Preparations for asit therapy. Specific immunotherapy (SIT) for the treatment of allergies. Which doctor performs this type of treatment

The task of an allergist is to restore the child's health and the ability to full life regardless of the diagnosis. Today this is possible with modern methods allergy treatment, including ASIT.

What is ASIT?

Allergens surround us and our children everywhere. It is very difficult to completely protect a child from their effects, especially if we are talking not about an allergy to food, but about a reaction to plant pollen or ordinary house dust.

The task of allergen-specific immunotherapy is to reduce or completely suppress the response to an allergen in a child's body. This is achieved by administering to the child a special allergy vaccine containing a causally significant allergen that causes an acute allergic reaction in a young patient. During treatment, the dose of the administered allergen is gradually increased, and the body's sensitivity to the allergen gradually decreases. By the end of the ASIT course, the child's body begins to better tolerate contact with the allergen.

Indications for ASIT

• plant pollen (trees, grasses),
• dust (dust mites).

Features of allergen-specific immunotherapy in children

With pollen allergy, ASIT is carried out for a child only outside the flowering season of plants. Therefore, if you want your child to be healthy and active in summer, you need to start treatment in advance, preferably 2-4 months before flowering, that is, in the autumn-winter period.

Allergy to house dust should be treated throughout the year, the maintenance dose is administered 1 time for 1.5 months.

Conducting ASIT in "SM-Doctor"

At the beginning of treatment, the drug is administered once a week. Then the frequency of admission decreases, since the child receives no longer the main, but a maintenance dose of the drug. A specific treatment schedule is drawn up by an allergist, depending on the condition of the child, the reaction to the drug and other factors. As a rule, the maintenance dose of the drug is administered 1 time in 1.5 months.

The young patient receives the first dose of the drug in the office of an allergist-immunologist. After training with your doctor, immunotherapy can be done at home.

Average duration The course of treatment is 4-5 years. Our clinic uses preparations for ASIT produced in France, the Czech Republic and Italy.

One of the leading allergologists and immunologists in Russia, professor, doctor works at SM-Doctor medical sciences Dali Shotaevna Macharadze. doctor throughout years successfully uses the ASIT method for the treatment of allergies in children. It is important to note that Dali Shotaevna is not only a highly qualified allergist-immunologist, but also a good pediatrician, which perfectly finds a common language with small patients.

Advantages of ASIT

An allergy is an increased sensitivity of the body to a substance. The most common manifestations of this disease are rash, edema, rhinitis, asthma, eczema, and even necrosis. allergies are usually carried out with the use of hormonal agents and antihistamines. However, with the use of such therapy, one can only stop the actual manifestations of the disease. The allergy itself is not treated in this way. But medical technology, with which you can get rid of the disease itself, fortunately, it still exists.

Application of allergen-specific therapy

As you know, in order to protect the body from infection with pathogenic viruses or bacteria, a method such as vaccination is used. Allergen-specific immunotherapy is somewhat similar to this technique. The patient is simply injected with microscopic doses of the substance that causes a negative reaction in him. Allergen-specific therapy usually lasts a very long time - from several months.

During this time, the patient's body, as it were, "gets used" to the action of the allergen. As a result, the patient passes all the signs of the disease.

Indications for therapy

Such treatment is usually prescribed only to people from 5 to 50 years old. Before starting therapy, the doctor must be 100% sure that the patient's disease is of an immunological nature.

Allergen-specific immunotherapy gives a very good effect in the following cases:

with conjunctivitis and seasonal rhinitis;

year-round rhinitis.

This method is also different high efficiency regarding treatment bronchial asthma and accompanying diseases - cardiovascular, endocrine, gastroenterological and neuroses.

May be treated with techniques such as allergen-specific immunotherapy and drug-induced lupus. However, this technology is rarely used in this case. ASIT can be used for such a disease only when the drug causing the reaction is vital and there is nothing to replace it.

The exclusion of contact with the allergen allows you to prevent the development negative symptoms, of course, much better than any therapy. In the absence of an irritant, the patient simply cannot show any symptoms. Therefore, allergen-specific treatment is usually prescribed only if contact cannot be excluded. For example, it would be appropriate to use such a technique if the patient is allergic to household dust, waste products skin mites etc.

What drugs can be used

Allergen-specific immunotherapy (ASIT) is carried out using:

purified allergens;

allergoids;

other modified allergens.

Preparations produced in Russia and used in such treatment as allergen-specific immunotherapy are standardized on the basis of their content of protein nitrogen (PNU). For example, medicines such as Staloral and Fostal can be used for ASIT.

How the drugs work

Actually, the ASIT mechanisms themselves are diverse. It could be:

restructuring of cytokine and immune metabolism;

production of blocking antibodies;

slowing down the mediator component of allergic inflammation;

decreased production of IgE.

ASIT can inhibit both late and early stage immediate allergic reaction. Also, during such therapy, the cellular pattern of inflammation and bronchial hyperactivity in asthma are inhibited.

