International Consensus on Allergen Immunotherapy II: Mechanisms, standardization, and pharmacoeconomics.
Identifieur interne : 002236 ( PubMed/Corpus ); précédent : 002235; suivant : 002237International Consensus on Allergen Immunotherapy II: Mechanisms, standardization, and pharmacoeconomics.
Auteurs : Marek Jutel ; Ioana Agache ; Sergio Bonini ; A Wesley Burks ; Moises Calderon ; Walter Canonica ; Linda Cox ; Pascal Demoly ; Antony J. Frew ; Robyn O'Hehir ; Jörg Kleine-Tebbe ; Antonella Muraro ; Gideon Lack ; Désirée Larenas ; Michael Levin ; Bryan L. Martin ; Harald Nelson ; Ruby Pawankar ; Oliver Pfaar ; Ronald Van Ree ; Hugh Sampson ; James L. Sublett ; Kazunari Sugita ; George Du Toit ; Thomas Werfel ; Roy Gerth Van Wijk ; Luo Zhang ; Mübeccel Akdis ; Cezmi A. AkdisSource :
- The Journal of allergy and clinical immunology [ 1097-6825 ] ; 2016.
English descriptors
- KwdEn :
- Allergens (administration & dosage), Allergens (immunology), Consensus, Cost-Benefit Analysis, Desensitization, Immunologic (economics), Desensitization, Immunologic (methods), Desensitization, Immunologic (standards), Economics, Pharmaceutical (legislation & jurisprudence), Humans, Hypersensitivity (immunology), Hypersensitivity (therapy), Immune Tolerance.
- MESH :
- chemical , administration & dosage : Allergens.
- chemical , immunology : Allergens.
- economics : Desensitization, Immunologic.
- immunology : Hypersensitivity.
- legislation & jurisprudence : Economics, Pharmaceutical.
- methods : Desensitization, Immunologic.
- standards : Desensitization, Immunologic.
- therapy : Hypersensitivity.
- Consensus, Cost-Benefit Analysis, Humans, Immune Tolerance.
Abstract
This article continues the comprehensive international consensus (ICON) statement on allergen immunotherapy (AIT). The initial article also recently appeared in the Journal. The conclusions below focus on key mechanisms of AIT-triggered tolerance, requirements in allergen standardization, AIT cost-effectiveness, and regulatory guidance. Potential barriers to and facilitators of the use of AIT are described in addition to future directions. International allergy specialists representing the European Academy of Allergy and Clinical Immunology; the American Academy of Allergy, Asthma & Immunology; the American College of Allergy, Asthma and Immunology; and the World Allergy Organization critically reviewed the existing literature and prepared this summary of recommendations for best AIT practice. The authors contributed equally and reached consensus on the statements presented herein.
DOI: 10.1016/j.jaci.2015.12.1300
PubMed: 26853128
Links to Exploration step
pubmed:26853128Le document en format XML
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<author><name sortKey="Jutel, Marek" sort="Jutel, Marek" uniqKey="Jutel M" first="Marek" last="Jutel">Marek Jutel</name>
<affiliation><nlm:affiliation>Department of Clinical Immunology, Wroclaw Medical University, and "ALL-MED" Medical Research Institute, Wroclaw, Poland. Electronic address: marek.jutel@umed.wroc.pl.</nlm:affiliation>
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<author><name sortKey="Agache, Ioana" sort="Agache, Ioana" uniqKey="Agache I" first="Ioana" last="Agache">Ioana Agache</name>
<affiliation><nlm:affiliation>Faculty of Medicine, Transylvania University, Brasov, Romania.</nlm:affiliation>
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<author><name sortKey="Bonini, Sergio" sort="Bonini, Sergio" uniqKey="Bonini S" first="Sergio" last="Bonini">Sergio Bonini</name>
<affiliation><nlm:affiliation>Second University of Naples and IFT-CNR, Rome, and Expert-on-Secondment European Medicines Agency, London, United Kingdom.</nlm:affiliation>
</affiliation>
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<author><name sortKey="Burks, A Wesley" sort="Burks, A Wesley" uniqKey="Burks A" first="A Wesley" last="Burks">A Wesley Burks</name>
<affiliation><nlm:affiliation>Department of Pediatrics, University of North Carolina, Chapel Hill, NC.</nlm:affiliation>
</affiliation>
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<author><name sortKey="Calderon, Moises" sort="Calderon, Moises" uniqKey="Calderon M" first="Moises" last="Calderon">Moises Calderon</name>
