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Here, we provide an overview of pAIT with respiratory allergens concerning the prevention of new sensitizations, allergic disease onset and progression as well as further immunomodulatory effects. Three databases were searched for clinical pAIT studies in children. Selected publications were reviewed for preventive outcomes according to prevention level (primary, secondary, and tertiary), allergen type, administration route, dose, and treatment duration. The primary prevention approach appears safe but showed no allergen\u2010specific effect on new sensitizations. Secondary prevention seems feasible and may induce regulatory T cell\u2010mediated immunotolerance. The number of studies at these prevention levels is limited. Tertiary prevention with grass and\/or tree pollen\u2010based pAIT has shown efficacy in preventing disease progression from allergic rhinitis\/conjunctivitis to asthma. Data on tertiary pAIT with house dust mites and other allergen types are inconclusive. Subcutaneous and sublingual routes appear similarly effective, but head\u2010to\u2010head comparative paediatric studies are scarce. Additionally, there are fewer placebo\u2010controlled studies. Nevertheless, immunomodulatory outcomes of pAIT are encouraging. Currently, limited but favourably suggestive evidence is available for preventing respiratory allergic diseases in children by pAIT. Primary and secondary prevention have potential and warrant further investigation through well\u2010designed studies.<\/jats:p>","DOI":"10.1111\/all.16115","type":"journal-article","created":{"date-parts":[[2024,4,8]],"date-time":"2024-04-08T09:34:59Z","timestamp":1712568899000},"page":"2065-2087","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["Preventive allergen immunotherapy with inhalant allergens in children"],"prefix":"10.1111","volume":"79","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-3831-1852","authenticated-orcid":false,"given":"Varsha","family":"Dwivedi","sequence":"first","affiliation":[{"name":"Division of Paediatric Pulmonology, Allergy and Endocrinology, Department of Paediatrics and Adolescent Medicine, Comprehensive Centre of Paediatrics Medical University of Vienna  Vienna 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