Master Course in Allergen Immunotherapy (AIT)

MODULE 1: Foundations of Immunotherapy (Weeks 1–3)

Session 1. History, Evolution & Philosophy of AIT

• Evolution from Noon and Freeman to precision AIT
• Disease-modifying concept
• Global practice models (Europe, USA, Asia)

Session 2. Immunology of Tolerance Induction

• Immune deviation, Treg induction
• IgG4 blocking antibodies
• Dendritic cell reprogramming
• Why some well-selected patients still fail AIT
• Primary vs secondary non-responders
• Poor adherence versus true immunological failure
• Incorrect extract selection
• Underdosing
• What immunologic changes matter clinically
• Biomarkers worth ordering vs academic markers

Session 3. Allergen Extracts & Manufacturing Science

• Natural vs recombinant allergens
• Standardization, potency units (IR, SQ, AU, BU)
• Quality control, storage, stability
• Regulatory frameworks (EMA, FDA, CDSCO)

MODULE 2: Clinical Indications & Patient Selection (Weeks 4–6)

Session 4. Indications & Contraindications for AIT

• Allergic rhinitis, asthma, venom allergy
• Atopic dermatitis, food allergy (current status)
• Age limits, pregnancy, comorbidities
• ENT / Pulmonology / Pediatric Red Flags

Session 5. Phenotypes, Endotypes & Precision AIT

• Th2-high vs Th2-low
• Biomarkers predicting response
• CRD patterns that change extract choice
• When polysensitization is real vs noise

Session 6. Diagnostic Work-up Before AIT

• Skin prick testing protocols
• Serum IgE, CRD interpretation
• Challenge tests
• Baseline lung function & asthma control metrics

MODULE 3: SCIT – Science & Practice (Weeks 7–10)

Session 7. Subcutaneous Immunotherapy (SCIT): Principles & Protocols

• Build-up vs cluster vs rush
• Maintenance schedules
• Dose adjustments – step-up vs step-down

Session 8. SCIT in Allergic Rhinitis & Asthma

• Evidence base and meta-analyses
• Outcomes and real-world data
• Pediatric vs adult protocols

Session 9. Safety, Adverse Events & Emergency Preparedness

• Local vs systemic reactions
• Anaphylaxis management in AIT clinics
• Risk mitigation strategies

Session 10. SCIT in Special Populations

• Young children
• Elderly
• Pregnancy
• Severe asthma
• Poly-sensitized patients

MODULE 4: SLIT & Novel Delivery Platforms (Weeks 11–13)

Session 11. Sublingual Immunotherapy (SLIT)

• Tablets vs drops
• Adherence and real-world outcomes
• Cost-effectiveness

Session 12. SLIT Protocols & Practical Implementation

• Dose titration
• Home initiation models
• Monitoring and follow-up

Session 13. Emerging AIT Platforms

• Epicutaneous IT
• Intralymphatic IT
• Modified allergens (allergoids, peptides, DNA vaccines)
• Monoclonal antibodies as adjuncts
• Recombinant allergen vaccines
• mRNA allergy vaccines
• Nanoparticle delivery systems

MODULE 5: Advanced & Special AIT Applications (Weeks 14–16)

Session 14. Venom Immunotherapy (VIT)

• Indications, protocols, life-saving role
• Emergency preparedness
• Duration and stopping rules

Session 15. AIT in Food Allergy & Oral Immunotherapy (OIT)

• Current evidence
• Safety controversies
• Where AIT and OIT converge
• Indian perspective

Session 16. AIT in Atopic Dermatitis & Chronic Urticaria

• Evidence gaps
• Case-based discussion

MODULE 6: Practice, Policy & Future (Weeks 17–20)

Session 17. Setting Up an AIT Clinic

• Infrastructure, staffing
• SOPs, consent, documentation
• Medico-legal risk mitigation
• Billing & reimbursement models
• Hospital vs clinic decision-making

Session 18. Monitoring Outcomes & Stopping Criteria

• Symptom scores, QoL tools
• Biomarkers of response
• When and how to stop AIT

Session 19. Case-Based Global Panel Discussion

• Complex AIT cases from India & abroad
• Failures and troubleshooting

Session 20. Future of Immunotherapy & Precision Allergy

• AI-guided AIT
• Personalized vaccines
• Policy and global allergy burden