Is There a Definitive Cure for Allergy?

Every 1 in 4 people in Turkey struggles with allergies at some point in their lives. Whether it’s pollen, food, or dust mite allergies, the quality of life can decrease significantly. So, is there a definitive cure for allergy? Does immunotherapy (allergy shots) really work? Which treatment methods provide the most effective results?

What does the concept of a “definitive cure” mean?

The concept of a “definitive cure” for allergy is medically controversial. Allergy occurs when the immune system overreacts to harmless substances. It may not always be possible to stop this reaction entirely, but modern medicine has made great strides in controlling symptoms and providing long-term improvement.

Immunotherapy (allergy shots) is the only treatment method that can change the course of the disease, with a success rate of 70-90% in certain types of allergies. This treatment provides long-term healing by “training” the immune system to tolerate the allergen.

Which allergies can be treated?

Not all allergies are treated in the same way. Here are the types of allergies according to treatment success rates:

High Success Rate (70-90%):

• Pollen allergy (seasonal allergic rhinitis)
• Dust mite allergy
• Insect sting allergy (bees, wasps)
• Pet allergy (cats, dogs)

Moderate Success Rate (40-60%):

• Mold allergy
• Latex allergy
• Certain food allergies like milk and eggs (in children)

Low Success Rate or No Treatment:

• Multiple food allergies (in adults)
• Drug allergies
• Chronic urticaria (unknown cause)

Allergy Treatment Methods

1. Immunotherapy (Allergy Vaccine)

Immunotherapy is the only treatment approach that can provide permanent improvement in allergic diseases. It aims to develop tolerance by gradually exposing the immune system to the allergen.

There are two types of immunotherapy:

Subcutaneous Immunotherapy (SCIT – Injection):

• Clinical visits 1-2 times a week (first 3-6 months)
• Maintenance treatment once a month thereafter
• Total treatment duration: 3-5 years
• Success rate: 80-90%

Sublingual Immunotherapy (SLIT – Under-the-tongue tablet/drops):

• Can be used at home.
• Taken daily.
• First dose administered under clinical supervision.
• Treatment duration: 3 years
• Success rate: 70-80%

2. Drug Treatments (Symptom Control)

Medications control the symptoms of allergy but do not change the course of the disease. Symptoms return when treatment is discontinued.

• Antihistamines: Effective for itching, sneezing, and runny nose.
• Nasal Corticosteroids: Sprays like fluticasone or mometasone. The most effective treatment for allergic rhinitis.
• Leukotriene Antagonists: Tablet form (montelukast) used for combined treatment of asthma and allergy.
• Decongestants: Short-term use for nasal congestion; longer use (over 3-5 days) can cause a rebound effect.

3. Avoidance Strategies

Staying away from the allergen is the simplest but often the most difficult method.

• For Pollen: Follow pollen calendars, stay indoors during early morning hours, and shower after being outside.
• For Dust Mites: Use anti-allergic mattress covers, wash bedding at 60°C, and use HEPA-filtered vacuums.
• For Pets: Keep pets out of the bedroom, bathe them twice a week, and use HEPA air purifiers.

How does the immunotherapy process work?

Step 1: Allergy Test and Diagnosis

A definitive diagnosis is essential before starting treatment.

• Skin Prick Test: Results in 15-20 minutes. Minimal invasion, identifies common allergens.
• Serum Specific IgE Test: A blood test that doesn’t require stopping antihistamines. Often preferred for infants.

Step 2: Build-up Phase (3-6 months)

The first stage aims to gradually habituate the body to the allergen with increasing doses.

Step 3: Maintenance Phase (2.5-4.5 years)

Once the target dose is reached, it is continued at regular intervals. Significant improvement becomes apparent during this period.

Side Effects and Risks

Immunotherapy: Mild effects like redness or itching at the injection site are common. Serious side effects like anaphylaxis are very rare (0.1%), which is why clinical supervision for the first 30 minutes is mandatory.

Medications: Modern (2nd generation) antihistamines have minimal side effects. Nasal steroids have very low systemic absorption and do not affect growth in children.

Allergy Treatment in Children

Immunotherapy can generally be started after age 5. Success rates are often higher in children because their immune systems are more flexible, and treatment can reduce the risk of developing asthma by 40-50%.

Note on Food Allergies: Many childhood food allergies (milk, egg) may be outgrown by age 5-7, while others (nuts, fish) are usually permanent.

New Developments

Oral Immunotherapy (OIT) is a promising approach for food allergies like peanuts. Treatments like Palforzia have received FDA approval to help build tolerance under strict medical supervision.