**8. Treatments**

Advancement in allergy research had made enormous contribution for the treatment of mild to severe allergic diseases. There are many treatments available to treat various symptoms of allergic diseases and several medications are available and are effectively treat and manage atopic conditions. For anaphylaxis epinephrine shots are available which can be carried with the patients and for others, anti histamines and anti inflammatory drugs are routinely recommended to cope up with the symptoms [46, 47]. Depending on the source of allergens various diagnosis methods have been devised and based on those therapeutic methods have evolved to address problems associated with allergic reactions. The following are some commonly followed approaches to treat allergic diseases.

#### **8.1 Avoidance**

Avoiding exposure to allergen is the best and valid recommendation for limiting allergic reactions in sensitized individuals. It is one of the simple and traditional approach for treatment of allergy. However, it becomes difficult to avoid certain environmental allergen which are dispersed in the air and can be easily inhaled without any notice or have any control. In such cases the avoidance becomes difficult and need alternative therapeutic methods to address problems.

#### **8.2 Pharmacotherapy**

When allergen tracking and avoidance is not possible and exposure to allergen becomes inevitable then the pharmacotherapy can provide protection to ease of allergen induced symptoms. Many drugs have been designed which act as antagonistic to the allergic mediators and block their actions. Some common drug targets are anti histamines and anti leukotrienes which prevent the action of inflammatory mediators and block the appearance of allergic symptoms [46]. The FDA approve drugs that include antihistamines, adrenaline (epinephrine), theophylline and Glucocorticosteroids which acts primarily as anti inflammatory molecules. The antileukotrienes such as Montelukast (Singulair) or Zafirlukast (Accolate) are in common use along with mast cell stabilizer, decongestants and eosinophil chemotoxins are used as drugs to prevent and monitor acute and chronic allergic disorders [47].

#### **8.3 Immunotherapy**

In case the allergen has been identified and sensitization process is well established with the subject, in that case the desensitization or hyposensitization is adopted as treatment to vaccinate the allergic subject with small doses of allergen over a long period. During this the subject tolerates the allergen dose and reduces its sensitivity and increase IgG production over IgE that avoid allergic reactions. Studies have demonstrated the efficiency of this type of immune therapy and the long term practice had shown preventive effect of immunotherapy in reducing the development of atopy. A second form of immunotherapy involves the intravenous

injection of monoclonal anti-IgE antibodies. These bind to free and B-cell associated IgE; signaling and induce their destruction [48]. A third type, Sublingual immunotherapy, is an orally-administered therapy that takes advantage of oral immune tolerance to non-pathogenic antigens such as foods and resident bacteria [49]. Allergen shot treatment may appear as future closest therapy to cure for allergy. This therapy requires close monitoring and long-term commitment for the efficient treatment by the subject.
