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Allergen Extract – Definition, Use and Therapy

An allergen extract is a medically prepared solution derived from allergy-triggering substances, used in the diagnosis and treatment of allergic conditions.

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Things worth knowing about "Allergen Extract"

An allergen extract is a medically prepared solution derived from allergy-triggering substances, used in the diagnosis and treatment of allergic conditions.

What Is an Allergen Extract?

An allergen extract is a standardized medical preparation derived from natural allergen-containing sources such as pollen, house dust mites, animal dander, mold spores, or food items. These extracts contain the proteins that can trigger immune responses in sensitized individuals. They are used both in allergy diagnostics and in allergen immunotherapy (desensitization treatment).

Production and Standardization

Allergen extracts are produced from biological raw materials using specialized extraction processes. The resulting material is purified, concentrated, and tested for its content of relevant allergen molecules. A key requirement for therapeutic use is the standardization of the extract, meaning that the allergen content is precisely defined to ensure consistent efficacy and safety. In the European Union and many other countries, allergen extracts are regulated and approved as medicinal products.

Areas of Application

Diagnostics

In allergy diagnostics, allergen extracts are used for various skin tests, most commonly the skin prick test and the intradermal test. A small amount of the extract is applied to or injected into the skin. If the patient is sensitized, a visible wheal reaction develops within minutes, indicating an allergic response. Allergen extracts are also used in in vitro blood tests that measure allergen-specific IgE antibodies.

Therapy: Allergen Immunotherapy

The therapeutic use of allergen extracts takes place within the framework of allergen immunotherapy (AIT), also known as desensitization or hyposensitization. The immune system is gradually accustomed to the triggering allergen through incrementally increasing doses, with the goal of reducing or eliminating the allergic response over the long term. There are two primary routes of administration:

Subcutaneous Immunotherapy (SCIT): The allergen extract is injected under the skin at regular intervals. This is the most widely used form.
Sublingual Immunotherapy (SLIT): The allergen extract is administered as drops or tablets placed under the tongue. This approach is particularly suited for pollen allergies and can often be used at home.

Mechanism of Action

Allergen extracts work by retraining the immune system. In an allergic reaction, the immune system overreacts to substances that are otherwise harmless. Through repeated, controlled exposure to the allergen, the immune response gradually shifts: production of allergy-promoting antibodies (IgE) is reduced, while regulatory T-cells are activated to dampen the overreaction. Over time, this leads to immunological tolerance toward the allergen.

Common Allergen Sources

Pollen (e.g., grasses, birch, mugwort)
House dust mites (Dermatophagoides pteronyssinus, Dermatophagoides farinae)
Animal dander (e.g., cat, dog, horse)
Mold spores (e.g., Alternaria, Cladosporium)
Insect venom (e.g., bee and wasp venom)
Food allergens (e.g., peanut, milk, egg)

Side Effects and Safety

Allergen extracts are generally well tolerated when administered by trained medical personnel. Possible side effects include:

Local reactions: Redness, swelling, or itching at the injection site
Systemic reactions: In rare cases, generalized allergic reactions may occur, including anaphylaxis (a severe, life-threatening allergic response)

For this reason, SCIT is always administered in a medical setting, with the patient monitored for at least 30 minutes after each injection. Emergency medications must be readily available at all times.

References

World Health Organization (WHO): Allergen standardization and skin tests. WHO Position Paper, Allergy, 1993.
Pfaar O. et al. - Guideline on allergen-specific immunotherapy in IgE-mediated allergic diseases. Allergo Journal International, 2014.
Jutel M. et al. - International consensus on allergy immunotherapy. Journal of Allergy and Clinical Immunology, 2015.

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