immunotherapy in bronchial asthma

1. Current conventional asthma medications are the gold standard treatment of asthma and has excellent effect with minor drawbacks .2. In some selected cases, immunotherapy remains the only truly disease-modifying treatment for asthma and allergic rhinitis. It restores the normal immune response to common allergens, and may be helpful in some but not all cases of bronchial asthma.3. Immunotherapy can prevent new sensitizations in monosensitized individuals. Furthermore, its salutary effects continue for years after completion of the course of treatment.4. The factors limiting the greater use of immunotherapy are concerns of safety, treatment schedules, controversy about results, and the development of anti-IgE (omalizumab).5. sublingual administration of the allergen extracts; sublingual immunotherapy (SLIT); is more safe than subcutaneous immunotherapy in treatment in bronchial asthma but short term studies showed that it is quite less effective.6. Anti-IgE (omalizumab) is a treatment option limited to patients with elevated serum levels of IgE. Its current indication is for patients with severe allergic asthma who are uncontrolled on inhaled glucocorticosteroids .