How is the treatment carried out

Allergen-specific immunotherapy can, of course, be prescribed and carried out only professional doctor(And only those with relevant experience). Under no circumstances should this method be used alone. An error in the dosage of an allergy vaccine can even lead to the death of the patient.

It is allowed to use such immunotherapy only in the non-attack period of the disease. Previously, the patient must be eliminated inflammatory processes in the lungs and other foci of chronic infections.

Allergen-specific immunotherapy is always started with the smallest doses of the drug. Irritant substances are administered most often by injection. Sometimes tablets or powder are also used for therapy. Subsequently, dosages are gradually increased.

The frequency of administration of the drug in most cases is 2-3 times a week. The standard full course is 25-50 injections. Patients should be given injections using disposable insulin syringes. Immunotherapy injections are given subcutaneously.

What courses can be offered

There are no standard treatment regimens for ASIT. Therapy is carried out by a doctor in accordance with individual characteristics the patient's body and the course of his illness. ASIT can be classified only into the following types:

short pre-season course;

full pre-season course;

year-round therapy.

You can also highlight the main phases of treatment using this technique:

Training. At this stage, the doctor carefully examines the patient's medical history and conducts an examination. Next, the cause-dependent allergen and the degree of sensitivity of the body to it (using samples) are determined. Based on this, the desired drug and its dose are selected.

initiating phase. At this stage, the patient begins to administer the drug with gradual increase doses.

maintenance phase. This stage can last from 3 to 5 years. During this time, the patient regularly takes the prescribed drug and is under the most careful supervision of a doctor.



special instructions

After the introduction of a dose of the drug, the patient's body, for obvious reasons, begins to experience a serious load. Therefore, it is strictly forbidden to give such injections to the patient simultaneously with any preventive vaccinations. Consequences of not doing so important condition can be really hard. Also, during the course of treatment, it is necessary to completely eliminate the additional impact on the patient's body of allergens.

Contraindications

the patient's pregnancy;

the patient has acute infectious processes;

permanent form of bronchial asthma of 2-3 degrees;

complications in the allergic disease itself;

the presence of tumor pathologies;

mental illness in the acute stage;

high levels of immunoglobulin E.

With caution, apply a similar treatment technology to patients:

under the age of 5 and over 50;

having skin pathologies;

suffering from chronic infectious diseases;

with poor skin sensitivity to the allergen.

Side effects

Of course, during such therapy, the patient may show different kind negative reactions of the body. Side effects when using allergen-specific treatment are as follows:

Skin redness and swelling at the injection site. Such a reaction usually occurs about half an hour after the administration of the drug. In the presence of such a side effect, the dose of the allergen used should be reduced.

An increase in the patient's body temperature or skin rashes. Such reactions usually appear immediately after drug administration. In this case, the dosages are also usually reduced.

How effective can therapy be?

At the moment, allergen-specific immunotherapy is the only method for the treatment of allergies and bronchial asthma that directly affects the immunological nature of the disease. After completing the full course according to all the rules, patients usually experience a long-term remission. With allergic rhinitis and polynoses great effect such therapy gives for 90% of patients. It is also noticed that best results in terms of treatment with ASIT can be achieved in young patients.

A pronounced clinical effect in patients usually appears only after 3-5 courses of ASIT. But improvements are most often noticeable after the first of them. The reaction of the patient's body to stimuli becomes less pronounced.

Allergen-specific immunotherapy: the price of the issue

The cost of treatment according to the ASIT method depends primarily on the type of stimulus causing the reaction. An examination by a doctor of the relevant specialization usually costs about 900 rubles. For treatment for allergies to pollen of trees and cereals, a patient can be charged, for example, from 6 to 12 thousand rubles, for ticks house dust- from 8 to 14.5 thousand rubles.

Allergen-specific immunotherapy: patient reviews

The opinion about this technology of treatment among the patients themselves is very good. Some patients consider ASIT the only effective methodology allergy therapy. After the course, many patients, according to them, finally begin to "live full life". This technique is praised by both patients with rhinitis, and Quincke's edema, and other manifestations of allergies.

Sometimes it happens that the technique does not help the patient. But in any case, as many patients note, it almost never causes harm. It is considered some disadvantage of such a technique as allergen-specific immunotherapy, the cost of courses. Of course, not every patient can afford to pay 12-14 thousand for treatment.

The chronic course of allergic reactions significantly complicates life, causes irritation, nervousness during exacerbations, makes it impossible to do what you love or relax in nature. Antihistamines eliminate negative symptoms only for a while, but they cannot completely get rid of a negative response to stimuli.

What to do? Are patients doomed to recurrences of pollinosis, bronchial asthma, year-round rhinitis throughout their lives? There is a way out - ASIT therapy for allergies eliminates not only the signs, but also the cause of negative reactions. More useful information about an effective method - in the article.

ASIT therapy for allergies: what is it

A set of measures with strict adherence to the methodology, taking into account the characteristics of a particular patient, eliminates the negative response of the body to stimuli. One of the benefits is negative signs do not appear for a long time, often for several years.

