Alerjen Spesifik İmmünoterapi

Year 2015, Volume: 13 Issue: 1, 46 - 55, 01.06.2015

Şükrü Çekiç , Nihat Sapan

https://doi.org/10.4274/jcp.02419

Abstract

Alerjen spesifik immünoterapi SİT , alerjik hastalıklarda kür sağlayabilen tek tedavi yöntemidir. Duyarlı olunan alerjenin belirli aralıklarla ve giderek artan dozlarda verilmesiyle bu alerjene karşı immüntolerans gelişmesi esasına dayanır. Alerjik hastalıkların tedavisinde, alerjenden korunma ve farmakoterapiden sonra gelir. İmmünoterapide klinik tablodan sorumlu, deri prik testi ya da spesifik immünglobulin E pozitifliği ile duyarlılığın gösterildiği alerjenler kullanılmalı ve tedavi alerji uzmanlarının yönetiminde yapılmalıdır. Çalışmalarda; immünoterapi ile astım bulgularında anlamlı iyileşme sağlandığı, hastalarda ilaç kullanımının azaldığı, rinitli hastalarda astım gelişimin önlendiği ve yeni duyarlanmaları azaltılabildiği gösterilmiştir. Önceki yıllarda sık görülen yan etkiler, standardize alerjen solüsyonlarının kullanıma girmesi ile azalmıştır. Ağır astımda kullanımı kontrendikedir, beta bloker ve anjiotensin konverting enzim AKE inhibitörü kullanımı olanlarda immünoterapiden kaçınılması önerilmekle birlikte mecbur kalınılan durumlarda fayda/zarar oranı dikkate alınarak başlanabileceği bildirilmektedir. En sık kullanılan subkütan ve sublingual yollar yanında, epikütan ve intralenfatik kullanım gibi yeni yöntemler geliştirilmektedir

Keywords

Alerji, immünoterapi, astım, rinit

Allergen Specific Immunotherapy

Abstract

Allergen specific immunotherapy SIT is the only treatment that can provide a cure for allergic disorders. This treatment is based on development of immune tolerance by exposure to allergen in repetitive and increasing doses. It is tertiary to avoidance of allergen and pharmacotherapy. Allergens used for immunotherapy, must be confirmed by skin prick test or specific IgE and must be applied in supervision of allergy specialists. Studies show that immunotherapy, improve asthma symptoms, decreases drug consumption, prevent development of asthma in rhinitis patients and reduce new sensitizations. Common side effects diminished with the usage of standardized allergen solutions. It is contraindicated in severe asthma. Though it is recommended to avoid immunotherapy in patients using beta blockers and ACE inhibitors, immunotherapy can be considered in mandatory situations regarding possible benefits and harms. Most common ways of administration are subcutaneous and sublingual; new methods such as epicutaneous and intralymphatic injections are currently being studied

Keywords

Allergy, immunotherapy, asthma, rhinitis

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