Pollen allergy sufferers, with the arrival of autumn, can literally breathe a sigh of relief, since the substantial reduction in the amount of allergens in the air finally grants a respite from annoying symptoms such as a stuffy and dripping nose, itchy and reddened eyes, accompanied by more or less abundant tearing. Unfortunately, the same cannot be said for those who have to cope with dust mite allergy: “perennial” allergens (in that they are always present in the environment), which are concentrated in homes and offices and give greater problems during the fall-winter season, when prolonged stay in closed, heated rooms increases exposure.
As much as and more than pollen allergy, dust mite allergy can cause oculorhinitis (corresponding to the above symptoms) or allergic asthma, representing more than just discomfort and requiring repeated medication for prolonged periods to keep the manifestations under control. In addition, mite allergy sufferers may have a reduced quality of life from difficulty sleeping during the night (resulting in fatigue and discomfort during the day) and the need to take extremely careful care of the hygiene of their living environments (mites and their sensitizing droppings lurk in blankets, pillows, mattresses, carpets, couches, etc., and it is not easy to flush them out).
To permanently remedy all these drawbacks, allergen-specific immunotherapy, initially developed against some pollen allergies and now also available against mite allergies, has been used for several years. In both cases, treatment consists of progressive desensitization from the allergens causing the abnormal immune reaction by administering controlled increasing doses of the allergens themselves until the allergy is “switched off” completely or largely. In addition to the strategy of administering allergen-specific immunotherapy by subcutaneous injection (which has long been used by allergists but is inconvenient for patients who have to travel to an outpatient clinic to take it), a sublingual drug, which must be prescribed by the allergy-immunology specialist but can then be taken at home, has also been available in Italy for a few months.
In addition to undoubted symptomatic and general well-being benefits, allergen-specific immunotherapy also has favorable clinical and practical implications, as it avoids the need to continuously take medications that can lead to side effects (especially, in the case of asthma corticosteroids), and economic ones, as it substantially reduces spending on symptomatic medications and allergy-related absences from school/work, improving performance in the professional sphere. Confirming the positive cost-benefit ratio of the treatment is the fact that the Tuscany Region has decided to grant free allergen-specific immunotherapy to all people with mite allergies in whom it finds indication. The hope is that other regional health systems will follow suit.
Sources: Tuscany Region(www.regione.toscana.it/bancadati/atti/Contenuto.xml?id=5216521&nomeFile=Delibera_n.646_del_13-05-2019); Accarizax RCP, July 17, 2019 (AIFA – farmaci.agenziafarmaco.gov.it/aifa/servlet/PdfDownloadServlet?pdfFileName=footer_003016_043755_FI.pdf&sys=m0b1l3 )