Allergen-specific immunotherapy allows not only to control the course of the disease, but also to completely eliminate the cause of acute or chronic reaction. ASIT is a symbiosis of vaccination and homeopathy, a combination of taking minimal doses of an allergen with preparation immune system to the action of a high concentration of the stimulus.

The essence of the method:

• identification of an allergen that provokes a specific negative reaction;
• prolonged administration minimum volume irritant extract;
• gradually the dose of the allergen increases, as the sensitization to a certain substance decreases, the body does not react to it;
• after some time (several months, a year, two, three or more), sensitivity to the stimulus completely disappears;
• as a result of therapy, the immune response switches from allergic to standard, normal. At the end of the ASIT course, doctors guarantee either complete immunity to the stimulus, or a stable, long-term remission.

Advantages and disadvantages

Like any technique, ASIT has both positive and negative sides. Subject to recommendations, sessions by an experienced allergist, active participation of the patient (control of reactions, regular visits to the doctor) negative manifestations rare during treatment. Before starting the course, the patient should receive information about the advantages and disadvantages of the method, tune in to long-term therapy.

Positive points:

• the first and main advantage is the elimination of the causes of many allergic reactions;
• subject to the rules, the result of treatment appears in the vast majority of cases;
• the patient does not experience discomfort from the manifestations of allergic diseases;
• conducting ASIT allows you to significantly reduce the dosage and frequency of taking antihistamine formulations;
• at the end of the course, remission is noticeable for a long time (for each patient differently, sometimes up to several years);
• the technique prevents the transition of mild symptoms to more severe ones, the risk of developing angioedema, anaphylactic reactions;
• the patient can practice usual things, symptoms do not interfere with work, study;
• specific therapy is prevention hypersensitivity to other stimuli.

There are few disadvantages:

• the technique is not allowed for all types of allergies;
• there are contraindications;
• children under five years of age do not undergo the procedure;
• possible side effects;
• treatment takes a year, two or more.

Indications for the procedure

An effective technique eliminates the cause of allergies in the following diseases:

• bronchial asthma;
• seasonal allergies, ;
• acute reactions to the poison of stinging insects;
• - a year-round variety of the disease.

Note! Antiallergic specific immunotherapy is suitable for patients different ages. The technique is approved for the treatment of children who are 5 years old.

Contraindications

The method is not suitable for all patients: there are certain indications and limitations. Procedures are not performed in the presence of certain chronic pathologies, serious diseases. It's important to know: Not all types of allergic reactions can be eliminated with ASIT.

Specific immunotherapy is not used in the detection of certain conditions and diseases:

• severe pathologies of the heart, blood vessels;
• mental disorders with pronounced clinical signs;
• severe form of immune pathologies;
• chronic diseases in the stage of decompensation;
• during pregnancy;
• while taking beta-blockers;
• with oncopathologies;
• in children under 5 years of age.

The introduction of small doses of irritants is not carried out with the following types of allergic reactions:

• , including giant
• allergic reactions to mold fungi;
• drug allergy;
• photodermatitis;
• negative reactions to three or more types of allergens;
• increased sensitivity to the action of non-pathogenic microflora;
• allergic reactions to saliva, wool, particles of the epidermis of animals.

Possible adverse reactions

During therapy with long-term administration of small doses of allergens, negative manifestations on the skin, in the respiratory system, and in the eyes are possible. The patient should be aware of the likelihood of adverse reactions. The best option- conducting ASIT in a hospital or an allergological office. The specialist will monitor the patient's condition, help in case of an acute response of the body.

Possible negative manifestations after an allergen dose:

• on the skin: swelling, redness, burning and itching;
• sore throat, allergic rhinitis;
• itching in the eyelids;
• hives.

Severe reactions are extremely rare: anaphylactic shock or .

After the procedure on an outpatient basis, the patient must be under medical supervision for at least an hour. If negative reactions appear, the doctor will take the necessary measures.

How is the procedure

Previously, doctors injected patients with a water-salt extract of the allergen. Now this view active components does not lose its relevance, but thanks to the research of scientists, it became possible to use other, more advanced drugs. Allergens of prolonged action provoke minimal negative reactions, show enhanced therapeutic effect, have low risk side effects.

How to treat ? Find out effective therapy options.

Effective and safe ways Allergy treatment during pregnancy is described on the page.

Go to the address and read about the causes of allergies under the eyes and the treatment of pathology.

The methodology consists of two phases:

• initiating. The task of doctors is to gradually achieve the maximum dose of the allergen for a particular patient. The introduction of the extract of the irritant occurs at short intervals;
• supportive. At this stage, it is important to consolidate the result, to ensure remission. For a maximum long periods the patient receives a certain dose of the active substance.

Prolonged allergens or water-salt extract of the irritant is found in several ways:

• drops in the mouth;
• subcutaneous injections;
• nasal drops;
• resorption of the substance under the tongue;
• in the form of inhalations.

Doctors consider two methods to be the most suitable: dissolve the extract under the tongue or inject the solution subcutaneously to the patient. When choosing an oral or intranasal route of administration (drops in the nose or taking the drug by mouth), the patient himself can carry out manipulations with mandatory periodic visits to the allergist. The choice of method of contact with the irritant is determined by the doctor.

