NEWS RELEASE

Embargoed until 00.01 June 10th 2011

UK – The Birthplace of Immunotherapy. However despite a Century of Progress,

Provisions for Hay Fever Sufferers Remain Inadequate.

On this day one hundred years ago the first paper on allergen specific immunotherapy was published in the Lancet. It was an account by Dr Leonard Noon of his experiments on hay fever patients at St Mary’s Hospital, London. He had injected them with grass pollen every few days, initially in minute quantities then gradually increasing the dose and had monitored their sensitivity to grass pollen by a conjunctival challenge, finding the lowest dose  to which they responded. In this way he demonstrated that the injections were associated with an increase in tolerance to grass pollen.

Sadly he was too ill to continue monitoring those treated subjects, but his colleague Dr John Freeman took over this task and published in September 1911 a further paper in the Lancet detailing the improvements noted during the hay fever season, presumably as a result of the injections. It was not until 50 years later that a proper double blind, placebo-controlled study was undertaken at St Mary’s  by  Dr William ( Bill ) Frankland,(who is also about to become a centenarian), proving beyond doubt that immunotherapy is effective.

The first Noon paper is truly seminal and includes dose standardization, up-titration of administered dose and monitoring of sensitivity: practices still employed today now that immunotherapy is in use world wide. The efficacy of immunotherapy, both by injection, and by the more recent, safer sublingual route has been confirmed in meta-analyses of high quality trials. It is the only form of treatment which has been shown to affect the natural history of the disease: preventing the progression of rhinitis to asthma and reducing the development of new allergic sensitization.

Dr Glenis Scadding, President of the British Society for Allergy and Clinical Immunology (BSACI) said ‘Recent surveys suggest that over 20 percent of UK adults suffer from hay  fever, and 40 per cent of British children have an allergy diagnosis. As the birthplace of immunotherapy, the UK should be championing its use, however sadly this is not the case as immunotherapy is vastly underutilised despite epidemic proportions of allergic disease which significantly impair quality of life, work and school performance, largely due to under-provision of allergy services within the NHS and poor understanding on the part of payers. ‘

In conjunction with the European Academy of Allergy and Clinical Immunology (EAACI) the BSACI will be promoting a call for further immunotherapy research in a European Declaration on Allergen Immunotherapy to be released on June 13th at the EAACI annual meeting in Istanbul. The document notes that  “Immunotherapy has not received adequate attention from the European research funding bodies; however, this could be one of the most rewarding fields in terms of return, translational value and European integration. It is also a field in which Europe is recognised as a leader worldwide.

Studies exploring the full cost of allergic rhinitis and asthma are still lacking and impaired by the variety of health systems across Europe. The macro-economic impact of allergies and the long-term cost-effectiveness of immunotherapy need further detailed evaluation and attention.  Awareness of immunotherapy and its treatment potential is inadequate in the general population. In some cases immunotherapeutic approaches are mistakenly considered as identical to ‘alternative’, non-proven treatments.”