الفهرس 
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Abstract
The incidence of allergic diseases is increased over the last few decades, especially in developed countries. It affects up to one quarter of the population in western countries at some time in their lives and the prevalence is rising. Immunotherapy is a promising treatment for allergic diseases. Its introduction as a main line of therapy for allergic children necessitates a comprehensive and detailed knowledge of the subject.
Allergen immunotherapy is the administration of gradually increasing quantities of an allergen vaccine to an allergic subject, reaching a dose which is effective in ameliorating the symptoms associated with subsequent exposure to the causative allergen.
Possible mechanisms of immunotherapy include specific IgE reduction, induction of IgG4 antibodies, reduced recruitment of effector cells, altered T cell cytokine balance, T cell anergy and induction of T regulatory cells.
Conventional immunotherapy is given subcutaneously. Patient receive course of injections until platue or maintenance phase achieved. Alternative routes of immunotherapy have been tried, the most promising of which is the sublingual – swallow (SLIT) route. This method requires administration of DROPs or rapid dissolving tablets under the tongue for 2-3 minutes, usually followed by swallowing.
Allergen extracts are prepared by extraction of the active allergenic constituents from animal or food substances. These products may be either unmodified or modified chemically or using recombinant allergens, T cell epitope based peptides with or without concurrent administration of adjunct therapies as anti IgE.
Immunotherapy has been shown to be effective in the management of allergic rhinitis and allergic asthma and it also dramatically reduces the risk of anaphylaxis in those who are sensitive to stinging insect venom.
Immunotherapy is generally administered for 3-5 years, although some patients may require longer periods of treatment to maintain relief of their allergic symptoms.
In conclusion, immunotherapy is a promising line of treatment for allergy. It is recommended that physicians should be updated with the new developments in the field of immunotherapy and more researches are needed for allergic Egyptian children.