Injection desensitisation in allergy: immunotherapy or "allergy shots"
Few medical treatments have been shrouded in as much controversy as the practice of allergen-specific immunotherapy or desensitisation. The use of allergen-specific subcutaneous injection immunotherapy spans 90 years. The procedure was pioneered by Noon at St Mary’s Hospital, London in 1911. Noon and Freeman successfully treated Hayfever sufferers by injecting them with pollen extracts. Immunotherapy has been enthusiastically adopted as the treatment of choice for allergic rhinitis and asthma in North America and Europe. In the UK, the procedure has never become as popular but is used as a treatment option in grass pollen allergic rhinitis and for bee or wasp sting anaphylaxis. In 1986, the practice of immunotherapy was practically halted in the UK when the British Medical Journal published its damning Committee on the Safety of Medicines (CSM) report. This report cautioned against the use of immunotherapy in general practice and cited 26 anaphylactic deaths over 30 years. These deaths arose mainly as a result of inappropriate and injudicious use of the procedure in treating uncontrolled asthma. Critics would therefore say that immunotherapy is a potentially life-threatening treatment for rather harmless, although inconvenient diseases. Immunotherapy does however definitely have a place in selected patient groups. The risk of adverse reactions is greatly reduced by careful patient selection and adoption of "good clinical practices" in immunotherapy.
