The study evaluates the cycles during and after the sublingual and subcutaneous allergy immunotherapy in inhalation allergy, which is a result of clinical and immunological changes. Increase in the production of inhibitory cytokines, such as IL-10 and IgE and IgG4 allergens are induced both for seasonal and permanent allergens within weeks after immunotherapy. Typically, the start of efficacy requires two-to-four months of immunotherapy, with maximum clinical impact in 1-2 years. If immunotherapy is inoperative for 2 years, it is reasonable to stop treatment if optimum patient selection, good compliance or at least moderate exposure to allergens are assumed. At least three years of subcutaneous or sublingual immunotherapy is required in the long-term clinical efficacy and results in clinical and immunological tolerance, persistence of clinical benefits for years after treatment discontinuation, and abolition of type 2 immunity.

Sublingual immunotherapy and subcutaneous immunotherapy are both effective and well tolerated. Initial treatment phases involve clinical and immunological changes. Long-term assessments support guidelines that both routines of administration should be continued for at least 3 years to achieve modification and long-term tolerance of diseases in international guidelines.