On a note! Many patients are interested in whether to take additional funds while taking ASIT. Decongestants, antihistamines and antipyretics are needed in severe forms of allergies or in case of negative reactions to irritant extracts. The choice of frequency of administration, dosage of auxiliary medicines for any type of allergic disease, the attending physician conducts.

Time of ASIT therapy:

• year-round. The best option for negative reactions to household allergens. At the first stage, doctors introduce the maximum dosage of a water-salt extract or a prolonged allergen, then a maintenance dosage is required until a positive trend appears;
• preseason. The variety is effective for hay fever. The first doses of the allergen are introduced into the body three to four months before the flowering time. dangerous plants. At the end of the season, therapy is suspended, a new round of treatment begins a year later, at the same time.

The patient receives a dose of the allergen in a hospital, an allergological office or at home. The first sessions are necessarily carried out under the supervision of physicians. When self-administering prolonged allergens, it is important to strictly follow the instructions, immediately inform the doctor about negative reactions and the effect of the drug.

Method effectiveness

Most studies confirm the effectiveness of therapy with low doses of allergens over a long period. Most of patients forget what a negative response to the action of pollen, stings of stinging insects is, complaints of rhinorrhea stop, for many, the remission period stretches for years. Reviews of ASIT therapy are most often positive.

To evaluate the effectiveness of the method, not only the subjective feelings of the patient are needed, but also laboratory research. AT without fail a blood test is done at regular intervals to check the level of immunoglobulin E. When a positive result specific therapy indicators are reduced compared to the values ​​before treatment.

Results:

• with each subsequent course negative symptoms weakens;
• severe forms of allergic diseases become milder;
• with relatively mild symptoms initial stage after several courses, negative symptoms do not appear;
• the need for antihistamines is reduced, often, the complete abolition of antiallergic drugs is possible;
• general well-being is normalized, it becomes possible to lead a habitual way of life.

When assigning a specific immune therapy to combat allergic reactions, you need to follow the doctor's recommendations, attend procedures in a timely manner, and observe the duration of the course. After treatment with ASIT, most patients do not experience negative reactions to stimuli, the immune system does not perceive flower pollen, bee or wasp venom, household allergens as irritants. The method really gives a positive result.

Read more about the prevention and treatment of allergies with ASIT therapy in the following video:

Choose a rubric Allergic diseases Symptoms and manifestations of allergies Diagnosis of allergies Treatment of allergies Pregnant and lactating Children and allergies Hypoallergenic life Allergy calendar

What is allergen-specific immunotherapy (ASIT)? The article gives an exhaustive answer to this question and tells not only about the purpose, methods and mechanism of therapy, but also touches on topics such as efficacy, safety, indications and contraindications, appropriateness of use, drugs used, side effects, as well as the cost of ASIT.

Allergen-specific immunotherapy is a principle of allergy treatment based on the long-term administration of an allergen to which a patient has been found to be hypersensitive.

The main goal is hyposensitization, or a decrease in susceptibility to the injected allergen. The therapy is called allergen-specific, because it reduces the sensitivity of the body only to the introduced allergen. Due to the fact that the action of the allergen extract is similar to the action of the vaccine, allergen preparations are also called allergenic vaccine.

Unlike pharmacotherapy, which acts on individual links of pathogenesis, prevents the development of allergy symptoms without removing the causes of the disease, and therefore is a temporary measure, ASIT qualitatively changes the mechanism of the immune response to the allergen, while after the end of the course of treatment, the effect kept for several years.

Synonyms:

Specific hyposensitization, allergy vaccination, specific allergy vaccination.

The effectiveness of ASIT for allergies has been confirmed by WHO studies, and subject to following conditions reaches an average of 80%:

• Accurate confirmation of IgE dependence of the disease;
• Hypersensitivity only to those allergens that cause the manifestation of the disease;
• Compliance with the doctor's recommendations;
• Carrying out elimination activities before start of treatment;
• Treatment with quality medicines
• No exacerbation of chronic diseases;

With the passage of three or more courses, the efficiency reaches 95%.

The result is also influenced by the age of patients: at the age of five to eleven years, a positive effect is manifested in 94.2% of cases, in children older than eleven - in 83.6%.

Mechanism of action of allergen-specific immunotherapy

To understand why ASIT is so effective and has such advantages over pharmacotherapy, it is necessary to consider in more detail the scheme and mechanism of action of the described therapy.

Before ASIT, the patient takes a clinical blood test with the definition leukocyte formula, general analysis urine, biochemical analysis blood, antibodies to hepatitis, HIV, RW. According to the indications, an ECG, FVD, ultrasound and a number of other tests are performed.

Testing is also carried out to determine which allergen the patient has an increased reaction to. After that, a test is made for sensitivity to the therapeutic form of the allergen.

1. The first stage begins with the introduction small dose the drug, which is gradually increased to the maximum acceptable-tolerated level (optimal dose).
2. In the second stage, the optimal dose is administered regularly for most of the time of the ASIT course. In this case, the dosage depends on the type and strength of the allergen, the method of administration and individual reaction patient.

