Abstract:

Allergic diseases represent a significant global health challenge， and allergen-specific immunotherapy （AIT）， as a first-line treatment， is the only therapeutic approach capable of altering the natural course of these diseases. This article provides a systematic review of the major advancements in AIT over recent years， encompassing novel routes of administration， the integration of biologics and adjuvants， advancements in allergen preparation， strategies for adverse reaction prevention and management， and efficacy evaluation methods. Among the new routes of administration， intratympanic， intratonsillar， epicutaneous， and intranasal immunotherapies have demonstrated safety， efficacy， and enhanced patient adherence. Biologics such as omalizumab， dupilumab， and Tezepelumab， each with distinct anti-allergic mechanisms， reduce adverse reactions and optimize outcomes when combined with AIT. The use of adjuvants represents another strategy to enhance AIT efficacy； agents like β-glucans， mannan， CpG oligodeoxynucleotides （CpG-ODN）， liposomes， and nanoparticles stimulate immune responses， promote immune tolerance， and improve the therapeutic effects of AIT. Recombinant allergens， produced through genetic engineering， offer high purity and consistency， providing more reliable and reproducible therapeutic results for AIT. In summary， this review highlights the latest developments in various approaches aimed at enhancing AIT efficacy， offering new insights into the treatment of allergic diseases.

Key words: allergen-specific immunotherapy, adjuvants, monoclonal antibody, recombinant allergens