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Specific immunotherapy was introduced for the treatment of grass pollen-induced hay fever in 1911. The treatment was soon extended to other pollens as well as perennial allergens, and to the treatment of bronchial asthma. Definitive studies of its efficacy for both rhinitis and asthma came only many decades later.

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Background: Children are thought to "outgrow" the allergy to insect stings, but there are no reports documenting the natural history of this reaction. We studied the outcome of allergic reactions to insect stings in childhood 10 to 20 years afterward in patients who had not received venom immunotherapy and in those who had been treated.

Methods: Between 1978 and 1985, we diagnosed allergic reaction to insect stings in 1033 children, of whom 356 received venom immunotherapy.

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Immunotherapy: 1999-2004.

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June 2004

Johns Hopkins Asthma and Allergy Center, Johns Hopkins University School of Medicine, 5501 Hopkins Bayview Circle, Baltimore, MD 21224, USA.

Allergen immunotherapy continues to be used worldwide in the management of allergic rhinitis and asthma. We continue to refine our knowledge of the indications for immunotherapy, the allergens that can be used successfully, and the requirements for dosage and route of administration. Several additional allergens have been shown to be effective in controlled studies.

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