During therapy, the permanent intake of the allergen causes a restructuring of the immune system, namely, it normalizes, and during repeated courses it reduces the level of specific E-immunoglobulins (lgE) involved in immediate allergic reactions, stimulates the production of G-immunoglobulin that binds the allergen, and inhibits the release of allergy mediators.

In general, such changes occur in all elements of the immune system involved in the formation of an allergic response. As a result, the susceptibility of the immune system to this allergen is significantly reduced, which is the goal of ASIT.

ASIT methods are used, such as:

• Injectable. The drug is administered by subcutaneous injection.
• Non-injectable. Oral ASIT (drops, tablets, capsules), sublingual, intranasal ( water solution or powder), endobrochial (in liquid or powder form).

According to the results of studies conducted by Professor O. M. Kurbacheva, injection and sublingual ASIT are not inferior to each other in terms of efficiency. At the same time, subcutaneous therapy large quantity side effects, incl. serious.

Schemes for ASIT from allergies

classical, designed for a period of 10 months to 3-5 years, with a break between allergen injections from a day to a month;

Such treatment is carried out on an outpatient basis, i. at home. Usually in the course of therapy there are no serious complications, no side effects, so the need for around the clock medical supervision no.

Short term:

• Accelerated scheme: subcutaneous injections of the drug 2-3 times a day;
• Lightning: the required dose of the allergen is injected subcutaneously for three days, every three hours in equal parts with adrenaline.
• Shock method: duration - day, subcutaneous injections of allergen and adrenaline are made every two hours.

Short-term ASIT is carried out in a hospital and is combined with taking antihistamines.

ASIT has its own features at anaphylactic reactions on the poison of stinging insects. Treatment includes precautions against insect bites. An allergic person should carry with him:

1. Allergy passport containing the name, phone number, home address, diagnosis and instructions for using the anti-shock kit.
2. The kit contains syringes, adrenaline solution, antihistamine and glucocorticoid systemic action. During the period of insect activity, a constant intake of antihistamines is desirable.

Food for ASIT should be hypoallergenic, like everyday life. And without errors in the diet, the body is stimulated, the doses are calculated strictly according to the well-being and condition of the person.

If you do not change your lifestyle (at least at the stage of increasing the dose), the proper effect of therapy may not be.

Video: ASIT from allergies - how is the therapy going

Drugs used in allergen-specific immunotherapy

The following allergen standards are used in the ASIT process:

• AU (Allergy units) - developed by the USA.
• BU (Biological units) - European development. The Reactivity Index (RI) is one important example of this standardization.

There are several forms of drugs for ASIT

• Water-salt extracts;
• Allergoids obtained by polymerization;
• Allergens for pcASIT;
• Allergens for slASIT.

We will consider some of them below.

Water-salt extracts of allergens

Mainly domestic drugs for ASIT, are produced by NPO MicroGen ( injectables pollen from oak, birch, etc.).

The same group includes the medicine "" produced in Kazakhstan. There are “vaccines” against weed pollen and meadow grasses, trees, sagebrush and house dust.

Preparations with allergens adsorbed by calcium sulfate suspension

This includes mostly imported funds. Among them:

• Diater Laboratories (), Spain. There are more than 25 allergens, both single and in combinations;
• : Lais Dermatophagoides (Lays Dermatophagoides) - a mixture of allergens from house dust mites; Lais Grass (Lice Grass) - pollen of cereal grasses.
• Stallergenes (Stallergen), France. The firm also has a huge variety of "vaccines". Among them:
  • for sublingual ASIT;
  • and for subcutaneous ASIT;

Each package with the drug has its own instructions, however, the minimum doses are determined by the doctor based on the examination, the results of the analyzes of each individual patient, his age, general condition and severity of allergic phenomena.

allergoids

In addition to allergens, which are natural molecules found in nature, allergoids are also used.

Allergoids are modified molecules that have a reduced ability to bind to E-immunoglobulins, which reduces the likelihood of side effects.

Most allergoids are polymers. However, the LAIS allergoid produced by the action of potassium cyanate on the allergen is a monomer and thus can be administered sublingually.

The most commonly used allergen preparations are grass and tree pollen, dust mites and animal hair.

Allergen-specific immunotherapy ASIT can be carried out with 2 types of allergens, and with the same efficiency as with one (according to research by Professor O.M. Kurbacheva).

Indications for allergen-specific therapy

1. A well-established lgE-dependent nature of the disease (immediate allergic type reactions).
2. No effect on symptomatic treatment allergies through pharmacotherapy.
3. Inability to avoid the action of the allergen.
4. Presence of adverse drug reactions.
5. Refusal of pharmacotherapy.
6. Age over 5 years.
7. Bronchial mild asthma forms.
8. Allergic rhinoconjunctivitis.

