Immunotherapy in atopic dermatitis

Atopic denmatitis (AD) is a common inflammatory disease involving the skin and often other organs and systems, mainly respiratory. A definitive genera l consensus on the AD pathogenesis has not yet been established, however se veral lines of evidence suggest that T-cells play a crucial role in priming AD early-stage lesions. Main topics involved in the disease pathogenesis h ave been reviewed, which considered the concept of local and systemic haemo poietic events as important contributors to allergic inflammation, a concep t now achieving great acceptance. The recently recognised atopic nature of the skin inflammation in AD has raised increasing interest for treatment wi th allergen-specific immunotherapy. However, we only found eight studies us ing specific immunotherapy (SIT) in AD, two double-blind, placebo-controlle d (DBPC) and six observational. One controlled and five observational repor ted favourable outcomes. The one unique study providing negative results wa s flawed by the ineffective oral route of extract administration. Despite b eing encouraging, the reported results do not allow definitive conclusions based on meta-analytic techniques because the amount and quality of informa tion in the literature is not sufficient. The highly promising sub-lingual immunotherapy (SLIT) is discussed with its potential capability of controll ing not only the skin lesion severity but also its capability of preventing the development of atopic dermatitis into asthma.