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EAACI: A European Declaration on Immunotherapy. Designing the future of allergen specific immunotherapy

Moises A Calderon1*, Pascal Demoly2, Roy Gerth van Wijk3, Jean Bousquet4, Aziz Sheikh5, Anthony Frew6, Glenis Scadding7, Claus Bachert8, Hans J Malling9, Rudolph Valenta10, Beatrice Bilo11, Antonio Nieto12, Cezmi Akdis13, Jocelyne Just14, Carmen Vidal15, Eva M Varga16, Emilio Alvarez-Cuesta17, Barbara Bohle18, Albrecht Bufe19, Walter G Canonica20, Victoria Cardona21, Ronald Dahl22, Alain Didier23, Stephen R Durham24, Peter Eng25, Montserrat Fernandez-Rivas26, Lars Jacobsen27, Marek Jutel28, Jörg Kleine-Tebbe29, Ludger Klimek30, Jan Lötvall31, Carmen Moreno32, Ralph Mosges33, Antonella Muraro34, Bodo Niggemann35, Giovanni Pajno36, Giovanni Passalacqua37, Oliver Pfaar38, Sabina Rak39, Gianenrico Senna40, Gabriela Senti41, Erkka Valovirta42, Marianne van Hage43, Johannes C Virchow44, Ulrich Wahn45 and Nikolaos Papadopoulos46

Author Affiliations

1 Section of Allergy and Clinical Immunology, Imperial College, National Heart and Lung Institute, Dovehouse Street, London, SW3 6LY, UK

2 Department and INSERM U657, Hôpital Arnaud de Villeneuve, University Hospital of Montpellier, Montpellier, France

3 Department of Allergology, Erasmus MC-University Medical Center, Rotterdam, The Netherlands

4 Allergy Department and INSERM U657, Hôpital Arnaud de Villeneuve, University Hospital of Montpellier, Montpellier, France

5 The University of Edinburgh, Centre for Population Health Sciences, Edinburgh, UK

6 Department of Respiratory Medicine, Royal Sussex County Hospital, Brighton, UK

7 The Royal National Throat, Nose and Ear Hospital, London, UK

8 Upper Airway Research Laboratory (URL), Ghent University Hospital, Ghent, Belgium

9 Allergy Clinic, National University Hospital, Copenhagen, Denmark

10 Division of Immunopathology, Department of Pathophysiology and Allergy Research, Centre for Pathophysiology, Infectiology & Immunology, Medical University of Vienna, Vienna, Austria

11 Department of Internal Medicine, Immunology, Allergy & Respiratory Diseases, University Hospital, Ospedali Riuniti di Ancona, Ancona, Italy

12 Pediatric Allergy and Pneumology Unit, Children's Hospital La Fe, Valencia, Spain

13 Swiss Institute of Allergy and Asthma Research (SIAF), University of Zurich, Davos, Switzerland

14 Centre de l'Asthme et des Allergies, Hôpital d'enfant Armand Trousseau, Paris, France

15 Department of Allergy, Hospital Clinico Universitario, Santiago de Compostela, Spain

16 Department of Paediatrics, Respiratory and Allergic Disease Division, Medical University Graz, Graz, Austria

17 Allergy Division, Ramon & Cajal University Hospital, Alcala de Henares University, Madrid, Spain

18 Department of Pathophysiology and Allergy Research, Christian Doppler Laboratory for Immunomodulation, Medical University of Vienna, Vienna, Austria

19 Department of Experimental Pneumology, Ruhr-University, Bochum, Germany

20 Allergy and Respiratory Diseases Clinic, Department of Internal Medicine, University of Genoa, Genoa, Italy

21 Allergy Section, Department of Internal Medicine, Hospital Universitari Vall d'Hebron, Barcelona, Spain

22 Department of Respiratory Diseases, Aarhus University Hospital, Aarhus, C, 8000, Denmark

23 Service de Pneumologie-Allergologie, Hôpital Larrey, CHU de Toulouse, Toulouse, France

24 Section of Allergy and Clinical Immunology, National Heart and Lung Institute, Imperial College and Royal Brompton Hospital, London, United Kingdom