Contraindications for carrying out

Contraindications for ASIT for allergies by sublingual, oral and parenteral methods:

• Oncology;
• Autoimmune diseases, immunodeficiency;
• Severe mental disorders;
• Inability to comply with the treatment regimen;
• Age less than five years;
• Diseases of cardio-vascular system in the stage of decompensation (due to the impossibility safe application adrenaline);
• Bronchial asthma in severe form not amenable to symptomatic treatment.
• Pregnancy and lactation require a doctor's consultation to continue treatment.

Also, you can not carry out against the background of treatment with β-blockers:

And taking MAO in combination with sympathomimetics:

Also, be healthy. thyroid- and ASIT can be carried out.

There are also temporary contraindications:

• Exacerbation of the underlying or concomitant diseases, pathologies;
• Vaccination;

In what cases is ASIT stopped:

• Severe reactions to treatment;
• Inability or unwillingness to continue therapy;
• Positive therapeutic effect after several ASIT courses.

Additional contraindications for SLIT

With sublingual ASIT, the drug enters directly into the oral cavity, so the following points should be considered. Must not be:

• damage to the oral mucosa, ulcers or erosion;
• open wounds in the oral cavity;
• inflammatory diseases, bleeding gums.

ASIT and vaccination

The issue of vaccination is important, because. treatment with the ASIT method involves satisfied long-term courses that may overlap with planned preventive measures dangerous diseases. What to do if you need to visit vaccination room"out of my head"? The situation is quite solvable if a number of conditions and recommendations are observed.

First of all, you need to make your doctor known. Depending on the situation, he will explain how best to act in a particular situation. For example, if you are just planning to start treatment with ASIT, then vaccination should be done at least a month before the start of the course of treatment.

If you are at the stage of recruiting the maximum therapeutic dose of the drug, then you should refrain from vaccination.

During the maintenance course, vaccination is possible, but only if treated without interruption for three or more years, but the following recommendations should also be followed:

• Do not take ASIT drugs and get vaccinated on the same day;
• After receiving the ASIT allergen, you can receive the vaccine no earlier than a week later;
• From date of vaccination to next appointment the ASIT preparation should take at least three weeks (and this is in the absence of side effects)
• In the case of the sublingual method of ASIT, at the stage of maintenance therapy, it is necessary to temporarily suspend the use of the allergen. The scheme is as follows: do not use the drug 3 days before vaccination, also on the day of the vaccination and in the next two weeks after vaccination.

ASIT in children and pregnant women

As already mentioned, ASIT during pregnancy is carried out only at the discretion of the doctor. The expectation of a child, generally speaking, is relative contraindication to this therapy.

The fact is that there are no studies that reliably confirm the safety of this method, firstly, for the woman herself.

The immune system of a pregnant woman behaves differently than in a normal state. On the one hand, it is greatly weakened, on the other hand, it is characterized by increased reactivity. Therefore, it is quite difficult to predict the body's reaction to the injected allergen. In addition, there is no data on how safe this technique is for the fetus, whether the introduction of an irritant will affect its growth and development.

There is a risk of systemic reactions that can lead to termination of pregnancy.

In this regard, when planning a child, the current ASIT course is completed, if it was, and a new one is not started until the pregnancy is resolved. If this occurs during the course of treatment, the doctor must assess the condition of the woman, compare the risks and benefits, and decide whether there is a need to continue therapy.

For children, ASIT is often a salvation from allergies. Their immunity is incredibly “vulnerable”, excitable, and allergies in this category of the population are often more difficult, getting rid of it is not so easy. Moreover, not all antihistamines acceptable to take at a tender age. Therefore, childhood and severe allergies are a direct indication for immunotherapy.

However, it is not given to those under the age of 5 (in rare cases- 4) years.

ASIT safety and possible side effects

Of course, when it comes to treatment, safety comes first.

When conducting allergen-specific immunotherapy, both local and systemic side effects can occur.

Local manifestations in the injection area:

• tissue swelling.

Most often, these symptoms occur within half an hour after the procedure. In this case, the dose is adjusted (downwards) of the administered allergen.

For sublingual ASIT local reactions may show itching, burning in the mouth, as well as swelling of the mucosa and tongue.

Systemic manifestations that occur outside the area of ​​​​administration of the drug include:

1. Lungs: rhinitis, itchy nose, watery eyes, dry cough, sore throat.
2. Medium: shortness of breath, itching and rashes on the body, headache, joint pain, fever.

It is worth noting that all systemic manifestations well controlled and stopped, the frequency of their occurrence is no more than 10%. a rare occurrence are severe reactions- anaphylactic shock, Quincke's edema (frequency of manifestation up to 0.001%). In this case, it is necessary to revise the treatment program using the ASIT method.

By the way, no such cases have been registered during the entire period of sublingual ASIT in Russia.

Worth knowing - the analysis of systemic reactions shows that in the vast majority of cases they arose due to deviations from the accepted rules for conducting ASIT, namely:

• Violation of the ASIT protocol:
  • error in the dosage of the allergen;
  • the use of an allergen from a new bottle (switching to another series, with a different allergenic activity);
  • administration of the drug to patients with bronchial asthma during the period of clinical manifestations of the disease;
  • the introduction of the next therapeutic dose of the allergen against the background of an exacerbation of the disease (including, not only allergic);
• An extremely high degree of hypersensitivity of the patient (an insufficiently adjusted dose regimen is associated with this);
• Simultaneous use of beta-blockers.

