Tehran University of Medical Sciences Iranian Journal of Allergy, Asthma and Immunology 1735-1502 23 2 2024 04 07 149 157 Maryam Khoshkhui Allergy Research Center, Mashhad University of Medical Sciences, Mashhad, Iran Farahzad Jabbari Allergy Research Center, Mashhad University of Medical Sciences, Mashhad, Iran Fateme Shafiee Zargar Department of Radiology, Qaem Hospital, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran Nasrin Motavalli Haghi Allergy Research Center, Mashhad University of Medical Sciences, Mashhad, Iran Nazila Ariaee Allergy Research Center, Mashhad University of Medical Sciences, Mashhad, Iran 2023 06 07 2024 01 17 Allergen-specific immunotherapy is the only disease-modifying treatment for IgE-mediated allergic disorders. Intra lymphatic immunotherapy (ILIT) is an efficacious and time-saving alternative to subcutaneous immunotherapy (SCIT). This study aimed to evaluate the effects and safety of ILIT in patients with moderate to severe allergic rhinitis.  In this clinical trial, patients between 18 and 65 years old with moderate to severe allergic rhinitis were enrolled. They received monthly intra-lymphatic inguinal injections of an active allergen (1000 SQ-U Salsola kali pollen). Their clinical symptoms were assessed before and four weeks after treatments. The clinical signs were also evaluated during two consecutive pollination seasons and the following non-pollination season in April. No moderate or severe reactions were recorded following ILIT treatment. Lymph node enlargement, angioedema/urticaria, and local itching were seen instantly after injection. Patients who received ILIT experienced a significant clinical improvement in self-recorded seasonal allergic symptoms after the treatments, compared to themselves before ILIT. Furthermore, their quality of life significantly improved. This study suggests ILIT with Salsola-pollen extract may decrease symptoms of allergic rhinitis. It was safe and did not cause any crucial complications. https://ijaai.tums.ac.ir/index.php/ijaai/article/view/3852 https://ijaai.tums.ac.ir/index.php/ijaai/article/download/3852/2055