<affiliation><nlm:affiliation>Section of Allergy and Clinical Immunology, Imperial College London, National Heart and Lung Institute, Royal Brompton Hospital, London, United Kingdom.</nlm:affiliation>
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</author>
<author><name sortKey="Canonica, Walter" sort="Canonica, Walter" uniqKey="Canonica W" first="Walter" last="Canonica">Walter Canonica</name>
<affiliation><nlm:affiliation>Allergy & Respiratory Diseases Clinic, DIMI University of Genoa, IRCCS AOU San Martino, Genova, Italy.</nlm:affiliation>
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<author><name sortKey="Cox, Linda" sort="Cox, Linda" uniqKey="Cox L" first="Linda" last="Cox">Linda Cox</name>
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<author><name sortKey="Demoly, Pascal" sort="Demoly, Pascal" uniqKey="Demoly P" first="Pascal" last="Demoly">Pascal Demoly</name>
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<author><name sortKey="Frew, Antony J" sort="Frew, Antony J" uniqKey="Frew A" first="Antony J" last="Frew">Antony J. Frew</name>
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<author><name sortKey="O Hehir, Robyn" sort="O Hehir, Robyn" uniqKey="O Hehir R" first="Robyn" last="O'Hehir">Robyn O'Hehir</name>
<affiliation><nlm:affiliation>Department of Allergy, Immunology and Respiratory Medicine, The Alfred Hospital and Monash University, Melbourne, Australia.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Kleine Tebbe, Jorg" sort="Kleine Tebbe, Jorg" uniqKey="Kleine Tebbe J" first="Jörg" last="Kleine-Tebbe">Jörg Kleine-Tebbe</name>
<affiliation><nlm:affiliation>Allergy & Asthma Center Westend, Berlin, Germany.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Muraro, Antonella" sort="Muraro, Antonella" uniqKey="Muraro A" first="Antonella" last="Muraro">Antonella Muraro</name>
<affiliation><nlm:affiliation>Department of Mother and Child Health, Padua General University Hospital, Padua, Italy.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Lack, Gideon" sort="Lack, Gideon" uniqKey="Lack G" first="Gideon" last="Lack">Gideon Lack</name>
<affiliation><nlm:affiliation>Division of Asthma, Allergy and Lung Biology, MRC and Asthma UK Centre in Allergic Mechanisms of Asthma, King's College London, and the Children's Allergy Unit, Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom.</nlm:affiliation>
</affiliation>
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<author><name sortKey="Larenas, Desiree" sort="Larenas, Desiree" uniqKey="Larenas D" first="Désirée" last="Larenas">Désirée Larenas</name>
<affiliation><nlm:affiliation>Hospital Médica Sur, Mexico City, Mexico.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Levin, Michael" sort="Levin, Michael" uniqKey="Levin M" first="Michael" last="Levin">Michael Levin</name>
<affiliation><nlm:affiliation>Division of Allergy, School of Child and Adolescent Health, Red Cross War Memorial Children's Hospital, Cape Town, South Africa.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Martin, Bryan L" sort="Martin, Bryan L" uniqKey="Martin B" first="Bryan L" last="Martin">Bryan L. Martin</name>
<affiliation><nlm:affiliation>Department of Allergy and Immunology, Walter Reed Army Medical Center, Silver Spring, Md.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Nelson, Harald" sort="Nelson, Harald" uniqKey="Nelson H" first="Harald" last="Nelson">Harald Nelson</name>
<affiliation><nlm:affiliation>National Jewish Health, Denver, Colo.</nlm:affiliation>
</affiliation>
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<author><name sortKey="Pawankar, Ruby" sort="Pawankar, Ruby" uniqKey="Pawankar R" first="Ruby" last="Pawankar">Ruby Pawankar</name>
<affiliation><nlm:affiliation>Department of Pediatrics, Nippon Medical School, Tokyo, Japan.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Pfaar, Oliver" sort="Pfaar, Oliver" uniqKey="Pfaar O" first="Oliver" last="Pfaar">Oliver Pfaar</name>
<affiliation><nlm:affiliation>Center for Rhinology and Allergology, Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Mannheim, Mannheim, Germany.</nlm:affiliation>
</affiliation>
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<author><name sortKey="Van Ree, Ronald" sort="Van Ree, Ronald" uniqKey="Van Ree R" first="Ronald" last="Van Ree">Ronald Van Ree</name>
