Subcutaneous allergen immunotherapy has been practiced clinically for decades to treat airborne allergies. Recently, the cutaneous route, which exploits the immunocompetence of the skin has received attention, which is evident from attempts to use it to treat peanut allergy. Delivery of allergens into the skin is inherently impeded by the barrier imposed by stratum corneum, the top layer of the skin. While the stratum corneum barrier must be overcome for efficient allergen delivery, excessive disruption of this layer can predispose to development of allergic inflammation. Thus, the most desirable allergen delivery approach must provide a balance between the level of skin disruption and the amount of allergen delivered. Such an approach should aim to achieve high allergen delivery efficiency across various skin types independent of age and ethnicity, and optimize variables such as safety profile, allergen dosage, treatment frequency, application time and patient compliance. The ability to precisely quantify the amount of allergen being delivered into the skin is crucial since it can allow for allergen dose optimization and can promote consistency and reproducibility in treatment response. In this work we review prominent cutaneous delivery approaches, and offer a perspective on further improvisation in cutaneous allergen-specific immunotherapy.

皮下过敏原免疫疗法已在临床上实践了数十年，以治疗空气传播的过敏症。最近，利用皮肤免疫能力的皮肤途径受到了关注，这从尝试使用它来治疗花生过敏的尝试中可以看出。皮肤表层角质层施加的屏障固有地阻碍了过敏原向皮肤的传递。虽然必须克服角质层屏障才能有效地传递过敏原，但过度破坏该层会导致过敏性炎症的发展。因此，最理想的过敏原输送方法必须在皮肤破坏程度和输送的过敏原量之间取得平衡。这种方法应旨在实现跨不同年龄和种族的不同皮肤类型的高过敏原递送效率，并优化安全性、过敏原剂量、治疗频率、应用时间和患者依从性等变量。精确量化输送到皮肤中的过敏原量的能力至关重要，因为它可以优化过敏原剂量，并可以促进治疗反应的一致性和可重复性。在这项工作中，我们回顾了突出的皮肤给药方法，并就进一步即兴皮肤过敏原特异性免疫治疗提供了一个视角。精确量化输送到皮肤中的过敏原量的能力至关重要，因为它可以优化过敏原剂量，并可以促进治疗反应的一致性和可重复性。在这项工作中，我们回顾了突出的皮肤给药方法，并就进一步即兴皮肤过敏原特异性免疫治疗提供了一个视角。精确量化输送到皮肤中的过敏原量的能力至关重要，因为它可以优化过敏原剂量，并可以促进治疗反应的一致性和可重复性。在这项工作中，我们回顾了突出的皮肤给药方法，并就进一步即兴皮肤过敏原特异性免疫治疗提供了一个视角。