Department of Internal Medicine, University Hospital San Martino, Genoa.
J Biol Regul Homeost Agents. 2009 Jul-Sep;23(3):165-71.
Polysensitization is very common in allergic patients and was previously reported to be associated with more severe symptoms and impaired quality of life. Polysensitization is often considered as a contraindication for specific immunotherapy (SIT). This study is aimed at evaluating the allergist attitude for decision making in choosing SIT in a cohort of Italian polysensitized patients. Moreover, the 1-year effectiveness of the prescribed sublingual immunotherapy (SLIT) in this cohort was evaluated. The study was performed on 244 patients (109 males, 135 females, mean age 28.7 years, S.D. 12.0) with allergic rhinitis (assessed by ARIA criteria) and/or mild to moderate asthma (assessed by GINA criteria) treated with SLIT for 1 year. The kind and the number of prescribed allergen extracts, type of diagnosis, severity of symptoms, use of drugs, and adverse events were evaluated at baseline and after 1 year. A total of 230 patients were treated with SLIT: 165 with a single extract, and 65 with two different extracts (mix). SLIT treatment significantly improved disease staging, and reduced symptom severity and drug use. No systemic reaction was reported. In conclusion, these findings provide preliminary evidence that SIT is effective and safe in polysensitized patients after 1 year of treatment also using single extracts, and thus does not represent an obstacle for prescribing SIT.
过敏患者常出现多致敏现象，先前有研究报道多致敏与更严重的症状和生活质量受损相关。多致敏通常被视为特异性免疫治疗（SIT）的禁忌症。本研究旨在评估意大利多致敏患者队列中，过敏专家在选择 SIT 时的决策态度。此外，还评估了该队列中规定的舌下免疫治疗（SLIT）的 1 年疗效。该研究纳入了 244 名（109 名男性，135 名女性，平均年龄 28.7 岁，标准差 12.0）患有过敏性鼻炎（根据 ARIA 标准评估）和/或轻度至中度哮喘（根据 GINA 标准评估）的患者，他们接受 SLIT 治疗 1 年。在基线和 1 年后评估了规定的过敏原提取物的种类和数量、诊断类型、症状严重程度、药物使用和不良反应。共有 230 名患者接受了 SLIT 治疗：165 名患者使用单一提取物，65 名患者使用两种不同的提取物（混合）。SLIT 治疗显著改善了疾病分期，并减轻了症状严重程度和药物使用。未报告全身性反应。总之，这些发现初步表明，SIT 在 1 年治疗后对多致敏患者是有效且安全的，即使使用单一提取物，也不会成为规定 SIT 的障碍。