<affiliation><nlm:affiliation>Academic Medical Center, Departments of Experimental Immunology and of Otorhinolaryngology, University of Amsterdam, Amsterdam, The Netherlands.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Sampson, Hugh" sort="Sampson, Hugh" uniqKey="Sampson H" first="Hugh" last="Sampson">Hugh Sampson</name>
<affiliation><nlm:affiliation>Department of Pediatrics, Division of Allergy-Immunology, and the Jaffe Food Allergy Institute at the Icahn School of Medicine at Mount Sinai, New York, NY.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Sublett, James L" sort="Sublett, James L" uniqKey="Sublett J" first="James L" last="Sublett">James L. Sublett</name>
<affiliation><nlm:affiliation>Department of Pediatrics, Section of Allergy and Immunology, University of Louisville School of Medicine, Louisville, Ky.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Sugita, Kazunari" sort="Sugita, Kazunari" uniqKey="Sugita K" first="Kazunari" last="Sugita">Kazunari Sugita</name>
<affiliation><nlm:affiliation>Swiss Institute for Allergy and Asthma Research, University of Zurich, and Christine Kühne-Center for Allergy Research and Education, Davos, Switzerland.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Du Toit, George" sort="Du Toit, George" uniqKey="Du Toit G" first="George" last="Du Toit">George Du Toit</name>
<affiliation><nlm:affiliation>Department of Pediatric Allergy, Division of Asthma, Allergy & Lung Biology, King's College London, and MRC & Asthma UK Centre in Allergic Mechanisms of Asthma, London, United Kingdom.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Werfel, Thomas" sort="Werfel, Thomas" uniqKey="Werfel T" first="Thomas" last="Werfel">Thomas Werfel</name>
<affiliation><nlm:affiliation>Department of Dermatology and Allergy, Division of Immunodermatology and Allergy Research, Hannover Medical School, Hannover, Germany.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Gerth Van Wijk, Roy" sort="Gerth Van Wijk, Roy" uniqKey="Gerth Van Wijk R" first="Roy" last="Gerth Van Wijk">Roy Gerth Van Wijk</name>
<affiliation><nlm:affiliation>Erasmus Medical Center, Rotterdam, The Netherlands.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Zhang, Luo" sort="Zhang, Luo" uniqKey="Zhang L" first="Luo" last="Zhang">Luo Zhang</name>
<affiliation><nlm:affiliation>Beijing Institute of Otolaryngology, Beijing, China.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Akdis, Mubeccel" sort="Akdis, Mubeccel" uniqKey="Akdis M" first="Mübeccel" last="Akdis">Mübeccel Akdis</name>
<affiliation><nlm:affiliation>Swiss Institute for Allergy and Asthma Research, University of Zurich, and Christine Kühne-Center for Allergy Research and Education, Davos, Switzerland.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Akdis, Cezmi A" sort="Akdis, Cezmi A" uniqKey="Akdis C" first="Cezmi A" last="Akdis">Cezmi A. Akdis</name>
<affiliation><nlm:affiliation>Swiss Institute for Allergy and Asthma Research, University of Zurich, and Christine Kühne-Center for Allergy Research and Education, Davos, Switzerland.</nlm:affiliation>
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<sourceDesc><biblStruct><analytic><title xml:lang="en">International Consensus on Allergen Immunotherapy II: Mechanisms, standardization, and pharmacoeconomics.</title>
<author><name sortKey="Jutel, Marek" sort="Jutel, Marek" uniqKey="Jutel M" first="Marek" last="Jutel">Marek Jutel</name>
<affiliation><nlm:affiliation>Department of Clinical Immunology, Wroclaw Medical University, and "ALL-MED" Medical Research Institute, Wroclaw, Poland. Electronic address: marek.jutel@umed.wroc.pl.</nlm:affiliation>
</affiliation>
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<author><name sortKey="Agache, Ioana" sort="Agache, Ioana" uniqKey="Agache I" first="Ioana" last="Agache">Ioana Agache</name>
<affiliation><nlm:affiliation>Faculty of Medicine, Transylvania University, Brasov, Romania.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Bonini, Sergio" sort="Bonini, Sergio" uniqKey="Bonini S" first="Sergio" last="Bonini">Sergio Bonini</name>
