Reasons for the ineffectiveness of allergen-specific immunotherapy

Peredkova, E.V.; Sebekina, O.V.; Nenasheva, N.M.

doi:10.46393/2712-9667_2021_2_30_38

Cited by 2 publications

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“…Эффективность АСИТ (отличный и хороший результаты), по данным разных источников, от 62,9% [6] до 85,7% [7]. Причиной низкой эффективности АСИТ могут быть поздняя диагностика АР и позднее назначение АСИТ, множественная сенсибилизация пациента, низкая доза лечебного аллергена, недостаточное количество курсов АСИТ, высокая экспозиция аллергена [8].…”

Section: Introductionunclassified

Comprehensive Treatment of Allergic Rhinitis

Санникова¹

2022

Рецепт

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Введение. В основе лечения аллергического ринита (АР) лежит элиминация аллергенов, медикаментозная терапия и аллерген-специфическая иммунотерапия (АСИТ). Для уменьшения клинических проявлений АР у пациентов и повышения качества жизни нами предложено дополнить симптоматическую терапию и предсезонную АСИТ пыльцевыми аллергенами курсом подземной спелеотерапии в сезон палинации в условиях ГУ «Республиканская больница спелеолечения» (ГУ «РБС»). Цель. Сравнить клинико-иммунологические показатели у пациентов с АР до и после проведения комплексного лечения: предсезонного курса подкожной АСИТ причинно-значимым пыльцевым аллергеном и курса подземной спелеотерапии в ГУ «РБС» в сезон палинации. Материалы и методы. Случайным образом было отобрано 15 пациентов, которые после АСИТ получили курс подземной спелеотерапии в ГУ «Республиканская больница спелеолечения». У всех 15 пациентов выявлена сенсибилизация к пыльцевым аллергенам. Каждый из пациентов оценил выраженность клинических проявлений АР (выделений из носа, заложенности носа, чихания и зуда носа) до лечения и после лечения по 4-балльной шкале. Результаты. Уменьшение размера прик-теста почти на 40% свидетельствует о снижении уровня сенсибилизации. Ринорея у исследуемой группы пациентов уменьшилась почти на 70%. Заложенность носа пациентов уменьшилась на 60%, на 85% уменьшился зуд носа, почти на 60% уменьшилось чихание. Выводы. 1. Комплексное лечение, состоящее из курса АСИТ пыльцевыми аллергенами и подземного спелеолечения в ГУ «РБС», является эффективным методом лечения АР, вызванного пыльцой растений. 2. Необходимо внедрять этот метод лечения АР в практическую работу врачей – аллергологов-иммунологов Республики Беларусь. Introduction. The treatment of allergic rhinitis (AR) is based on allergen elimination, drug therapy and allergen-specific immunotherapy (ASIT). To reduce the clinical manifestations of AR in patients and improve the quality of life, we proposed to supplement symptomatic therapy and pre-season ASIT with pollen allergens with a course of underground speleotherapy during the palination season in the conditions of the State Institution "Republican Speleotherapy Hospital" (RSH). Purpose. To compare clinical and immunological parameters in patients with AR before and after complex treatment: a pre-season course of subcutaneous ASIT with a causally significant pollen allergen and a course of underground speleotherapy at the State Institution "RSH" during the palination season. Materials and methods. Randomly, 15 patients were selected who, after ASIT, received a course of underground speleotherapy at the State Institution "Republican Hospital for Speleotherapy". All 15 patients showed sensitization to pollen allergens. Each of the patients assessed the severity of the clinical manifestations of AR (nasal discharge, nasal congestion, sneezing and nasal itching) before and after treatment on a 4-point scale. Results. A decrease in the size of the prick test by almost 40% indicates a decrease in the level of sensitization. Rhinorrhea in the study group of patients decreased by almost 70%. Nasal congestion of patients decreased by 60%, itching of the nose decreased by 85%, sneezing decreased by almost 60%. Conclusions. 1. Comprehensive treatment, consisting of a course of ASIT with pollen allergens and underground speleotherapy at the State Institution "RSH", is an effective method of treating AR caused by plant pollen. 2. It is necessary to introduce this method of AR treatment into the practical work of allergologists and immunologists of the Republic of Belarus.

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Section: Introductionunclassified

Comprehensive Treatment of Allergic Rhinitis

Санникова¹

2022

Рецепт

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Patient with comorbid pathology: is ASIT possible?

Orlova,

Kandrashkina,

Trushina

et al. 2024

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Introduction. ASIT is characterized by a high safety profile, however, when prescribing ASIT, indications and certain contraindications should be taken into account, knowledge of which is mandatory for every practicing allergist. In recent years, clinical contraindications to ASIT have been revised due to the publication of the Position Paper of the European Academy of Allergy and Clinical Immunology (EAACI). The decision to prescribe ASIT is based on an assessment of the individual patient’s condition, analysis of indications, consideration of contraindications to ASIT, assessment of concomitant diseases, and their pharmacotherapy. The doctor must make the final decision when prescribing allergen treatment, weighing the risk-benefit ratio. Refusal to perform ASIT on a patient with must be clearly reasoned and justified.Presentation of a clinical case. A child aged 11 years was observed with a diagnosis of allergic bronchial asthma, mild intermittent course. Allergic rhinitis, persistent course. Allergy to trees, cereals, weeds. Cross food allergy (peas, melon) with clinical manifestations in the form of oral allergic syndrome, acute urticaria, angioedema of the lips and tongue. Asperger’s syndrome. Congenital cataract. Despite the annual progression of respiratory allergies and the expansion of the spectrum of sensitization, the patient was not offered ASIT for a long time if there were indications for its implementation due to the presence of comorbid pathology. The presence of mental illness, according to the Position Document, is a relative contraindication to ASIT. ASIT with the therapeutic allergen Grazax is not accompanied by side effects and is characterized by high compliance, which led to a significant therapeutic effect.Conclusion. This clinical observation clearly demonstrates a situation where the initial refusal to administer ASIT to a patient with an indication for this type of treatment was unfounded. Even in the case of complex comorbid pathology, ASIT can be performed effectively and safely.

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Reasons for the ineffectiveness of allergen-specific immunotherapy

Cited by 2 publications

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Comprehensive Treatment of Allergic Rhinitis

Comprehensive Treatment of Allergic Rhinitis

Patient with comorbid pathology: is ASIT possible?

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