Allergen-Immuntherapie: Facts und FAQs

Mortasawi, V.; Pfützner, Wolfgang

doi:10.1007/s00105-021-04872-8

Cited by 4 publications

(5 citation statements)

References 72 publications

(101 reference statements)

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“…However, information is available from studies of patients receiving different types of vaccinations at the same time. Because of various immunological similarities, this information can be applied to VIT, which is also called “allergy vaccination” [ 105 ]. For example, vaccinations are considered effective even when combined with long-term systemic administration (> 4 weeks) of less than 20 mg prednisolone equivalent/day [ 106 ].…”

Section: Allergen-specific Immunotherapymentioning

confidence: 99%

Diagnosis and treatment of Hymenoptera venom allergy

Ruëff,

Bauer,

Becker

et al. 2023

ALS

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Hymenoptera venom (HV) is injected into the skin during a sting by Hymenoptera such as bees or wasps. Some components of HV are potential allergens and can cause large local and/or systemic allergic reactions (SAR) in sensitized individuals. During their lifetime, ~ 3% of the general population will develop SAR following a Hymenoptera sting. This guideline presents the diagnostic and therapeutic approach to SAR following Hymenoptera stings. Symptomatic therapy is usually required after a severe local reaction, but specific diagnosis or allergen immunotherapy (AIT) with HV (VIT) is not necessary. When taking a patient’s medical history after SAR, clinicians should discuss possible risk factors for more frequent stings and more severe anaphylactic reactions. The most important risk factors for more severe SAR are mast cell disease and, especially in children, uncontrolled asthma. Therefore, if the SAR extends beyond the skin (according to the Ring and Messmer classification: grade > I), the baseline serum tryptase concentration shall be measured and the skin shall be examined for possible mastocytosis. The medical history should also include questions specific to asthma symptoms. To demonstrate sensitization to HV, allergists shall determine concentrations of specific IgE antibodies (sIgE) to bee and/or vespid venoms, their constituents and other venoms as appropriate. If the results are negative less than 2 weeks after the sting, the tests shall be repeated (at least 4 – 6 weeks after the sting). If only sIgE to the total venom extracts have been determined, if there is double sensitization, or if the results are implausible, allergists shall determine sIgE to the different venom components. Skin testing may be omitted if in-vitro methods have provided a definitive diagnosis. If neither laboratory diagnosis nor skin testing has led to conclusive results, additional cellular testing can be performed. Therapy for HV allergy includes prophylaxis of reexposure, patient self treatment measures (including use of rescue medication) in the event of re-stings, and VIT. Following a grade I SAR and in the absence of other risk factors for repeated sting exposure or more severe anaphylaxis, it is not necessary to prescribe an adrenaline auto-injector (AAI) or to administer VIT. Under certain conditions, VIT can be administered even in the presence of previous grade I anaphylaxis, e.g., if there are additional risk factors or if quality of life would be reduced without VIT. Physicians should be aware of the contraindications to VIT, although they can be overridden in justified individual cases after weighing benefits and risks. The use of β-blockers and ACE inhibitors is not a contraindication to VIT. Patients should be informed about possible interactions. For VIT, the venom extract shall be used that, according to the patient’s history and the results of the allergy diagnostics, was the trigger of the disease. If, in the case of double sensitization and an unclear history regarding the trigger, it is not possible to de...

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Section: Allergen-specific Immunotherapymentioning

confidence: 99%

Diagnosis and treatment of Hymenoptera venom allergy

Ruëff,

Bauer,

Becker

et al. 2023

ALS

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“…Wenn eine Hyposensibilisierung geplant ist, erfolgen RAST und Pricktest. Es ist sehr fraglich, ob sich IgE-Spiegel und -spezifitäten als Biomarker für Verlaufskontrollen einer Hyposensibilisierung oder der Therapie einer atopischen Dermatitis eignen [33]. Allgemein gilt: Hohes IgE heißt nicht automatisch Atopie (Familienanamnese und v. a. klinisches Bild gehören nach Hanifin und Raika dazu [25,32]).…”

Section: Heutzutage Braucht Jeder Einen Allergietest (?)unclassified

“…Dies gilt auch für einen möglichen Zusammenhang einer Nahrungsmittelallergie als Auslöser einer chronischen Urtikaria oder als Trigger für eine atopische Dermatitis. Hier sei auf kürzlich erschienene ausgezeichnete Übersichtsarbeiten verwiesen [33,34].…”

Section: Heutzutage Braucht Jeder Einen Allergietest (?)unclassified

Immunologie in der dermatologischen Praxis – wieviel, warum, wann?

Diamanti¹,

Föhr

Papageorgiou³

et al. 2022

Aktuelle Dermatologie

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ZusammenfassungDie Haut als Grenzorgan zum Körperäußeren realisiert viele immunologische Abwehrfunktionen. Folglich sind Immunologie und Dermatologie eng miteinander verknüpft. Die Diagnostik immunologischer Hauterkrankungen und deren Immuntherapie, labormedizinische Analysen, Hyposensibilisierung – Begegnungen mit der Immunologie finden auch in einer dermatologischen Praxis im Alltag nahezu ständig statt. Ziel dieser Arbeit ist es, praxisnah aufzuzeigen, wie uns Dermatologen die Immunologie in unserer Fachdisziplin helfen kann.

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“…In comparison with parenteral, non-invasive ASIT methods have a number of advantages: sufficiently high efficiency, the possibility of outpatient treatment, good tolerability, the ability to achieve high course doses of the allergen, a low risk of anaphylactic reactions, safety, and non-trauma [ 15 – 17 ].…”

Section: Introductionmentioning

confidence: 99%

Clinical efficiency of allergen-specific immunotherapy with fungal allergens in patients with chronic polypous rhinosinusitis against the background of fungal sensitization

et al. 2022

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Fungal flora is one of the causes of inflammatory, including polypous, processes in the nasal cavity. In this regard, studies aimed at reducing the effect of fungal sensitization (FS) on the course of chronic polypous rhinosinusitis (CPRS) are relevant. The objective of the study was to evaluate the effect of various treatment options on the clinical course of the disease in patients with chronic polypous rhinosinusitis against the background of sensitization to fungi. The study included 90 patients with chronic polypous rhinosinusitis in combination with FS. The patients were divided into two groups – the first clinical group (G1) and the second clinical group (G2). G1 patients received allergen-specific immunotherapy (ASIT) according to the scheme. G2 patients received basic treatment. Evaluation of the clinical efficiency of ASIT was made based on complaints, assessment of symptom severity on a visual analog scale (VAS), and rhinoendoscopic examination. The treatment outcomes were evaluated on a 4-point scale, with excellent results (4 points) – complete remission of the disease during the follow-up period (6–12 months); good (3 points) – exacerbation of the disease 1-2 times a year, in mild form and removed by expectant treatment; satisfactory (2 points) – the number of exacerbations did not decrease. The use of ASIT therapy is pathogenetically justified and leads to a significant improvement in the clinical condition of patients with CPRS with FS.

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Allergen-Immuntherapie: Facts und FAQs

Cited by 4 publications

References 72 publications

Diagnosis and treatment of Hymenoptera venom allergy

Diagnosis and treatment of Hymenoptera venom allergy

Immunologie in der dermatologischen Praxis – wieviel, warum, wann?

Clinical efficiency of allergen-specific immunotherapy with fungal allergens in patients with chronic polypous rhinosinusitis against the background of fungal sensitization

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