<affiliation><nlm:affiliation>Second University of Naples and IFT-CNR, Rome, and Expert-on-Secondment European Medicines Agency, London, United Kingdom.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Burks, A Wesley" sort="Burks, A Wesley" uniqKey="Burks A" first="A Wesley" last="Burks">A Wesley Burks</name>
<affiliation><nlm:affiliation>Department of Pediatrics, University of North Carolina, Chapel Hill, NC.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Calderon, Moises" sort="Calderon, Moises" uniqKey="Calderon M" first="Moises" last="Calderon">Moises Calderon</name>
<affiliation><nlm:affiliation>Section of Allergy and Clinical Immunology, Imperial College London, National Heart and Lung Institute, Royal Brompton Hospital, London, United Kingdom.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Canonica, Walter" sort="Canonica, Walter" uniqKey="Canonica W" first="Walter" last="Canonica">Walter Canonica</name>
<affiliation><nlm:affiliation>Allergy & Respiratory Diseases Clinic, DIMI University of Genoa, IRCCS AOU San Martino, Genova, Italy.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Cox, Linda" sort="Cox, Linda" uniqKey="Cox L" first="Linda" last="Cox">Linda Cox</name>
<affiliation><nlm:affiliation>Allergy and Asthma Center, Fort Lauderdale, Fla.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Demoly, Pascal" sort="Demoly, Pascal" uniqKey="Demoly P" first="Pascal" last="Demoly">Pascal Demoly</name>
<affiliation><nlm:affiliation>University Hospital of Montpellier-INSERM U657, Montpellier, France.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Frew, Antony J" sort="Frew, Antony J" uniqKey="Frew A" first="Antony J" last="Frew">Antony J. Frew</name>
<affiliation><nlm:affiliation>Department of Respiratory Medicine, Royal Sussex County Hospital, Brighton, United Kingdom.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="O Hehir, Robyn" sort="O Hehir, Robyn" uniqKey="O Hehir R" first="Robyn" last="O'Hehir">Robyn O'Hehir</name>
<affiliation><nlm:affiliation>Department of Allergy, Immunology and Respiratory Medicine, The Alfred Hospital and Monash University, Melbourne, Australia.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Kleine Tebbe, Jorg" sort="Kleine Tebbe, Jorg" uniqKey="Kleine Tebbe J" first="Jörg" last="Kleine-Tebbe">Jörg Kleine-Tebbe</name>
<affiliation><nlm:affiliation>Allergy & Asthma Center Westend, Berlin, Germany.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Muraro, Antonella" sort="Muraro, Antonella" uniqKey="Muraro A" first="Antonella" last="Muraro">Antonella Muraro</name>
<affiliation><nlm:affiliation>Department of Mother and Child Health, Padua General University Hospital, Padua, Italy.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Lack, Gideon" sort="Lack, Gideon" uniqKey="Lack G" first="Gideon" last="Lack">Gideon Lack</name>
<affiliation><nlm:affiliation>Division of Asthma, Allergy and Lung Biology, MRC and Asthma UK Centre in Allergic Mechanisms of Asthma, King's College London, and the Children's Allergy Unit, Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Larenas, Desiree" sort="Larenas, Desiree" uniqKey="Larenas D" first="Désirée" last="Larenas">Désirée Larenas</name>
<affiliation><nlm:affiliation>Hospital Médica Sur, Mexico City, Mexico.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Levin, Michael" sort="Levin, Michael" uniqKey="Levin M" first="Michael" last="Levin">Michael Levin</name>
<affiliation><nlm:affiliation>Division of Allergy, School of Child and Adolescent Health, Red Cross War Memorial Children's Hospital, Cape Town, South Africa.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Martin, Bryan L" sort="Martin, Bryan L" uniqKey="Martin B" first="Bryan L" last="Martin">Bryan L. Martin</name>
<affiliation><nlm:affiliation>Department of Allergy and Immunology, Walter Reed Army Medical Center, Silver Spring, Md.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Nelson, Harald" sort="Nelson, Harald" uniqKey="Nelson H" first="Harald" last="Nelson">Harald Nelson</name>
<affiliation><nlm:affiliation>National Jewish Health, Denver, Colo.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Pawankar, Ruby" sort="Pawankar, Ruby" uniqKey="Pawankar R" first="Ruby" last="Pawankar">Ruby Pawankar</name>
<affiliation><nlm:affiliation>Department of Pediatrics, Nippon Medical School, Tokyo, Japan.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Pfaar, Oliver" sort="Pfaar, Oliver" uniqKey="Pfaar O" first="Oliver" last="Pfaar">Oliver Pfaar</name>
