Principles of detection, treatment and prevention of allergies. Desensitization (hyposensitization) of the body: types, methods, possible mechanisms of desensitization. Immunotherapy (specific hyposensitization) Specific hyposensitization

Allergy in the modern world is a common disease. Doctors say that about 90% of the world's population suffer from allergies. However, not everyone has it manifested in the same way and diagnosed. At the heart of the problem lies the sensitization of the body. Let's try to understand the essence of this process and its types.

In medical practice, sensitization of the body in children and adults is the process of increasing sensitivity to stimuli as a result of repeated interaction with them. It is this phenomenon that is the basis of allergies. The sensitization period is the period of time during which, after the first contact with the stimulus, hypersensitivity to it develops.

Doctors identify several versatile causes that can provoke sensitization:

1. Some people with allergies are prone to this at the genetic level. In this case, the symptom of the disease often appears on the skin.
2. Allergy can develop against the background of dysfunctions of the central and peripheral nervous systems of a congenital or acquired type.
3. Hormonal disorders are another cause of the disease. These include dysfunctions of the hypothalamus, pituitary gland, adrenal glands and glands of the reproductive system.
4. and chronic diseases of infectious origin, which recur, "help" to sensitize the body to certain substances.
5. With diseases of the kidneys and digestive system, the amount of toxins in the blood increases. Because of this, allergies develop.

There are several types of sensitization:

1. The type of sensitization that causes asthma in a neglected state is household.
2. Fungal sensitization results from contact with fungi. This phenomenon leads to bronchial asthma.
3. Food sensitization occurs as a result of heredity or diseases of the gastrointestinal tract.

Types of allergens and substances that cause an allergic reaction

Treatment depends on the type of allergen. At the very beginning of diseases, it is important to determine what exactly causes the reaction of the body in order to properly treat them. There are a large number of substances that cause allergies. They are divided into several groups:

Skin autosensitization - causes, ICD code 10, is it contagious?

The international code for skin autosensitization according to the ICD is L30.2. The prefix auto indicates that the process occurs independently. This is a skin disease of allergic origin. It is manifested by inflammation of the skin. You can determine the disease by a pronounced symptom - redness. In addition, the patient is concerned about itching, discomfort, peeling of the inflamed skin. A known type of reaction is dermatitis.

The disease develops as a result of interaction with certain external stimuli.

It is provoked by such factors:

1. The use of drugs without the supervision of a doctor, compliance with the rules of dosage.
2. Reception of dietary supplements.
3. Protracted treatment with one drug.
4. Uncontrolled intake of antibiotics.
5. Bad environmental situation.
6. Weak immunity affects the occurrence of allergic reactions.
7. Incorrect intake of potent substances.
8. Exposure to vaccines and antibiotics.
9. Reaction to sleeping pills.
10. Taking aspirin and similar substances.
11. Ignoring hypersensitivity to the drugs used.

Skin sensitization is a disease with a pronounced symptom. Many are concerned about the question of whether it is contagious.

It is known that this is a disease of allergic origin, it is not based on an infectious process. Based on this, we can conclude that it cannot be transmitted.

The main methods of treating allergies with manifestations on the skin

Treatment of an allergic reaction on the skin requires a lot of time, as it is carried out in several stages. The main common way to get rid of it is to take antihistamines, corticosteroids and topical preparations.

Antihistamines neutralize allergic reactions. They are allowed to be taken only under the supervision of a doctor, because only a specialist can determine the necessary effective dosage and monitor the body's reaction. Of the advertised and well-known funds, Suprastin and Tavegil can be distinguished. These drugs, if taken incorrectly and the characteristics of the body, cause side effects in the form of numbness and swelling. With allergies in childhood, it is allowed to take Cetirizine. Additionally, you can call Zirtek, Claritin. Erius helps to quickly relieve itching, redness and swelling, this medicine has a minimum of contraindications and side effects.

The second stage consists of taking hormonal drugs - corticosteroids. They are responsible for suppressing allergic reactions. However, hormones must be taken with extreme caution.

External preparations relieve redness, itching and swelling resulting from sensitivity to the allergen. Unlike hormonal drugs, gels and ointments take a long time.

What is specific and nonspecific hyposensitization?

To get rid of allergies, hyposensitizing therapy is used. The prefix hypo - speaks for itself. Hyposensitization is a decrease in the body's sensitivity to an irritant. In medical practice, specific and nonspecific hyposensitization are distinguished.

The basis of specific hyposensitization is the introduction of an allergen into the body of a sick person with a gradual increase in the dosage of the substance. As a result, sensitivity to the stimulus is reduced. The metabolism is normalized. Specific hyposensitization is used only if the patient is not able to stop contact with the allergen. Most often this occurs with allergies to dust, pollen, microbes. Before the procedure, it is important to determine exactly what is causing the reaction. This is not so easy to do. To do this, a number of procedures are carried out: allergic skin tests are taken, a specific immunoglobulin is determined. Then you need to determine how much allergen is needed for the reaction to occur. Possible complications as a result of the introduction of an irritant - edema. If redness, urticaria or swelling occurs, the intervals between injections are increased or treatment is discontinued. In asthma, specific sensitization is contraindicated.

Desensitization is a decrease in the body's sensitivity.

Non-specific desensitization is a treatment aimed at reducing sensitivity with medication. Allergoprotectors are used strictly at the appointed time of day and in a certain dosage. For treatment, Lomuzol, Optikorm, Ditek, Nalcrom, Ketotifen are used. These drugs help desensitize the body to the irritant.

Attention! Each drug has a number of contraindications, ignoring them leads to side effects and deterioration of well-being.

