Новые возможности аллерген-специфической иммунотерапии

Павлова К.С. Новые возможности аллерген-специфической иммунотерапии. Педиатрия (Прил. к журн. Consilium Medicum). 2017; 4: 56–58.

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Pavlova K.S. New opportunities allergen immunotherapy. (Suppl. Consilium Medicum). 2017; 4: 56–58.

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Аннотация

Аллерген-специфическая иммунотерапия (АСИТ) имеет более чем 100-летний опыт применения при лечении аллергического ринита и атопической бронхиальной астмы. АСИТ индуцирует толерантность к аллергенам посредством восстановления баланса иммунной системы; позволяет предупредить трансформацию аллергического ринита в бронхиальную астму и является единственным лечением аллергии с пролонгированным эффектом в отношении всех симптомов. Эффективность АСИТ доказана многими рандомизированными контролируемыми исследованиями и систематическими обзорами. Использование современных высокодозных сублингвальных лечебных аллергенов позволяет достигать столь же высоких результатов, как и при проведении подкожной АСИТ. При этом сублингвальная АСИТ имеет более высокий профиль безопасности относительно подкожной АСИТ, что делает ее предпочтительным выбором в педиатрической практике.

Ключевые слова: аллерген-специфическая иммунотерапия, сублингвальная аллерген-специфическая иммунотерапия, высокодозная аллерген-специфическая иммунотерапия, аллергический ринит, бронхиальная астма.

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Allergen-specific immunotherapy (AIT) has over 100 years of experience use in the treatment of allergic rhinitis (AR) and atopic bronchial asthma (BA). AIT induces tolerance to allergens by restoring balance in the immune system; prevents the transformation of AR to BA, is the unique treatment of allergy with a prolonged effect in respect of all symptoms. The efficacy of AIT has been proved by many randomized controlled studies and systematic reviews. The use of modern highdose sublingual allergen treatment allows to achieve the same high results as in the subcutaneous AIT. While sublingual AIT (SLIT) has a higher safety profile relative to subcutaneous AIT (SCIT), which makes SLIT the preferred choice in pediatric practice.

Key words: allergen immunotherapy, sublingual allergen immunotherapy, high-dose AIT, allergic rhinitis, bronchial asthma.

