Desensitisation |
A temporary increase in reaction threshold. Maintained
by continuing daily treatment. |
Patient is protected from accidental
reactions but ongoing maintenance dosing must be continued life-long. |
Temporary suppression of basophil and mast cell (effector cell)
responses. Increased sIgG4; no change in serum levels of sIgE or modest
reduction after prolonged treatment. |
Remission |
Also referred to as sustained unresponsiveness. The absence
of clinical reactivity that persists weeks or months after stopping
treatment. |
Individual may stop treatment and consume the allergen
freely in the diet. Some level of allergen intake is considered
important to consolidate the immune changes supporting remission. |
Remission/SU is thought to result from redirection of the underlying
allergy towards tolerance, however the precise immune changes involved
remain poorly understood. |
Long-term remission |
Lasting persistence of remission/SU years after
treatment discontinuation. |
As it is not possible to demonstrate
permanence of a treatment effect in the clinical trial setting,
long-term remission/SU may offer a surrogate measure of true immune
tolerance/resolution of allergy. |
Mechanistic studies with data years
after treatment remain rare and the immune drivers leading to long-term
remission remain unidentified. |