Interview with Dr. Sheldon Spector Immunotherapy for allergies to pollen, cats, dogs, molds, dust mites by Dr. Sheldon Spector interviewed by Mercia Tapping

 
Ever wondered whether Immunotherapy is worthwhile or just a lot of trouble for questionable results?


Dr Sheldon Spector is one of the most preeminent and respected internationally known allergists in the field. In an interview with our staff he answers your questions on Immunotherapy.
Immunotherapy
Q. What exactly is Immunotherapy?

A. Immunotherapy is commonly known as " getting allergy shots". It is the process of administering by injection increasing amounts of substances a patient is allergic to , such as pollen and dust mite, with the aim to eventually build tolerance to these substances and prevent them from causing symptoms. Immunotherapy is especially useful against substances that are difficult to avoid such as pollen or dust mites.

Q. Is Immunotherapy a "cure"?

A. Immunotherapy is not a cure but can significantly lessen symptoms caused by specific substances. For example, a person with allergic rhinitis may no longer react to Bermuda grass or Olive trees but will always have a higher tendency than the general population of manifesting allergic symptoms to other substances.
Q. Does Immunotherapy mean I would no longer suffer from allergies?

A. Immunotherapy improves symptoms to substances contained in the immunotherapy injections to different degrees. For example, some patients with cat allergy may no longer have symptoms around cats while others will need much less medication to prevent symptoms. Q. Are there different types of Immunotherapy?

A. Yes. Immunotherapy is given most commonly to improve symptoms from aeroallergens ( inhaled allergens ). Venom immunotherapy is given to patients who have experienced systemic or life-threatening reactions to stinging or biting insects.

Q. What is the success rate of Immunotherapy?

A. Studies showing the effectiveness of immunotherapy ,show that roughly 8 out of 10 patients benefit from immunotherapy.
Q. Does Immunotherapy work better for one kind of allergy more than another?

A. Immunotherapy has been shown to be effective in allergies to pollen, cats, dogs, molds, dust mites as well as stinging insects. Immunotherapy is not effective for food allergies.
Q. Are there different types of Immunotherapy? When I go to a doctor are they all going to use the same formulas?

A. Although there are community mixes that include common substances from a specific region, the most effective formulas or mixtures are made especially for the patient to include all specific substances or allergens he or she is allergic to. Q. How long does Immunotherapy take?

A. Immunotherapy is usually given for three to five years for long-term benefit.
Q. Is there a chance that I could go through all this trouble and it make no difference?

A. Improvement in symptoms is usually observed in most patients after 6 months to 1 year of immunotherapy. It is not effective in all patients and if no improvement is seen within the first year, the allergist may decide to stop or change the therapy.
Q. If I went through Immunotherapy would I still need to use HEPA filters and the like and take special environmental precautions in my house?

A. Yes. While the body is developing tolerance to allergens by increasing doses of immunotherapy, it is advisable to continue avoidance measures such as HEPA filters or dust mite covers to increase the chances of successful immunotherapy.
Q. I have an HMO as medical insurance. Do HMOs pay for this kind of treatment?

A. Most HMOs today consider immunotherapy effective and pay for at least part of the treatment. Please check with your HMO to find out specific policies.
Q. How bad do your allergies need to be before your insurance will pay for it?

A. Most insurance companies will pay for immunotherapy if your primary care doctor refers you to an allergist and the allergist recommends immunotherapy as part of your treatment. Even patients with mild symptoms may be recommended immunotherapy to avoid worsening of symptoms, if they cannot avoid the things they are allergic to, such as pets or specific native trees.
Q. If Immunotherapy has such a good success rate why doesn't everyone do it instead of taking medication and spending a ton of money on allergy control products?

A. The time and commitment involved in starting and undergoing immunotherapy is still seen as an obstacle by many patients looking for a "quick fix". In time , more and more patients realize that the long term benefits of immunotherapy are much better than being on medications for the rest of their life.
Q. Any future new developments in Immunotherapy that I should be aware of? I heard of a cat vaccine that was due to be released and then it seems to have disappeared-any update on that?

A. The promising "catvax" vaccine is still being studied. It is being touted as a fast-acting vaccine that would induce tolerance in allergic patients after only about 6 injections as opposed to the two to three year conventional cat immunotherapy.
With grateful acknowledgement to Drs. Spector and Tan in this interview.
Dr. Spector's web site together with his partner Dr. Tan and bibliographies are at Calallergy.com

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