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Список литературы

1. Jutel M, Agache I, Bonini S et al. International Consensus On (ICON) Allergy Immunotherapy (AIT). J Allergy Clin Immunol 2015; 136 (3): 556–68.
2. Bousquet J, Lockey R, Malling HJ. WHO Position Paper. Allergen immunotherapy: therapeutic vaccines for allergic diseases. Allergy 1998; 53 (Suppl. 44): 1–42.
3. Курбачева О.М., Павлова К.С. Федеральные клинические рекомендации. Аллерген-специфическая иммунотерапия. РАЖ. 2016; 4–5: 55–61. / Kurbacheva O.M., Pavlova K.S. Federal'nye klinicheskie rekomendatsii. Allergen-spetsificheskaia immunoterapiia. RAZh. 2016; 4–5: 55–61. [in Russian]
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6. Jutel M, Agache I, Bonini S et al. International Consensus on Allergen Immunotherapy II: Mechanisms, standardization, and pharmacoeconomics. J Allergy Clin Immunol 2016; 137 (2): 358–68.
7. Eifan AO, Calderon MA, Durham SR. Allergen immunotherapy for house dust mite: clinical efficacy and immunological mechanisms in allergic rhinitis and asthma. Expert Opin Biol Ther 2013; 13 (11): 1543–56.
8. Radulvic S, Calderon MA, Wilson D, Durham S. Sublingual immunotherapy for allergic rhinitis. Cochrane Database Syst Rev 2010; 8 (12): CD002893.
9. Zielen S et al. Sublingual immunotherapy provides long-term relief in allergic rhinitis and reduces the risk of asthma: a retrospective, real-world database analysis. Allergy 2017. DOI: 10.1111/all.13213.
10. Akdis M, Schmidt-Weber C, Jutel M et al. Mechanisms of allergen immunotherapy. Allergy Clin Immunol Int – J World Allergy Org 2004; 16 (2): 65–9.
11. Calderon MA, Larenas D, Kleine-Tebbe J et al. European academy of allergy and clinical immunology task force report on ‘dose-response relationship in allergen-specific immunotherapy’. Allergy 2011; 66: 1345–59.
12. Didier A, Malling HJ, Worm M et al. Optimal dose, efficacy, and safety of once-daily sublingual immunotherapy with a 5-grass pollen tablet for seasonal allergic rhinitis. J Allergy Clin Immunol 2007; 120: 1338–45.
13. Durham SR, Yang WH, Pedersen MR et al. Sublingual immunotherapy with once-daily grass allergen tablets: a randomized controlled trial in seasonal allergic rhinoconjunctivitis. J Allergy Clin Immunol 2006; 117: 802–9.
14. Skoner D, Gentile D, Bush R et al. Sublingual immunotherapy in patients with allergic rhinoconjunctivitis caused by ragweed pollen. J Allergy Clin Immunol 2010; 125: 660–6.
15. Valovirta E, Jacobsen L, Ljorring C et al. Clinical efficacy and safety of sublingual immunotherapy with tree pollen extract in children. Allergy 2006; 61: 1177–83.
16. Khinchi MS, Poulsen LK, Carat F et al. Clinical efficacy of sublingual and subcutaneous birch pollen allergen-specific immunotherapy: a randomized, placebo-controlled, double-blind, double-dummy study. Allergy 2004; 59 (1): 45–53.
17. Novembre E, Galli E, Landi F et al. Coseasonal sublingual immunotherapy reduces the development of asthma in children with allergic rhinoconjunctivitis. J Allergy Clin Immunol 2004; 114: 851–7.
18. Pichler CE, Marquardsen A, Sparholt S et al. Specific immunotheraoy with Dermatophagoides pteronyssinus and D. farina results in decreased bronchial hyperreactivity. Allergy 1997; 52: 274–83.
19. Zielen S, Kardos P, Madonini E. Steroid-sparing effects with allergen-specific immunotherapy in children with asthma: a randomized controlled trial. J Allergy Clin Immunol 2010; 126 (5): 942–9.
20. Di Rienzo V, Marcucci F, Pucinelli P et al. Long-lasting effect of sublingual immunotherapy in children with asthma due to house dust mite: a 10-year prospective study. Clin Exp Allergy 2003; 33 (2): 206–10.
21. Nelson H, Cartier S, Allen-Ramey F et al. Network meta-analysis shows commercialized subcutaneous and sublingual grass products have comparable efficacy. J Allergy Clin Immunol Pract 2015; 3 (2): 256–66.

