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How to fit allergen immunotherapy in the elderly

机译：老年人如何适应过敏原免疫疗法

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Asthma, allergic rhinitis (AR) and atopic dermatitis are very common in young people, but in the latest decades it was increasingly recognized that also individuals of higher ages, including the population over 65 years, are concerned. Actually, it is now acknowledged the aging does not considerably alter the immune response to allergens. Allergen immunotherapy (AIT) is the only treatment that works on the causes of allergy, but elderly people are commonly excluded from AIT, except the cases of insect sting allergy. A number of recent studies showed that aged individuals also successfully respond to AIT for respiratory allergy. Therefore, there is no reason to exclude elder patients from AIT. Anyhow, clinical conditions that are considered absolute or relative contraindications are quite frequent in this aged population, thus the risk/benefit ratio must be carefully evaluated for each patient, taking into account that the more frequent occurrence of co-morbidities and the consequent need of daily-based multidrug regimen can favor adverse effects. An important issue concern the ability of AIT, and particularly of sublingual immunotherapy, to significantly improve the quality of life, that often is particularly impaired in the elderly, reducing symptoms and drugs consumption.
机译：哮喘，变应性鼻炎（AR）和特应性皮炎在年轻人中非常普遍，但是在最近的几十年中，人们越来越意识到年龄较大的个体，包括65岁以上的人群也受到关注。实际上，现在已经认识到衰老并不会显着改变对过敏原的免疫反应。变应原免疫疗法（AIT）是唯一对过敏原因有效的治疗方法，但除昆虫ing过敏的情况外，通常将老年人排除在AIT之外。最近的许多研究表明，老年人也可以成功地对呼吸道过敏的AIT做出反应。因此，没有理由将老年患者排除在AIT之外。无论如何，在这个年龄较大的人群中，被视为绝对或相对禁忌症的临床情况非常普遍，因此，必须考虑到合并症的发生频率更高以及随之而来的需要，认真评估每位患者的风险/获益比。每天使用多种药物治疗可能会产生不良反应。一个重要的问题涉及AIT（尤其是舌下免疫疗法）显着改善生活质量的能力，这在老年人中尤其容易受损，从而减少症状和药物消耗。

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