IMMUNOTHERAPY FOR ALLERGICRHINITIS

Autor: Blažina, Vedran
Přispěvatelé: Braut, Tamara, Kujundžić, Milodar, Belušić-Gobić, Margita, Kovač, Dražen
Jazyk: chorvatština
Rok vydání: 2020
Předmět:
Popis: Alergenska imunoterapija jedina je etiološka terapija alergijskog rinitisa koja djeluje imunomodulacijski i mijenja odnos Th1/Th2 odgovora u korist Th1. Većina danas postojeće terapije za alergijski rinitis je isključivo simptomatska, jedino alergijska imunoterapija osim što djeluje na sam uzrok istovremeno ima i prevenirajući učinak jer moţe spriječiti progresiju u astmu što je naročito bitno kod mlaĎe populacije. SCIT i SLIT su dvije metode koje se danas koriste u kliničkoj praksi. Indikacije za oba pristupa su slabo kontrolirani intermitenti ili perzistentni alergijski rinitis, mlaĎa ţivotna doba te dobro regulirana astma. Kontraindikacije uključuju slabo kontroliranu astmu, maligne bolesti, autoimune bolesti, imunodeficijencije, psihičke bolesti, stariju ţivotnu dob s komorbiditetima te terapiju beta blokatorima. Budućnost alergenske imunoterapije, osim usavršavanja postojećih metoda, vidi se u usavršavanju i pročišćavanju alergena te uvoĎenju novih pristupa intralimfatičnog i epikutanog kojima bi se poboljšala učinkovitost i sigurnost te istovremeno smanjilo trajanje terapije. Potrebno je raditi na trajnoj edukaciji liječnika i informiranju pacijenata kako bi alergenska imunoterapija postala zastupljenija terapijska opcija.
Allergenic immunotherapy is the only etiological treatment for allergic rhinitis that has an immunomodulatory effect and changes the Th1/Th2 response ratio in favor of Th1, i.e. the immune response from IgE antibodies to blocking IgG. Most of the existing treatments for allergic rhinitis are exclusively symptomatic; only allergenic immunotherapy, in addition to affecting the cause, also has a preventive effect because it can prevent the progression to asthma, which is especially important in the younger population. SCIT and SLIT are two methods used in clinical practice today. Indications for both approaches are poorly-controlled intermittent or persistent allergic rhinitis and well-controlled asthma. Contraindications include poorly-controlled asthma, malignancies, autoimmune diseases, immunodeficiencies, mental illness, elderly patients with comorbidities, and beta-blocker therapy. The future of allergen immunotherapy, in addition to improving the existing methods, is the introduction of enhanced synthetic allergens and the introduction of new approaches such as intralymphatic and epicutaneous method to improve efficiency and safety while reducing the duration of treatment. Physicians must be continuously educated and patients must be informed in order for allergen immunotherapy to become a more common treatment option.
Databáze: OpenAIRE
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