<affiliation><nlm:affiliation>Center for Rhinology and Allergology, Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Mannheim, Mannheim, Germany.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Van Ree, Ronald" sort="Van Ree, Ronald" uniqKey="Van Ree R" first="Ronald" last="Van Ree">Ronald Van Ree</name>
<affiliation><nlm:affiliation>Academic Medical Center, Departments of Experimental Immunology and of Otorhinolaryngology, University of Amsterdam, Amsterdam, The Netherlands.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Sampson, Hugh" sort="Sampson, Hugh" uniqKey="Sampson H" first="Hugh" last="Sampson">Hugh Sampson</name>
<affiliation><nlm:affiliation>Department of Pediatrics, Division of Allergy-Immunology, and the Jaffe Food Allergy Institute at the Icahn School of Medicine at Mount Sinai, New York, NY.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Sublett, James L" sort="Sublett, James L" uniqKey="Sublett J" first="James L" last="Sublett">James L. Sublett</name>
<affiliation><nlm:affiliation>Department of Pediatrics, Section of Allergy and Immunology, University of Louisville School of Medicine, Louisville, Ky.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Sugita, Kazunari" sort="Sugita, Kazunari" uniqKey="Sugita K" first="Kazunari" last="Sugita">Kazunari Sugita</name>
<affiliation><nlm:affiliation>Swiss Institute for Allergy and Asthma Research, University of Zurich, and Christine Kühne-Center for Allergy Research and Education, Davos, Switzerland.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Du Toit, George" sort="Du Toit, George" uniqKey="Du Toit G" first="George" last="Du Toit">George Du Toit</name>
<affiliation><nlm:affiliation>Department of Pediatric Allergy, Division of Asthma, Allergy & Lung Biology, King's College London, and MRC & Asthma UK Centre in Allergic Mechanisms of Asthma, London, United Kingdom.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Werfel, Thomas" sort="Werfel, Thomas" uniqKey="Werfel T" first="Thomas" last="Werfel">Thomas Werfel</name>
<affiliation><nlm:affiliation>Department of Dermatology and Allergy, Division of Immunodermatology and Allergy Research, Hannover Medical School, Hannover, Germany.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Gerth Van Wijk, Roy" sort="Gerth Van Wijk, Roy" uniqKey="Gerth Van Wijk R" first="Roy" last="Gerth Van Wijk">Roy Gerth Van Wijk</name>
<affiliation><nlm:affiliation>Erasmus Medical Center, Rotterdam, The Netherlands.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Zhang, Luo" sort="Zhang, Luo" uniqKey="Zhang L" first="Luo" last="Zhang">Luo Zhang</name>
<affiliation><nlm:affiliation>Beijing Institute of Otolaryngology, Beijing, China.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Akdis, Mubeccel" sort="Akdis, Mubeccel" uniqKey="Akdis M" first="Mübeccel" last="Akdis">Mübeccel Akdis</name>
<affiliation><nlm:affiliation>Swiss Institute for Allergy and Asthma Research, University of Zurich, and Christine Kühne-Center for Allergy Research and Education, Davos, Switzerland.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Akdis, Cezmi A" sort="Akdis, Cezmi A" uniqKey="Akdis C" first="Cezmi A" last="Akdis">Cezmi A. Akdis</name>
<affiliation><nlm:affiliation>Swiss Institute for Allergy and Asthma Research, University of Zurich, and Christine Kühne-Center for Allergy Research and Education, Davos, Switzerland.</nlm:affiliation>
</affiliation>
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<front><div type="abstract" xml:lang="en">This article continues the comprehensive international consensus (ICON) statement on allergen immunotherapy (AIT). The initial article also recently appeared in the Journal. The conclusions below focus on key mechanisms of AIT-triggered tolerance, requirements in allergen standardization, AIT cost-effectiveness, and regulatory guidance. Potential barriers to and facilitators of the use of AIT are described in addition to future directions. International allergy specialists representing the European Academy of Allergy and Clinical Immunology; the American Academy of Allergy, Asthma & Immunology; the American College of Allergy, Asthma and Immunology; and the World Allergy Organization critically reviewed the existing literature and prepared this summary of recommendations for best AIT practice. The authors contributed equally and reached consensus on the statements presented herein.</div>
