Allergen-specific immunotherapy (SIT, hyposensitization) in children. Indications and contraindications

Allergen-specific immunotherapy (SIT: specific immunotherapy, hyposensizitation) represents at present the single therapeutic entity for allergic disease, which reduces symptom burden and demonstrates disease-modifying effects. In children with allergic rhinitis/rhinoconjunctivitis, allergic asthma, and systemic reactions to hymenoptera stings, SIT has proven efficacy. The use of SIT in children with atopic dermatitis and oral allergy syndrome is under discussion. Prerequisites for the initiation of SIT are the detection of IgE (immunoglobulin E) antibodies or evidence of sensitization with the skin prick test to clinically relevant allergens, the availability of allergen extracts with proven efficacy for the underlying allergic disease, and the impossibility of allergen avoidance. Contraindications for SIT are partially or fully uncontrolled asthma [FEV1 < 70 % (FEV1: forced expiratory volume in 1 s)], severe acute autoimmune disorders, severe immunodeficencies, acute inflammatory syndromes, malignancies, treatment with beta-blockers and ACE (angiotensin-converting enzyme) inhibitors and cardiovascular diseases with increased risk of adverse events during administration of epinephrine.