In world practice, the use of ASIT is very common.

There are also statistics on the occurrence of side effects.

For example, the incidence of anaphylactic shock on the introduction of allergens is recorded only in 0.0007% of cases (1 in 146010 injections with the injection method of ASIT).

But most often, reactions of this kind occur if the treatment is not performed by an allergist, but by a general practitioner who does not have special knowledge in this area.

A logical conclusion follows from this. To avoid negative consequences, it is necessary to undergo treatment in a medical office or hospital. Treatment should be carried out by an allergist with the proper level of qualification.

Maximum effectiveness of ASIT for allergies

Now the procedure is performed for almost all types of allergies. It is considered the most effective in patients). If you are allergic to ragweed, grass pollen, etc. Why?

The fact is that one of the most acute problems is the fight against pollen allergens. If you can not communicate with a cat and “not meet” with an allergy, then it is almost impossible to run away from pollen.

In this regard, studies on the treatment of hay fever have been conducted for a long time. And brought out optimal ratios components, doses and programs of therapy.

For mold allergies, and also if the allergen is a mite (i.e. fighting household allergens), ASIT is also quite effective. Among the drugs there are mixtures that fight allergies to mites, as well as to fungi (allergy from dust). In particular, the company Diater offers more than 5 "vaccines" against these allergens - both single products and combinations of 2, 3 and even 4 irritants. The therapy will be very effective.

cat like strong allergen This is a problem for many, especially children. Treatment of hypersensitivity to these pets is usually successful.

But to a sufficient extent effective remedy still no food allergies.

Video: It is clear about ASIT from our consultant doctor Ilyintseva N.V.

Also on the portal, Nadezhda Viktorovna answered FAQ about sublingual ASIT. The rules for taking the allergen are considered - why exactly, and not otherwise. Questions of duration of reception and efficiency.

The cost of allergen-specific immunotherapy

The cost of the ASIT course consists of a consultation with an allergist, a skin test for sensitivity to allergens, and the price of the drug itself.

It is impossible to say that its implementation is inexpensive. In general, the cost of immunotherapy for allergies can reach tens of thousands of rubles, but in the future this is not so critical, since after completing the course, the need for antiallergic drugs disappears, which compensates for the costs of ASIT.

Below you can see examples of the cost of the procedure in one of the clinics in Moscow (prices may vary depending on the exchange rate).

The price of sublingual ASIT

The price of injection ASIT

The price of tablet ASIT

Is it possible to carry out ASIT for allergies for free, under the CHI policy?

It is difficult to judge this. AT federal law No. 326 “On Compulsory Medical Insurance of Citizens” does not specify a specific list of services that medical organizations are required to provide without payment to the patient. Everything depends on the territorial program of state guarantees.

Answers to common questions

Below you will find answers to frequently asked questions that concern patients and those who are just planning to have a procedure.

How to dilute allergens for ASIT?

The subtleties of the use of the drug undergoing therapy should be explained by the doctor. Each drug has its own characteristics that distinguish it from the rest. However, there is a general approximate scheme for preparing a sublingual allergen:

1. Strictly defined volume of the drug drops into a spoon, pour a small amount water;
2. Pour the product under the tongue, hold it there for a couple of minutes, swallow;
3. The drug should be taken one hour before or one hour after meals;
4. If a single dose of medication is recommended, this should be done at bedtime, not earlier than one hour after eating;
5. The drug is used under the condition strict observance regimen and diet.

It is best to start therapy a few months before flowering. On average, birch blossoms in mid-April-May, respectively, taking drugs can be started in November-December. It is necessary to stop taking drugs until complete recovery, and then, after consulting an allergist, continue therapy.

So, the conclusions from the above are as follows:

• ASIT is effective;
• If the treatment regimen is followed, it is safe;
• The result is preserved for many years;
• The system continues to improve;
• The costs are compensated by the further refusal to use antiallergic drugs in the future.

Allergies are quite common in modern world which is directly related to environmental degradation. Allergic reactions require a person to pay more attention to their health. You must always carry first aid drugs with you and strictly limit all contact with the allergen.

Such discomfort makes you think: is it possible to completely get rid of allergies? There are several ways to combat such a disease: allergen-specific immunotherapy and autolymphocyte therapy. Let's consider these methods in detail.

What is Allergen Specific Immunotherapy?

ASIT is a way to change the body's sensitivity to an antigen. The essence of the treatment is the introduction of gradually increasing doses of the allergen into the body. As a result, immunological tolerance develops to a substance that previously caused an allergy. And the symptoms of the disease disappear.

This method of treatment is more than a hundred years old, and during this time he has proven himself well. ASIT is carried out and prescribed only by an allergist and only during the period of complete remission. The procedure gives more lasting result compared to antihistamine therapy, which simply removes allergy symptoms.

