Lymph Node Shots Tested for Grass Pollen Allergy
TUESDAY, Nov. 11 -- A Swiss-led study appears to point the way toward a faster, safer and less painful treatment for grass pollen allergy by using direct injections into the lymph node.
Compared with traditional under-the-skin shot regimens lasting several years and involving dozens of injections, the new method appears to offer patients the same degree of relief -- with fewer side effects -- with just three shots over two months.
"Because direct administration of the allergen into the lymph node markedly enhanced efficacy, the injected allergen dose could be reduced more than 1,000-fold, and this again significantly reduced the allergic side effects," said study co-author Dr. Thomas Kundig, medical director of the department of dermatology at University Hospital of Zurich.
Kundig and colleagues published their findings in this week's online edition of the Proceedings of the National Academy of Sciences.
The authors noted that allergic asthma affects upwards of 35 percent of those living in Westernized countries. To combat the problem, standard allergy shots -- injected in fatty tissue under the skin -- are considered the "gold standard" approach.
However, a typical shot regimen involves between 30 to 70 injections over three to five years, a time-consuming treatment that often provokes allergic reactions ranging from swelling at the shot site to systemic allergic reactions.
The result: "Less than 5 percent of allergy patients are treated with allergen-specific immunotherapy," Kundig said.
To test the potential of lymph node shots, the Swiss-American team focused on just under 100 patients between the ages of 18 and 65.
The volunteers were divided into two groups: those receiving a standard injection allergy treatment tracking a 54-injection schedule over a three-year period, and those receiving the lymph node therapy, which involved three injections over an eight-week period.
Kundig and his colleagues found that both approaches afforded similar benefits to the two groups of patients. However, those receiving the lymph node therapy experienced less pain and less frequent side effects than those undergoing conventional treatment.
After conducting nasal tests to assess allergy symptoms such as sneezing, nasal secretion, coughing, and shortness of breath, Kundig and his team concluded that their lymph node method proved to be both a shorter and safer treatment option compared with conventional shots. And they suggested that the relatively pain-free alternative could go a long way toward encouraging patients to stick with their anti-allergy treatment to the end.
"As the lymph node itself has no nerves, injection into a lymph node is painless," noted Kundig. "In fact, it was judged less painful than a blood draw. Overall, this treatment enhanced patient compliance, and the amelioration of hay fever symptoms was long lasting."
For his part, Dr. Clifford Bassett, a clinical instructor at New York University School of Medicine and attending physician in the allergy and immunology department of Long Island College Hospital in Brooklyn, N.Y., described the lymph node therapy as "quite novel" and "intriguing."
"I've never seen this type of approach before," noted Bassett, who is also the medical director of Allergy and Asthma Care of New York in New York City. "The allergens we're using now are certainly very potent and very effective. But we're obviously always looking at new ways to treat the epidemic of allergy. And there's a need for better treatment, and more cost-effective and safer treatment. So, this is a piece of information, although preliminary and focused only on grass pollen, that provides some insight into other ways to approach the problem."
Posted: November 2008