________________________________________________

1. Jutel M, Agache I, Bonini S et al. International Consensus On (ICON) Allergy Immunotherapy (AIT). J Allergy Clin Immunol 2015; 136 (3): 556–68.
2. Bousquet J, Lockey R, Malling HJ. WHO Position Paper. Allergen immunotherapy: therapeutic vaccines for allergic diseases. Allergy 1998; 53 (Suppl. 44): 1–42.
3. Kurbacheva O.M., Pavlova K.S. Federal'nye klinicheskie rekomendatsii. Allergen-spetsificheskaia immunoterapiia. RAZh. 2016; 4–5: 55–61. [in Russian]
4. Kurbacheva O.M., Pavlova K.S., Galitskaia M.A. Allergen-spetsificheskaia immunoterapiia. Analiticheskii obzor sovremennykh mezhdunarodnykh i otechestvennykh pozitsionnykh dokumentov. RAZh. 2017; 1: 24–32. [in Russian]
5. Gushchin I.S., Kurbacheva O.M. Allergiia i allergen-spetsificheskaia immunoterapiia. M.: Farmarus Print Media, 2010. [in Russian]
6. Jutel M, Agache I, Bonini S et al. International Consensus on Allergen Immunotherapy II: Mechanisms, standardization, and pharmacoeconomics. J Allergy Clin Immunol 2016; 137 (2): 358–68.
7. Eifan AO, Calderon MA, Durham SR. Allergen immunotherapy for house dust mite: clinical efficacy and immunological mechanisms in allergic rhinitis and asthma. Expert Opin Biol Ther 2013; 13 (11): 1543–56.
8. Radulvic S, Calderon MA, Wilson D, Durham S. Sublingual immunotherapy for allergic rhinitis. Cochrane Database Syst Rev 2010; 8 (12): CD002893.
9. Zielen S et al. Sublingual immunotherapy provides long-term relief in allergic rhinitis and reduces the risk of asthma: a retrospective, real-world database analysis. Allergy 2017. DOI: 10.1111/all.13213.
10. Akdis M, Schmidt-Weber C, Jutel M et al. Mechanisms of allergen immunotherapy. Allergy Clin Immunol Int – J World Allergy Org 2004; 16 (2): 65–9.
11. Calderon MA, Larenas D, Kleine-Tebbe J et al. European academy of allergy and clinical immunology task force report on ‘dose-response relationship in allergen-specific immunotherapy’. Allergy 2011; 66: 1345–59.
12. Didier A, Malling HJ, Worm M et al. Optimal dose, efficacy, and safety of once-daily sublingual immunotherapy with a 5-grass pollen tablet for seasonal allergic rhinitis. J Allergy Clin Immunol 2007; 120: 1338–45.
13. Durham SR, Yang WH, Pedersen MR et al. Sublingual immunotherapy with once-daily grass allergen tablets: a randomized controlled trial in seasonal allergic rhinoconjunctivitis. J Allergy Clin Immunol 2006; 117: 802–9.
14. Skoner D, Gentile D, Bush R et al. Sublingual immunotherapy in patients with allergic rhinoconjunctivitis caused by ragweed pollen. J Allergy Clin Immunol 2010; 125: 660–6.
15. Valovirta E, Jacobsen L, Ljorring C et al. Clinical efficacy and safety of sublingual immunotherapy with tree pollen extract in children. Allergy 2006; 61: 1177–83.
16. Khinchi MS, Poulsen LK, Carat F et al. Clinical efficacy of sublingual and subcutaneous birch pollen allergen-specific immunotherapy: a randomized, placebo-controlled, double-blind, double-dummy study. Allergy 2004; 59 (1): 45–53.
17. Novembre E, Galli E, Landi F et al. Coseasonal sublingual immunotherapy reduces the development of asthma in children with allergic rhinoconjunctivitis. J Allergy Clin Immunol 2004; 114: 851–7.
18. Pichler CE, Marquardsen A, Sparholt S et al. Specific immunotheraoy with Dermatophagoides pteronyssinus and D. farina results in decreased bronchial hyperreactivity. Allergy 1997; 52: 274–83.
19. Zielen S, Kardos P, Madonini E. Steroid-sparing effects with allergen-specific immunotherapy in children with asthma: a randomized controlled trial. J Allergy Clin Immunol 2010; 126 (5): 942–9.
20. Di Rienzo V, Marcucci F, Pucinelli P et al. Long-lasting effect of sublingual immunotherapy in children with asthma due to house dust mite: a 10-year prospective study. Clin Exp Allergy 2003; 33 (2): 206–10.
21. Nelson H, Cartier S, Allen-Ramey F et al. Network meta-analysis shows commercialized subcutaneous and sublingual grass products have comparable efficacy. J Allergy Clin Immunol Pract 2015; 3 (2): 256–66.

Авторы

К.С.Павлова*

ФГБУ ГНЦ «Институт иммунологии» ФМБА России. 115478, Россия, Москва, Каширское ш., д. 24, корп. 2
*ksenimedical@gmail.com

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K.S.Pavlova*

Institute of Immunology of FMBA of Russia. 115478, Russian Federation, Moscow, Kashirskoe sh., d. 24, korp. 2
*ksenimedical@gmail.com

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