How and where is ASIT carried out?

Allergen-specific immunotherapy acts only on those allergens to which special cells (antibodies) have formed in the blood - immunoglobulins E (IgE). When an allergen enters in a small dose, IgG gradually begins to be produced instead of IgE (they block the antibody without causing pathological symptoms of the disease).

An allergen vaccine is used for treatment - a preparation containing a processed allergen.

Before starting therapy, the patient must undergo a complete examination. It includes blood tests, urine tests, ECG, spirometry and allergy tests by scarification (skin). Based on the data, the doctor selects the type of vaccine, dose and quality of administration.

ASIT is often carried out in a polyclinic. But, ideally, you need to choose a hospital, because. The patient must be monitored around the clock.

The drug is administered in several ways:

• orally - the patient takes the vaccine by mouth;
• sublingual - under the tongue;
• percutally - the solution is injected under the skin of the forearm;
• intranasally - the drug is instilled into the patient's nose.

After the medicine is administered, the person is at least an hour in the clinic, so that as a result of complications, help is provided instantly.

Indications and contraindications for ASIT

As with any treatment, ASIT has categories that can and cannot be treated.

Indications for ASIT:

• allergic rhinitis, conjunctivitis, bronchial asthma in mild form;
• the presence of a specific allergen (1 or 2);
• inability to limit contact with him;
• the willingness of the patient to complete the course of treatment.

Contraindications:

• severe diseases of internal organs;
• immunodeficiency;
• treatment with beta-blockers;
• oncology;
• children's age up to 5 years.

The disadvantages can also be attributed to the fact that vaccines are not developed for each person individually. They simply contain the most popular allergens.

If during treatment the patient becomes pregnant, then ASIT should not be stopped. But still, you do not need to plan a pregnancy with such serious therapy.

The method of treatment is successfully used not only public hospitals but also private clinics.

For 1 injection of the vaccine, the price varies from 330 rubles. up to 4000 r. The cost of the full course depends on the number of procedures: 5700 rubles - 43000 rubles.

Before choosing a particular medical institution, study the reviews on the Internet and consult with your doctor.

How to prepare for ASIT?

Such therapy is carried out only in relation to those allergens, contact with which cannot be avoided. Before starting treatment, the patient must be completely healthy. After the last viral disease must be at least 3 weeks. Also, during therapy, you should not carry out any routine vaccinations.

ASIT with hay fever is not carried out during the flowering period of plants.

During allergen-specific immunotherapy, adverse reactions often occur: local and systemic. An immunologist evaluates the degree of complications, and decides whether to continue treatment.

Main side effects:

• local (redness, swelling, itching at the injection site of the allergy vaccine);
• systemic (nasal congestion, sneezing, difficulty breathing, lacrimation, swelling of the eyes, fever, anaphylactic shock, Quincke's edema).

Due to the fact that side effects are often manifested during ASIT, therapy requires additional medicines(antihistamines, NSAIDs, analgesics).

What are the features of autolymphocytotherapy?

ALT is a way to correct allergies with your own lymphocytes. These blood cells are modified in such a way that they retain all the receptors previously in contact with the allergens. That is, the body adapts to substances that previously caused pathological symptoms.

The technique is quite new, it was patented in 1992.

After treatment, remission lasts from 2 to 5 years. Sometimes the allergy disappears completely.

The principle of ALT

Before starting treatment, the patient full examination, as in the case of ASIT.

An allergy sufferer is fenced venous blood(5-10 ml), from which leukocytes are isolated. White blood cells are cleaned in a certain way, diluted with saline, and injected back into the vein. This procedure reduces the susceptibility of the immune system to allergens.

The course of treatment lasts about a month, during this time about 10 injections are carried out.

This treatment is usually carried out by private medical centers. This method does not require constant control medical staff, so some time after the procedure, the patient can go home.

Autolymphocytotherapy also has several ways of administering a substance:

• intradermally;
• subcutaneously;
• endonasally.

The specificity of administration, method and dose is chosen by the immunologist.

Benefits and contraindications to ALT

With the help of autolymphocytotherapy, almost any disease of allergic etiology can be treated. It can be used in cases where ASIT is prohibited.

Also, the advantage of this therapy is that it can be carried out simultaneously to several allergens. The course of this therapy does not require additional administration of drugs.

Contraindications for ALT are similar to ASIT:

• oncology;
• early childhood (up to 5 years);
• diseases of the immune system;
• pregnancy, breastfeeding;
• severe diseases of the internal organs.

The price of one procedure varies from 3000 r. up to 5000 r. The entire course of treatment will cost 15,000-30,000 rubles. In general, ALT costs less than ASIT, because does not require the development of a special vaccine and the use of additional drugs.

Preparation for autolymphocytotherapy

special training given treatment does not require. But to be sure of a positive result, it is worth starting therapy 2-3 weeks after the transferred acute illness.

In the case of ALT, there is no rejection of the drug, because only one's own lymphocytes and saline are injected into the person.

To possible adverse reactions redness at the site of injection of the solution.

Comparison table of two allergy treatments