25 Allergy Unit, Children’s Hospital, Kantonsspital Aarau, Switzerland

26 Hospital Clínico San Carlos, Facultad de Medicina-UCM, IdISSC, Madrid, Spain

27 Research Centre for Prevention and Health, Glostrup University Hospital, Copenhagen, Denmark

28 Department of Clinical Immunology, Wroclaw Medical University, Wrocław, Poland

29 Allergy & Asthma Center Westend, Outpatient Clinic Hanf, Ackermann & Kleine-Tebbe, Berlin, Germany

30 Center for Rhinology and Allergology, Wiesbaden, Germany

31 Krefting Research Centre, Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden

32 Seccion de Alergia, Hospital Reina Sofía, Cordoba, Spain

33 Institute of Medical Statistics, Informatics and Epidemiology (IMSIE), Medical Faculty, University at Cologne, Cologne, Germany

34 Department of Pediatrics, Padua General Hospital, Padua, Italy

35 Pediatric Allergology and Pneumology, German Red Cross Clinic Westend, Berlin, Germany

36 Department of Pediatrics, Allergy Unit, University of Messina, Messina, Italy

37 Allergy and Respiratory Diseases, University of Genoa, Genoa, Italy

38 Center for Rhinology and Allergology, Wiesbaden, Germany

39 Department of Respiratory Medicine and Allergology, Sahlgrenska University Hospital, Goteborg, Sweden

40 Allergy Service, Verona General Hospital, Verona, Italy

41 Clinical Trials Center, University Hospital Zurich, Zurich, Switzerland

42 Suomen Terveystalo Allergy Clinic, Turku, Finland

43 Division of Respiratory Medicine, Department of Medicine, Karolinska Institutet, Stockholm, Sweden

44 Department of Pulmonology, Intensive Care Medicine, Zentrum f. Innere Medizin, Klinik I, University Clinic Rostock, Rostock, Germany

45 Department for Pediatric Pneumology and Immunology, Charité Medical University, Berlin, Germany

46 UPC Research Laboratories, Allergy Department, 2nd Pediatric Clinic, University of Athens, Athens, Greece

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Clinical and Translational Allergy 2012, 2:20  doi:10.1186/2045-7022-2-20

Published: 30 October 2012


Allergy today is a public health concern of pandemic proportions, affecting more than 150 million people in Europe alone. In view of epidemiological trends, the European Academy of Allergy and Clinical Immunology (EAACI) predicts that within the next few decades, more than half of the European population may at some point in their lives experience some type of allergy.

Not only do allergic patients suffer from a debilitating disease, with the potential for major impact on their quality of life, career progression, personal development and lifestyle choices, but they also constitute a significant burden on health economics and macroeconomics due to the days of lost productivity and underperformance. Given that allergy triggers, including urbanization, industrialization, pollution and climate change, are not expected to change in the foreseeable future, it is imperative that steps are taken to develop, strengthen and optimize preventive and treatment strategies.

Allergen specific immunotherapy is the only currently available medical intervention that has the potential to affect the natural course of the disease. Years of basic science research, clinical trials, and systematic reviews and meta-analyses have convincingly shown that allergen specific immunotherapy can achieve substantial results for patients, improving the allergic individuals’ quality of life, reducing the long-term costs and burden of allergies, and changing the course of the disease. Allergen specific immunotherapy not only effectively alleviates allergy symptoms, but it has a long-term effect after conclusion of the treatment and can prevent the progression of allergic diseases.

Unfortunately, allergen specific immunotherapy has not yet received adequate attention from European institutions, including research funding bodies, even though this could be a most rewarding field in terms of return on investments, translational value and European integration and, a field in which Europe is recognized as a worldwide leader. Evaluation and surveillance of the full cost of allergic diseases is still lacking and further progress is being stifled by the variety of health systems across Europe. This means that the general population remains unaware of the potential use of allergen specific immunotherapy and its potential benefits.

We call upon Europe’s policy-makers to coordinate actions and improve individual and public health in allergy by:

Promoting awareness of the effectiveness of allergen specific immunotherapy

Updating national healthcare policies to support allergen specific immunotherapy

Prioritising funding for allergen specific immunotherapy research

Monitoring the macroeconomic and health economic parameters of allergy

Reinforcing allergy teaching in medical disciplines and specialties

The effective implementation of the above policies has the potential for a major positive impact on European health and well-being in the next decade.

Allergy; Asthma; Rhinitis; Immunotherapy; Health economics; Quality of life