What is Allergy Immunology?

Greg Caramenico

Allergy immunology is a subspecialty of medicine. Physicians in this field treat diseases of the immune system such as allergic reactions, anaphylactic shock, asthma, autoimmune disorders and transplant rejection. Allergy immunology is important to other fields of clinical medicine and research, especially dermatology, pulmonology, infectious diseases and transplant surgery. Some physicians in this specialty are called allergists, and they mostly work in allergy clinics. Research topics in immunology are robust and range widely, from the study of plant- and animal-induced allergies to the development of better treatments for immunodeficiency.

An allergy immunologist can help a patient manage long-term allergies.
An allergy immunologist can help a patient manage long-term allergies.

Clinically, allergy immunology specialists diagnose and treat patients for many conditions, including allergic reactions that are caused by other, non-immune diseases. As with most specialties, patients usually arrive by referral from primary care providers or hospital admitting physicians. Allergists provide extensive allergy testing, screen for food or substance sensitivity and provide treatments such as oral anti-inflammatories and steroid injections. Allergy clinics also develop personal treatment regimens for patient allergies, with specialized diets designed to avoid offending foods.

Immunologists may focus on specific allergies, such as sinus allergies.
Immunologists may focus on specific allergies, such as sinus allergies.

Allergy immunology includes the hospital care of patients with anaphylactic shock, systemic food allergies and severe cases of asthma that have become life-threatening. Research suggests that asthmatic patients who are cared for by allergists/immunologists have fewer breathing problems and respond better to therapy than those receiving more generalized medical care. Hospital care also includes treatment of those suffering with immunosuppression, from human immunodeficiency virus (HIV) patients to recipients of organ transplants who require constant treatment to prevent their immune systems from rejecting the new tissue that they have received. Without this field, organ transplantation would not be possible.

An allergy immunology specialist helps patients to pinpoint the cause of their allergies.
An allergy immunology specialist helps patients to pinpoint the cause of their allergies.

Major priorities in allergy and immunology research reflect the challenges of treating a biological system with very diverse cellular and systemic functions. One key interest is in the development of better drugs to reduce immunosuppression in HIV. Work on preventing transplant rejection without complete suppression of T-cell response also receives much funding and intellectual dedication. Some researchers have tried to improve immunization efficacy or develop new vaccines, often in conjunction with virologists. Immunologists also pursue research into lupus and other autoimmune diseases with no known cures, incorporating techniques from genetics and molecular biology into their inquiry.

Depending on the severity of the allergy, people may experience symptoms when cooking with onions.
Depending on the severity of the allergy, people may experience symptoms when cooking with onions.

Physicians who specialize in allergy immunology must first complete an internship and residency in internal medicine or pediatrics. They then pursue a two- to three-year fellowship. Education involves adult and pediatric consultation and comprehensive training in laboratory medicine. Additional clinical learning might include rotations in allergy clinics, HIV care, transplantation immunology, pediatric and adult asthma centers, otolaryngology and hematology. Many fellows perform their own clinical or basic science research in these fields before taking a certification test.

Sore throats are common with a variety of allergies.
Sore throats are common with a variety of allergies.
One recent focus of immunology has been to improve on the current cocktail of antiretroviral drugs used to treat HIV.
One recent focus of immunology has been to improve on the current cocktail of antiretroviral drugs used to treat HIV.

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