Pros and Cons of Intralymphatic Immunotherapy (ILIT)

Flory S, Hviid- Vyff B, Šošić L, et al. How to hit the allergy target: A critical appraisal of intralymphatic immunotherapy with practical recommendations on ultrasound- guided injections. Allergy. 2024;00:1-13

Intralymphatic Immunotherapy (ILIT) is an emerging, fast-track alternative to traditional allergy shots. Instead of years of weekly injections, ILIT targets the immune system directly at its source: the lymph nodes.

The Pros: Speed and Convenience

• Rapid Timeline: While traditional subcutaneous immunotherapy (SCIT) typically requires 3–5 years and up to 100 injections, the ILIT Protocol usually involves just three injections over a two-month period.

• Fast-Acting Relief: Many patients report significant symptom reduction within weeks or months, rather than the 6–12 months often required for traditional shots to take effect.

• High Safety Profile: By injecting directly into lymph nodes—which contain very few mast cells (the triggers for allergic reactions)—the risk of severe systemic reactions like anaphylaxis is significantly lower than with standard shots.

• Minimal Pain: Surprisingly, lymph node injections are described as practically painless, often less so than a standard blood draw, because the nodes lack traditional pain-sensing nerves.

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The Cons: Cost and Availability

• Financial Barrier: Because ILIT is not yet FDA-approved, it is typically not covered by insurance. Patients often pay $3,000 to $5,000 out-of-pocket for the full series.

• Access: Only a limited number of specialized clinics, such as Avant Allergy in Los Angeles currently offer the procedure under ultrasound guidance.