiety, headaches, and palpitations.
   A drug allergy is different from an intolerance. A drug intolerance, which is often a milder, non-immune-mediated reaction, does not depend on prior exposure. 
  
  Section::::Signs and symptoms.
  
  Symptoms of drug hypersensitivity reactions can be similar to non-allergic adverse effects. Common symptoms include:
  
  BULLET::::- Hives
  
  BULLET::::- Itching
  
  BULLET::::- Rash
  
  BULLET::::- Fever
  
  BULLET::::- Facial swelling
  
  BULLET::::- Shortness of breath due to the short-term constriction of lung airways or longer-term damage to lung tissue
  
  BULLET::::- Anaphylaxis, a life-threatening drug reaction (produces most of these symptoms as well as low blood pressure)
   Section::::Mechanism of action.
  
  In desensitization immunotherapy the aim is to induce or restore tolerance to the allergen by reducing its tendency to induce IgE production. People are desensitized through the administration of escalating doses of allergen that gradually decreases the IgE-dominated response. The objective of immunotherapy is to direct the immune response away from humoral immunity and toward cellular immunity, thereby encouraging the body to produce fewer IgE antibodies and more CD4+ T regulatory cells that secrete IL-10 and TGF-β, which skews the response away from IgE production.
   In allergic angioedema, avoidance of the allergen and use of antihistamines may prevent future attacks. Cetirizine is a commonly prescribed antihistamine for angioedema. Some patients have reported success with the combination of a nightly low dose of cetirizine to moderate the frequency and severity of attacks, followed by a much higher dose when an attack does appear. Severe angioedema cases may require desensitization to the putative allergen, as mortality can occur. Chronic cases require steroid therapy, which generally leads to a good response. In cases where allergic attack is progressing towards airway obstruction, epinephrine may be life-saving.
  
  Section::::Management.:Drug induction.
   Delay is the next element that is necessary in the inoculation process. There has been much debate on whether there is a certain amount of time necessary between inoculation and further attacks on a persons' attitude that will be most effective in strengthening that person's attitude. McGuire (1961) suggested that delay was necessary strengthening a person's attitude and since then many scholars have found evidence to back that idea up. There are also scholars on the other side who suggest that too much of a delay lessens the strengthening effect of inoculation. With this being said, it has been revealed that the effect of inoculation can still be significant weeks or even months after initial introduction or the treatment showing that it does produce somewhat long-lasting effects (Banas & Rains, 2010).
   Epinephrine (adrenaline) is the first-line treatment for severe allergic reactions (anaphylaxis). If administered in a timely manner, epinephrine can reverse its effects. Epinephrine relieves airway swelling and obstruction, and improves blood circulation; blood vessels are tightened and heart rate is increased, improving circulation to body organs. Epinephrine is available by prescription in an autoinjector.
  
  Section::::Treatment.:Antihistamines.
   While a number of side effects have been associated with sublingual immunotherapy, serious adverse effects are very rare (about 1.4/100000 doses), and there has not been a reported fatality. There have been a small number of reports of anaphylaxis. The majority of side effects are ‘local’ and usually resolve within a few days. They include swelling of the mouth, tongue or lip, throat irritation, nausea, abdominal pain, vomiting, diarrhea, heartburn, and uvular edema. It is not yet clear if there are any risk factors that might increase a person's susceptibility to these adverse effects. Sublingual immunotherapy appears to be better tolerated than subcutaneous immunotherapy and causes fewer side effects. The safety of sublingual immunotherapy has not been studied extensively in people with chronic immunodeficiency or autoimmune disorders.
   An allergic reaction will not occur on the first exposure to a substance. The first exposure allows the body to create antibodies and memory lymphocyte cells for the antigen. However, drugs often contain many different substances, including dyes, which could cause allergic reactions. This can cause an allergic reaction on the first administration of a drug. For example, a person who developed an allergy to a red dye will be allergic to any new drug which contains that red dye.
   Immunosuppressive drugs are used to suppress the immune response, but the effect is not specific. Therefore, organism can be affected by the infection much more easily. The goal of the future therapies is to suppress the alloimmune response specifically to prevent these risks.
  
  The tolerance could be achieved by elimination of most or all alloreactive T cells and by influencing alloreactive effector-regulatory T-lymphocytes ratio in favor of regulatory cells which could inhibit alloreactive effector cells. Another method would be based on costimulatory signal blockade during alloreactive T-lymphocytes activation.
  
  Section::::See also.
  
  BULLET::::- Allograft diseases
  
  BULLET::::- Allotransplantation
  
  BULLET::::- Neonatal alloimmune thrombocytopenia
   Meta-analyses have found that injections of allergens under the skin are effective in the treatment in allergic rhinitis in children and in asthma. The benefits may last for years after treatment is stopped. It is generally safe and effective for allergic rhinitis, allergic conjunctivitis, allergic forms of asthma, and stinging insects. The evidence also supports the use of sublingual immunotherapy against rhinitis and asthma, but it is less strong. In this form the allergen is given under the tongue and people often prefer it to injections. Immunotherapy is not recommended as a stand-alone treatment for asthma.
  
presuppositions: allergy shots clear up more allergens. Allergy shots are used to clear up allergens in your system.
corrections: They introduce allergens into the body, not clear them up. Allery shots introduce allergens into the body to build up tolerance, not clear them up.
raw_presuppositions: allergy shots clear up more allergens. Allergy shots are used to clear up allergens in your system.
raw_corrections: They introduce allergens into the body, not clear them up. Allery shots introduce allergens into the body to build up tolerance, not clear them up.