Wüthrich B
Dermatologische Klinik, Universitätsspital Zürich.
Schweiz Rundsch Med Prax. 1993 May 4;82(18):534-9.
Hyposensitization (desensitization, immunotherapy) is--next to avoidance of allergens--the only causal treatment of IgE-mediated allergic diseases. In a number of well-controlled studies, immunotherapy has shown a clinical efficacy in allergic rhinitis, mainly hay fever, and in allergic asthma. Here, immunotherapy is primarily useful in children and young adults. Immunotherapy is highly effective in hymenoptera-venom allergy. The quality of the extracts in terms of potency and composition is essential both to the diagnosis of relevant allergens and to an optimal result of immunotherapy. The hyposensitization extracts used in Switzerland are listed in the 'Spezialitätenliste des Bundesamtes für Sozialversicherung' and have, therefore, to be payed for by the health insurance. Since the early seventies so-called semi-depot extracts are used in practice; here, the allergens are adsorbed to aluminium hydroxide and thus liberated in a delayed way. For a few years a short-term therapy, using so-called depot allergoids, is possible. A hyposensitization should be initiated only after a through evaluation and a careful allergological examination. With regard to pollen allergies one has to take into consideration especially the presence of the leading pollens, the cross-reactivity and the patient's account of his symptoms. The practice of hyposensitization is discussed extensively. The information of the patient regarding efficacy, length of treatment and risk of side effects is of great importance.
减敏疗法（脱敏疗法、免疫疗法）是除了避免接触过敏原之外，唯一能够对IgE介导的过敏性疾病进行病因治疗的方法。在多项严格对照研究中，免疫疗法已显示出对过敏性鼻炎（主要是花粉症）和过敏性哮喘具有临床疗效。在此，免疫疗法主要对儿童和年轻人有用。免疫疗法对膜翅目毒液过敏非常有效。提取物在效力和成分方面的质量对于相关过敏原的诊断以及免疫疗法的最佳效果都至关重要。瑞士使用的减敏疗法提取物列在《联邦社会保险局特种产品清单》中，因此需由医疗保险支付费用。自七十年代初以来，实际上一直使用所谓的半储存库提取物；在此，过敏原吸附在氢氧化铝上，从而以延迟方式释放。几年来，使用所谓的储存库变应原制剂进行短期治疗成为可能。减敏疗法应仅在经过全面评估和仔细的变态反应学检查后启动。对于花粉过敏，尤其必须考虑主要花粉的存在、交叉反应性以及患者对其症状的描述。减敏疗法的实践已得到广泛讨论。向患者提供有关疗效、治疗时长和副作用风险的信息非常重要。
