Subcutaneous and Sublingual Immunotherapy by Inhaler Allergens

Yıl 2017, Cilt: 9 Sayı: 2, 165 - 170, 15.03.2017

Prof. Dr. Nerin N. Bahçeciler

Öz

Abstract

Currently, it is demonstrated that allergen spesific immunotherapy (SIT) is theonly treatment that capable to change the natural course or allergic diseases such asallergic rhinitis and asthma. Although, subcutaneous immunotherapy (SCIT) is approved as the gold standart treatment, sublingual immunotherapy (SLIT) has been shown to demonstrate similar efficacy with more safety. Cochrane systematic reviews and metaanalyses, published to date has demonstrated the efficacy of both SLIT and SCIT in patients withallergic rhinitis and asthma sensitizied to either perrenial or seasonal airborne allergens. Although, both methods are demonstrated to be clinically efficient and to induce immunological tolerance in many studies, literature is scarce comparing SLITversus SCIT head to head in terms of efficacy and immune tolerance induction. On the other hand, data in literature suggests that both methods are highly evidential and selection of sublingual or SCIT should be tailored based on compliance, availability, and co-decision of doctor-patient.

Anahtar Kelimeler

ubcutaneous immunotherapy, sublingualimmunotherapy

İnhalen Allerjenlerle Subkutan ve Sublingual İmmünoterapi

Öz

Öz

Günümüzde allerjik rinit ve astım gibi solunum yolu allerjik hastalıklarının tedavisinde hastalığın doğal seyrini değiştirebilen tek tedavi yönteminin allerjen spesifik immünoterapi (SIT) olduğu kanıtlanmıştır. Subkutan immünoterapi (SCIT) altın standart tedavi olarak kabul görmesine karşın sublingual immünoterapinin (SLIT)son 3 dekadda benzer etkinliği olan emniyetli bir tedavi yöntemi olduğu kanıtlanmıştır. Günümüze dek yayınlanmış Cochrane sistematik derleme ve meta analizlerde gerek SCIT gerekse SLIT’ın mevsimsel veya perennial inhalen allerjenlere duyarlı allerjik rinit ve astımlı olgulardaki etkinliği gösterilmiştir. Her iki tedavi yöntemi ile semptom ve ilaç kullanımında anlamlı azalma olduğu ve immünolojik toleransı indüklediği birçok araştırmada kanıtlanmış olmasına rağmen, bu iki yöntemin etkinlik ve immün tolerans yönünden birebir karşılaştırıldığı çalışmalar pek azdır. Öte yandan literatürdeki veriler her iki yöntemin de yüksek kanıt değerinde olup,sublingual veya subkutan immünoterapi seçiminin uygulanabilirlilik, ulaşılabilirlilik ve hasta hekim ortak kararı ile uygulanmasını önermektedir.

Anahtar Kelimeler

Subkutan immünoterap, sublingual immünoterapi

Kaynakça

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