Strengthening the case for intralymphatic immunotherapy

Abstract

Purpose of reviewIntralymphatic immunotherapy (ILIT) is a promising novel method of immunotherapy, that is short and convenient, and may be very effective. Results have been varied, and efforts to unravel the real value of the treatment are ongoing. Methods used to assess the effect in clinical trials have been so varied that it is difficult to compare studies with each other.Recent findingsSome advances have been made; the importance of injecting into the lymph node has been illustrated, and treatment with a range of medicines has proven to be successful. In meta-analyses the treatment has been shown to have no serious side effects and to be an effective short term desensitizing agent. Now it remains to be shown that ILIT also has long-term effects of tolerance. Preliminary data suggest that there is a long-term effect.SummaryInjecting allergen directly into a lymph node strengthens the protective immune response. ILIT is safe and induces desensitization and very likely also induces tolerance. Compliance will improve compared with other treatment forms. If ILIT holds its promise, it will become an attractive option for patients with allergy.

The Role of Regulatory T Cells in Allergic Diseases: Collegium Internationale Allergologicum (CIA) Update 2024

“…Compelling evidence has demonstrated that subcutaneous immunotherapy (SCIT) and sublingual immunotherapy (SLIT), as well as oral immunotherapy for the management of food allergies show safety and efficacy for many allergic patients [190]. Other alternative routes of administration such as epicutaneous immunotherapy or direct injection into lymph nodes (intralymphatic immunotherapy), have been explored to attempt to improve safety and patients’ convenience while maintaining efficacy [191, 192].…”

Intralymphatic Immunotherapy : A Novel Route to Ameliorate Allergic Rhinitis Due to Pollen

“…However, the same year a Malaysian meta-analysis of 11 trials found ILIT to be safe but not effective; high variation amongst the trials may have contributed to this finding [66]. The following year, 2022, a Danish review and meta-analysis of 14 studies, including our first double-blind randomised clinical trial published in 2022 [67], found that injecting allergen directly into a lymph node strengthens the protective immune response, is safe, induces desensitisation, and very likely induces tolerance as well [68]. A Chinese metaanalysis from 2023 [69] concludes that for individuals with AR, ILIT is safe and effective.…”

Ultrasound‐guided intralymphatic immunotherapy: A single‐center trial of a clinical skills training programme

“…To the Editor, Relevant symptom-reducing effect of intra-lymphatic immunotherapy, ILIT, previously found in clinical trials 1 has recently been reviewed. 2 The review contains three meta-analyses; one found ILIT safe but not effective, whereas two studies found ILIT to be safe and effective in the first year of treatment. In ILIT allergen is injected directly into a lymph node to reduce symptom response to the culprit allergen.…”