Slowing Progression Along the Allergic Disease Continuum: Quo Vadit Immunotherapy?

There is emerging evidence that rhinitis frequently precedes the onset of asthmatic symptoms. The frequent association of rhinitis and asthma has led to the concept that these conditions are likely manifestations of the same disease. This hypothesis has important implications for both the diagnosis and the management of these common conditions. Unfortunately, there is little known regarding the risk factors responsible for the progression of rhinitis to asthma. The current treatment options can control symptoms but do not prevent or cure the disease. However, there is recent data supporting the notion that it is possible to prevent new asthma cases by modifying the immune response and clinical outcome with allergen immunotherapy. This review article evaluates the impact of rhinitis on the development of asthma, examines putative predictors for the progression of rhinitis to asthma, and reviews recent, promising literature suggesting that early treatment of allergic individuals with immunotherapy may aid in asthma prevention.