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For many people, the spring and early summer can be a difficult time as hay fever season takes hold in earnest. 

This can mean taking a regular dose of antihistamines, nasal sprays and eye drops to try to relieve the irritating symptoms like a runny nose, itchy eyes and persistent sneezing.

But for others, the symptoms of acute hay fever can be debilitating and life-altering, to the extent that common remedies have little effect.

Some of these more serious sufferers may be referred for immunotherapy to try to help them, and there is hope that new research “highlighting its effectiveness” may lead to it becoming “more widely available on the NHS”, said the Daily Mail.

What is immunotherapy?

In essence, immunotherapy aims to “induce a shift in the immune response” of a patient. So instead of producing histamines that cause the classic symptoms of hay fever, the body produces “antibodies that can neutralise the allergen” and prevent an allergic reaction from occurring, said Samuel J. White and Philippe B. Wilson from Nottingham Trent University on The Conversation.

The process of immunotherapy trains the body to “avoid its overreaction” to a specific allergen and build a “tolerance” to it, said Healthnews. 

That usually begins with a three- to six-month “build-up phase”, said White and Wilson, where small doses of the allergen are administered to induce T-regulatory cells, which prevent the release of histamines. After the initial period, doses are gradually increased until the target dose is reached, at which point the “maintenance phase” begins, lasting “three to five years” or longer.

Immunotherapy can be administered in two ways, under the skin via an injection (subcutaneous), or via the newer method of under the tongue using liquid drops or tablets (sublingual).

How effective is it?

Both types of immunotherapy treatment have demonstrated effectiveness in research. Subcutaneous has been used for much longer and so has a greater history of evidence showing it works. While it is considered safe, uncommon side effects including allergic reactions and a rash around the injection site have been known to occur. 

The oral method has be shown to be “marginally less effective” than injections, but is considered “slightly safer”, said White and Wilson.

The treatment usually begins a few months before the pollen season starts. Research has shown that treatment over three to five years can have longer-lasting benefits and is “effective in reducing symptoms and use of medications such as antihistamines”. Sublingual treatment has been shown to be “particularly effective for hay fever caused by grass or tree pollens” and is a “safe and effective treatment option for hay fever in adults”.

How do people access the treatment?

Despite the evidence of the effectiveness of immunotherapy in treating hay fever, it is currently “not available to the majority of people” with the condition in Britain, said The Sun.

In fact, only 2,839 people in the UK out of the estimated 13 million hay fever sufferers are receiving three years of immunotherapy treatment, according to research by the British Society for Allergy & Clinical Immunology. The use of immunotherapy in the UK “severely lags behind the US and Europe”, consultant paediatrician Dr Tom Dawson told the Daily Mail, despite the UK being “at the forefront of allergy research”.

Most people need to demonstrate severe hay fever symptoms that can’t be relieved with standard treatments before a GP may refer them for immunotherapy.

But with a cost of around £2,000 a year per patient, there is also an argument that immunotherapy treatment could in the long term save the NHS money, with fewer people potentially succumbing to more severe conditions like seasonal asthma.

Despite evidence of its efficacy, not all patients will experience a complete relief of symptoms through immunotherapy and it “may not be a suitable option for everyone”, said White and Wilson. It also requires a long-term commitment to regular treatment and it can often take “several months or even years to see the full benefits”. For many people, though, it could prove a “valuable tool” in easing their hay fever symptoms, and its potential remains largely untapped in the UK.