Summary of the chapter

Evolutionary plausibility of specific immunotherapy in allergy

Alvaro Daschner

In its different of administration routes specific immunotherapy has been established for decades for the therapeutic approach of allergic diseases. In this work an evolutionary view of the immune response against antigens is offered with which we usually have contact. It is described how tolerance to ubiquitous agents such as food is not simply an absence of reactivity, but rather an active regulatory response, in which the anti-inflammatory forces inhibit the specific effector response also present.

The theory of discontinuity proposes that an effector immune response makes more biological sense when there is an antigenic difference in a given temporal context, which would explain its biological usefulness in case of acute infections, in which contact with antigens is rapidly increasing. In the same way, it would explain the tolerance of antigens with which we have usually or frequent contact, or if exposure to antigens is maintained continuously, as in chronic infections.

Applying these ideas for allergy treatment, differentiated dynamics of controlled exposure to allergens with specific dosages can be postulated. In this sense, immunological studies have shown the induction of a specific anti-inflammatory response when immunotherapy is administered in contrasting scenarios of very rapid administration of high doses or slower increasing doses of allergen. Thus in a gradient, which includes a function of speed and intensity of antigen exposure, anti-inflammatory features seem to appear at both the beginning and the end, whereas effector responses are expected in an intermediate scenario.

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