</front>
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<ELocationID EIdType="doi" ValidYN="Y">10.1016/j.jaci.2015.12.1300</ELocationID>
<ELocationID EIdType="pii" ValidYN="Y">S0091-6749(15)03114-0</ELocationID>
<Abstract><AbstractText>This article continues the comprehensive international consensus (ICON) statement on allergen immunotherapy (AIT). The initial article also recently appeared in the Journal. The conclusions below focus on key mechanisms of AIT-triggered tolerance, requirements in allergen standardization, AIT cost-effectiveness, and regulatory guidance. Potential barriers to and facilitators of the use of AIT are described in addition to future directions. International allergy specialists representing the European Academy of Allergy and Clinical Immunology; the American Academy of Allergy, Asthma & Immunology; the American College of Allergy, Asthma and Immunology; and the World Allergy Organization critically reviewed the existing literature and prepared this summary of recommendations for best AIT practice. The authors contributed equally and reached consensus on the statements presented herein.</AbstractText>
<CopyrightInformation>Copyright © 2015 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.</CopyrightInformation>
</Abstract>
<AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Jutel</LastName>
<ForeName>Marek</ForeName>
<Initials>M</Initials>
<AffiliationInfo><Affiliation>Department of Clinical Immunology, Wroclaw Medical University, and "ALL-MED" Medical Research Institute, Wroclaw, Poland. Electronic address: marek.jutel@umed.wroc.pl.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Agache</LastName>
<ForeName>Ioana</ForeName>
<Initials>I</Initials>
<AffiliationInfo><Affiliation>Faculty of Medicine, Transylvania University, Brasov, Romania.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Bonini</LastName>
<ForeName>Sergio</ForeName>
<Initials>S</Initials>
<AffiliationInfo><Affiliation>Second University of Naples and IFT-CNR, Rome, and Expert-on-Secondment European Medicines Agency, London, United Kingdom.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Burks</LastName>
<ForeName>A Wesley</ForeName>
<Initials>AW</Initials>
<AffiliationInfo><Affiliation>Department of Pediatrics, University of North Carolina, Chapel Hill, NC.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Calderon</LastName>
<ForeName>Moises</ForeName>
<Initials>M</Initials>
<AffiliationInfo><Affiliation>Section of Allergy and Clinical Immunology, Imperial College London, National Heart and Lung Institute, Royal Brompton Hospital, London, United Kingdom.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Canonica</LastName>
<ForeName>Walter</ForeName>
<Initials>W</Initials>
<AffiliationInfo><Affiliation>Allergy & Respiratory Diseases Clinic, DIMI University of Genoa, IRCCS AOU San Martino, Genova, Italy.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Cox</LastName>
<ForeName>Linda</ForeName>
<Initials>L</Initials>
<AffiliationInfo><Affiliation>Allergy and Asthma Center, Fort Lauderdale, Fla.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Demoly</LastName>
<ForeName>Pascal</ForeName>
<Initials>P</Initials>
<AffiliationInfo><Affiliation>University Hospital of Montpellier-INSERM U657, Montpellier, France.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Frew</LastName>
<ForeName>Antony J</ForeName>
<Initials>AJ</Initials>
<AffiliationInfo><Affiliation>Department of Respiratory Medicine, Royal Sussex County Hospital, Brighton, United Kingdom.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>O'Hehir</LastName>
<ForeName>Robyn</ForeName>
<Initials>R</Initials>
<AffiliationInfo><Affiliation>Department of Allergy, Immunology and Respiratory Medicine, The Alfred Hospital and Monash University, Melbourne, Australia.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Kleine-Tebbe</LastName>
<ForeName>Jörg</ForeName>
<Initials>J</Initials>
<AffiliationInfo><Affiliation>Allergy & Asthma Center Westend, Berlin, Germany.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Muraro</LastName>
