Riechelmann H
Universitäts-HNO-Klinik Ulm.
HNO. 2005 Jun;53(6):517-20, 522-6, 528-30. doi: 10.1007/s00106-005-1273-7.
Immunotherapy with allergens is an established therapy for allergic rhinitis. It reverses the T(H2)-skewed immune response and induces immune tolerance to the allergen applied. Weekly and later monthly allergen injections with sustained-release preparations over 3 years are the current reference method. Also chemically modified allergens and immune adjuvants may be used. Immunotherapy reduces allergy symptoms, the consumption of antiallergic drugs, and the mucosal inflammatory reaction. A particular characteristic is the reduction of asthma morbidity and additional sensitizations to new allergens. In Germany, serious side effects arise on the average per every 10,000 injections, and an anaphylactic shock approximately per every 250,000 injections. Serious adverse events are substantially rarer with sublingual immunotherapy, but they also occur. At present, efficacy of sublingual immunotherapy has been demonstrated in adults with pollen allergy. The effects of immunotherapy last for several years after its termination. As a consequence, immunotherapy is also economically reasonable.
变应原免疫疗法是治疗过敏性鼻炎的一种成熟疗法。它可逆转T(H2)偏向的免疫反应，并诱导对所应用变应原的免疫耐受。目前的参考方法是在3年时间内每周（之后每月）注射缓释制剂形式的变应原。也可使用化学修饰的变应原和免疫佐剂。免疫疗法可减轻过敏症状、减少抗过敏药物的使用以及减轻黏膜炎症反应。一个特别的特点是降低哮喘发病率以及减少对新变应原的额外致敏。在德国，平均每10000次注射会出现一次严重副作用，每250000次注射大约会出现一次过敏性休克。舌下免疫疗法出现严重不良事件的情况要少得多，但也会发生。目前，已证实舌下免疫疗法对患有花粉过敏的成年人有效。免疫疗法在结束后其效果可持续数年。因此，免疫疗法在经济上也是合理的。
