Definition Benefit to patient Immune mechanisms
Desensitisation A temporary increase in reaction threshold. Maintained by continuing daily treatment. Patient is protected from accidental reactions but ongoing maintenance dosing must be continued life-long. Temporary suppression of basophil and mast cell (effector cell) responses. Increased sIgG4; no change in serum levels of sIgE or modest reduction after prolonged treatment.
Remission Also referred to as sustained unresponsiveness. The absence of clinical reactivity that persists weeks or months after stopping treatment. Individual may stop treatment and consume the allergen freely in the diet. Some level of allergen intake is considered important to consolidate the immune changes supporting remission. Remission/SU is thought to result from redirection of the underlying allergy towards tolerance, however the precise immune changes involved remain poorly understood.
Long-term remission Lasting persistence of remission/SU years after treatment discontinuation. As it is not possible to demonstrate permanence of a treatment effect in the clinical trial setting, long-term remission/SU may offer a surrogate measure of true immune tolerance/resolution of allergy. Mechanistic studies with data years after treatment remain rare and the immune drivers leading to long-term remission remain unidentified.