<ForeName>Antonella</ForeName>
<Initials>A</Initials>
<AffiliationInfo><Affiliation>Department of Mother and Child Health, Padua General University Hospital, Padua, Italy.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Lack</LastName>
<ForeName>Gideon</ForeName>
<Initials>G</Initials>
<AffiliationInfo><Affiliation>Division of Asthma, Allergy and Lung Biology, MRC and Asthma UK Centre in Allergic Mechanisms of Asthma, King's College London, and the Children's Allergy Unit, Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Larenas</LastName>
<ForeName>Désirée</ForeName>
<Initials>D</Initials>
<AffiliationInfo><Affiliation>Hospital Médica Sur, Mexico City, Mexico.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Levin</LastName>
<ForeName>Michael</ForeName>
<Initials>M</Initials>
<AffiliationInfo><Affiliation>Division of Allergy, School of Child and Adolescent Health, Red Cross War Memorial Children's Hospital, Cape Town, South Africa.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Martin</LastName>
<ForeName>Bryan L</ForeName>
<Initials>BL</Initials>
<AffiliationInfo><Affiliation>Department of Allergy and Immunology, Walter Reed Army Medical Center, Silver Spring, Md.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Nelson</LastName>
<ForeName>Harald</ForeName>
<Initials>H</Initials>
<AffiliationInfo><Affiliation>National Jewish Health, Denver, Colo.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Pawankar</LastName>
<ForeName>Ruby</ForeName>
<Initials>R</Initials>
<AffiliationInfo><Affiliation>Department of Pediatrics, Nippon Medical School, Tokyo, Japan.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Pfaar</LastName>
<ForeName>Oliver</ForeName>
<Initials>O</Initials>
<AffiliationInfo><Affiliation>Center for Rhinology and Allergology, Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Mannheim, Mannheim, Germany.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>van Ree</LastName>
<ForeName>Ronald</ForeName>
<Initials>R</Initials>
<AffiliationInfo><Affiliation>Academic Medical Center, Departments of Experimental Immunology and of Otorhinolaryngology, University of Amsterdam, Amsterdam, The Netherlands.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Sampson</LastName>
<ForeName>Hugh</ForeName>
<Initials>H</Initials>
<AffiliationInfo><Affiliation>Department of Pediatrics, Division of Allergy-Immunology, and the Jaffe Food Allergy Institute at the Icahn School of Medicine at Mount Sinai, New York, NY.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Sublett</LastName>
<ForeName>James L</ForeName>
<Initials>JL</Initials>
<AffiliationInfo><Affiliation>Department of Pediatrics, Section of Allergy and Immunology, University of Louisville School of Medicine, Louisville, Ky.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Sugita</LastName>
<ForeName>Kazunari</ForeName>
<Initials>K</Initials>
<AffiliationInfo><Affiliation>Swiss Institute for Allergy and Asthma Research, University of Zurich, and Christine Kühne-Center for Allergy Research and Education, Davos, Switzerland.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Du Toit</LastName>
<ForeName>George</ForeName>
<Initials>G</Initials>
<AffiliationInfo><Affiliation>Department of Pediatric Allergy, Division of Asthma, Allergy & Lung Biology, King's College London, and MRC & Asthma UK Centre in Allergic Mechanisms of Asthma, London, United Kingdom.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Werfel</LastName>
<ForeName>Thomas</ForeName>
<Initials>T</Initials>
<AffiliationInfo><Affiliation>Department of Dermatology and Allergy, Division of Immunodermatology and Allergy Research, Hannover Medical School, Hannover, Germany.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Gerth van Wijk</LastName>
<ForeName>Roy</ForeName>
<Initials>R</Initials>
<AffiliationInfo><Affiliation>Erasmus Medical Center, Rotterdam, The Netherlands.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Zhang</LastName>
<ForeName>Luo</ForeName>
<Initials>L</Initials>
<AffiliationInfo><Affiliation>Beijing Institute of Otolaryngology, Beijing, China.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Akdis</LastName>
<ForeName>Mübeccel</ForeName>
<Initials>M</Initials>
