Why is pet (cat/dog) allergen immunotherapy (AIT) such a controversial topic? Current perspectives and future directions

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Authors Information

1Department of Experimental Medicine, Postgraduate School of Respiratory Medicine, University of Rome Tor Vergata, Rome, Italy
2Department of Clinical and Molecular Sciences, Marche Polytechnic University, Ancona, Italy
3Allergy Unit, Department of Internal Medicine, University Hospital Ospedali Riuniti, Ancona, Italy
4SOS Allergy and Clinical Immunology, USL Toscana Centro, Prato, Italy
5Division of Pulmonology, S. Corona Hospital, Pietra Ligure, Savona, Italy
6Allergy and Clinical Immunology Unit, Department of Medical Sciences, University of Torino & Mauriziano Hospital, Turin, Italy
7Respiratory Medicine Unit, Department of Experimental Medicine, University of Rome Tor Vergata, Rome, Italy


Published: 09 February 2023
Accepted: 05 February 2023
Received: 23 October 2023 


Dogs and cats are the most common pets worldwide. In Italy, the prevalence of allergic sensitization to cats and dogs is 16% and 9%, respectively. The limited standardization of allergenic extracts, especially for dogs, empha­sizes the importance of component resolved diagnosis (CRD) for accurate diagnosis and subsequent prescription of allergen immunotherapy (AIT).
However, this low standardization is the main factor contributing to the unsatisfactory clinical efficacy of traditional AIT, AIT with modified al­lergens, and intralymphatic allergen-specific immunotherapy (ILAIT). Emerging immunological approaches, particularly for controlling the pri­mary cat allergen, show promise but are hindered by high costs (e.g., use of anti-Fel d 1 monoclonal antibodies in humans) or by exclusively targeting Fel d 1 produced by one’s own animal (e.g., immunizing cats to induce neutralizing antibodies against Fel d 1 or including an egg product with anti Fel d 1 IgY antibodies in feline diet). Further studies are imperative for standardizing pet allergens, enhancing the efficacy of various AIT mo­dalities, and exploring other immunological approaches, to optimize the relationship between pets and their owners and prevent distressing “forced removals”.

Allergic rhinitis; bronchial asthma; cat allergen; dog allergen; immunotherapy.

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