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Hyposensitization – Allergen Immunotherapy Explained

Hyposensitization is a medical treatment for allergies in which the immune system is gradually exposed to allergens to reduce long-term hypersensitivity and allergic reactions.

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Things worth knowing about "Hyposensitization"

Hyposensitization is a medical treatment for allergies in which the immune system is gradually exposed to allergens to reduce long-term hypersensitivity and allergic reactions.

What is Hyposensitization?

Hyposensitization, also called Allergen Immunotherapy (AIT), is a medical treatment designed to reduce the immune system´s overreaction to specific substances that trigger allergic responses, known as allergens. Unlike conventional allergy medications that only relieve symptoms, hyposensitization targets the underlying cause of the allergy and can lead to long-lasting or even permanent relief.

How Does Hyposensitization Work?

During hyposensitization, the patient is exposed to gradually increasing doses of the relevant allergen over an extended period. This trains the immune system to tolerate the allergen rather than overreact to it. There are two primary forms of delivery:

Subcutaneous Immunotherapy (SCIT): The allergen is administered via injections under the skin at regular intervals.
Sublingual Immunotherapy (SLIT): The allergen is given in the form of drops or dissolving tablets placed under the tongue.

When is Hyposensitization Used?

Hyposensitization is most commonly indicated for the following allergies:

Pollen allergy (e.g., grass, birch, hazel)
House dust mite allergy
Insect venom allergy (e.g., bee or wasp stings)
Pet dander allergy
Mold allergy

A prerequisite for treatment is that the specific allergen has been clearly identified through allergy testing and that a suitable therapeutic preparation is available. It is especially recommended when symptoms persist despite allergen avoidance and standard medication.

Treatment Process

Build-Up Phase

During the build-up phase, the dose of the allergen is gradually increased until the individual maintenance dose is reached. Depending on the treatment protocol, this phase can take several weeks.

Maintenance Phase

In the maintenance phase, the maximum dose is administered at regular intervals, typically every four to six weeks. This phase usually lasts three years to achieve a sustained therapeutic effect.

Effectiveness and Outcomes

Clinical studies confirm that hyposensitization leads to significant symptom reduction in many patients. Success rates for insect venom allergy exceed 90%, and strong evidence also supports its use in hay fever and house dust mite allergy. Consistent adherence to the full treatment duration is essential, as early discontinuation can substantially reduce effectiveness.

Side Effects and Risks

Hyposensitization is generally well tolerated, but side effects can occur:

Local reactions: Redness, swelling, or itching at the injection site
Systemic reactions: In rare cases, hives, asthma attacks, or in very rare cases, anaphylaxis

For this reason, injections must always be administered in a medical setting with a mandatory observation period of at least 30 minutes and emergency medications readily available.

Contraindications

Not every patient is suitable for hyposensitization. Contraindications include:

Severe cardiovascular diseases
Pregnancy (initiation of new therapy)
Active autoimmune diseases
Severe or uncontrolled asthma
Use of certain medications such as beta-blockers

References

Jutel M. et al. - International consensus on allergy immunotherapy. Journal of Allergy and Clinical Immunology, 2015.
World Allergy Organization (WAO): WAO White Book on Allergy, 2013.
Calderon M.A. et al. - Allergen injection immunotherapy for seasonal allergic rhinitis. Cochrane Database of Systematic Reviews, 2007.

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