<AffiliationInfo><Affiliation>Swiss Institute for Allergy and Asthma Research, University of Zurich, and Christine Kühne-Center for Allergy Research and Education, Davos, Switzerland.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Akdis</LastName>
<ForeName>Cezmi A</ForeName>
<Initials>CA</Initials>
<AffiliationInfo><Affiliation>Swiss Institute for Allergy and Asthma Research, University of Zurich, and Christine Kühne-Center for Allergy Research and Education, Davos, Switzerland.</Affiliation>
</AffiliationInfo>
</Author>
</AuthorList>
<Language>eng</Language>
<PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType>
<PublicationType UI="D016454">Review</PublicationType>
</PublicationTypeList>
</Article>
<MedlineJournalInfo><Country>United States</Country>
<MedlineTA>J Allergy Clin Immunol</MedlineTA>
<NlmUniqueID>1275002</NlmUniqueID>
<ISSNLinking>0091-6749</ISSNLinking>
</MedlineJournalInfo>
<ChemicalList><Chemical><RegistryNumber>0</RegistryNumber>
<NameOfSubstance UI="D000485">Allergens</NameOfSubstance>
</Chemical>
</ChemicalList>
<CitationSubset>AIM</CitationSubset>
<CitationSubset>IM</CitationSubset>
<MeshHeadingList><MeshHeading><DescriptorName UI="D000485" MajorTopicYN="N">Allergens</DescriptorName>
<QualifierName UI="Q000008" MajorTopicYN="N">administration & dosage</QualifierName>
<QualifierName UI="Q000276" MajorTopicYN="Y">immunology</QualifierName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D032921" MajorTopicYN="N">Consensus</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D003362" MajorTopicYN="N">Cost-Benefit Analysis</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D003888" MajorTopicYN="Y">Desensitization, Immunologic</DescriptorName>
<QualifierName UI="Q000191" MajorTopicYN="N">economics</QualifierName>
<QualifierName UI="Q000379" MajorTopicYN="N">methods</QualifierName>
<QualifierName UI="Q000592" MajorTopicYN="N">standards</QualifierName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D017850" MajorTopicYN="N">Economics, Pharmaceutical</DescriptorName>
<QualifierName UI="Q000331" MajorTopicYN="N">legislation & jurisprudence</QualifierName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D006967" MajorTopicYN="N">Hypersensitivity</DescriptorName>
<QualifierName UI="Q000276" MajorTopicYN="Y">immunology</QualifierName>
<QualifierName UI="Q000628" MajorTopicYN="Y">therapy</QualifierName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D007108" MajorTopicYN="N">Immune Tolerance</DescriptorName>
</MeshHeading>
</MeshHeadingList>
<KeywordList Owner="NOTNLM"><Keyword MajorTopicYN="N">International consensus</Keyword>
<Keyword MajorTopicYN="N">allergen standardization</Keyword>
<Keyword MajorTopicYN="N">allergen vaccine</Keyword>
<Keyword MajorTopicYN="N">allergy</Keyword>
<Keyword MajorTopicYN="N">cost-effectiveness</Keyword>
<Keyword MajorTopicYN="N">immunotherapy</Keyword>
<Keyword MajorTopicYN="N">marketing authorization</Keyword>
<Keyword MajorTopicYN="N">mechanisms</Keyword>
<Keyword MajorTopicYN="N">pharmacoeconomics</Keyword>
<Keyword MajorTopicYN="N">regulatory authorities</Keyword>
<Keyword MajorTopicYN="N">tolerance</Keyword>
<Keyword MajorTopicYN="N">unmet needs</Keyword>
</KeywordList>
</MedlineCitation>
<PubmedData><History><PubMedPubDate PubStatus="received"><Year>2015</Year>
<Month>10</Month>
<Day>23</Day>
</PubMedPubDate>
<PubMedPubDate PubStatus="revised"><Year>2015</Year>
<Month>11</Month>
<Day>30</Day>
</PubMedPubDate>
<PubMedPubDate PubStatus="accepted"><Year>2015</Year>
<Month>12</Month>
<Day>08</Day>
</PubMedPubDate>
<PubMedPubDate PubStatus="entrez"><Year>2016</Year>
<Month>2</Month>
<Day>9</Day>
<Hour>6</Hour>
<Minute>0</Minute>
</PubMedPubDate>
<PubMedPubDate PubStatus="pubmed"><Year>2016</Year>
<Month>2</Month>
<Day>9</Day>
<Hour>6</Hour>
<Minute>0</Minute>
</PubMedPubDate>
<PubMedPubDate PubStatus="medline"><Year>2016</Year>
<Month>7</Month>
<Day>1</Day>
<Hour>6</Hour>
<Minute>0</Minute>
</PubMedPubDate>
</History>
<PublicationStatus>ppublish</PublicationStatus>
<ArticleIdList><ArticleId IdType="pubmed">26853128</ArticleId>
<ArticleId IdType="pii">S0091-6749(15)03114-0</ArticleId>
<ArticleId IdType="doi">10.1016/j.jaci.2015.12.1300</ArticleId>
</ArticleIdList>
</PubmedData>
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