Principles of treatment of bronchial asthma

The treatment of bronchial asthma is based on several principles. In order to quickly and effectively get rid of it, efforts should be made not only by the doctor and medicines, but also by the patient. It is important to follow the recommendations of a specialist and monitor well-being. Here are the basic principles of effective treatment.

Desensitization- This is the removal of hypersensitivity of the body. Desensitization can be specific and non-specific.

Specific- this means that the hypersensitivity is removed by the antigen with which the body is sensitized. There are two types of specific desensitization:

Method - when the resolving dose is administered before 8 days.

The method of specific desensitization is called by the name of the author who proposed it, the method according to A.M. Bezredko.

This method is used when 8 days have already passed since the moment of sensitization (from the moment of the first injection). According to this method, the resolving dose is administered in parts (ie, fractional doses). First, 1 ml is administered, and after 20-30 minutes the rest of the dose. Desensitization according to Bezredka is carried out if it is necessary to re-introduce hyperimmune sera for prophylactic or therapeutic purposes, or during vaccination. Small doses of the antigen bind antibodies, prevent cell degradation, the release of biologically active substances, and the development of clinical symptoms.

Nonspecific- desensitization consists in the fact that hypersensitivity is removed by the introduction into the body of drugs that inhibit proteolytic enzymes, inactivate allergy mediators - histamine, serotonin, etc.

Such substances can be calcium chloride solution, alcohol, ephedrine, diphenhydramine, pipolfen, suprastin, fencarol, tavegil.

In order to correct emerging disorders, sick animals use drugs that inhibit the activity of the central nervous system, antispasmodics to reduce bronchospasm in bronchial asthma, etc. Hyposensitization and desensitization are also used as a method of immunotherapy for allergic diseases by sequentially introducing increasing doses of the antigen.

PRACTICAL PART

The purpose of the lesson: To study some of the manifestations of allergic reactions of the body.

EXPERIENCE 1. The Arthus Phenomenon.

The purpose of the experiment: to study the picture of a local allergic reaction in a rabbit.

Experience accessory: rabbit, syringe, scissors, tweezers, cotton wool, iodine, horse serum.

Method of experiment: 20-30 days before the session, the rabbit is sterilely injected under the skin with 5 ml of normal horse serum five times with 5-6 day intervals.

After the 3rd, 4th sensitizing injection, an infiltrate is formed at the injection site of the serum, followed by the development of acute hyperergic inflammation with the formation of necrosis.

EXPERIENCE 2.

The purpose of the experiment: to study the picture of anaphylactic shock in a guinea pig.

Experience accessory: guinea pig, syringe, scissors, tweezers, cotton wool, iodine, horse serum.

Methodology of the experiment: two weeks before the experiment, the guinea pig is sensitized by introducing into the abdominal cavity or subcutaneously 1 ml of horse serum. To obtain shock, re-introduction of horse serum is carried out. Such an introduction can be made in several ways: in the heart, abdominal cavity, subcutaneously. Depending on this, the picture of the shock will be different.

The results of the experiment and their discussion:

According to the clinical manifestation, five main forms of the clinical course of anaphylactic shock are distinguished:

Erased form manifested by scratching the body, there are chewing movements, sneezing, sometimes shuddering of the body and this form lasts from 3-5 minutes.

Light form- the animal has clearly expressed motor restlessness, shuddering of the body, the animal sits ruffled and this clinical form lasts 15-20 minutes.

Medium characterized by a state of stupor, sometimes anxiety is observed.

Severe form characterized by convulsions and paralysis.

Deadly form(Distinguish between fulminant and protracted course. Lightning- all phenomena proceed violently, quickly, the animal falls on its back, general convulsions, involuntary defecation, urination and death within 3-30 minutes; protracted- all phenomena will develop gradually, death occurs within 8-24 hours.

Various forms of the clinical course of anaphylactic shock depend on the method of administration of the resolving dose and the reactivity of the body.

Desensitization (hyposensitization) for allergies is an effective method of dealing with this common disease.

Every year the number of people suffering from allergies is growing in the world. According to various estimates, some form of this disease is observed in 20-40% of the world's population. Among the reasons for the spread of the number of allergy sufferers are the deterioration of the environmental situation, the increase in the consumption of foods rich in "chemistry" and even excessive hygiene.

In order not to suffer from unpleasant symptoms of the disease,. Unfortunately, this is not always possible. Potential sources of allergens surround us everywhere: at home (house dust, animal hair), in nature (plant pollen, insects), in medicines, in food.

To date, does not exist allergy treatment once and for all. Some medications help relieve symptoms quickly, while others work as long as the person continues to use them.

One of the effective methods of treating allergies is specific immunotherapy. It is aimed at reducing the sensitivity of the body to the allergen. Now there are several terms that denote this method of treatment - desensitization, hyposensitization, allergovaccination. Patients often call it "".

Questions from readers

Good afternoon. Please tell me if it is possible to get a dog now if a child (3 years old) has a food allergy (allergic dermatitis) October 18, 2013, 17:25 Good afternoon. Please tell me if it is possible to get a dog now if a child (3 years old) has a food allergy (allergic dermatitis). From birth to 2.6 years old, we had a dog with a cat, and my grandmother has animals and now (we go to visit 2-3 times a month), there were no allergic reactions. We're going through an examination now. After the rash goes away, we'll do allergen tests. Thanks for the consultation.

The essence of immunotherapy

Recall that an allergy is an oversensitivity of the immune system, which occurs when repeated exposure to an allergen on the body. Thus, by changing the reactivity of the immune system, you can get rid of the disease.

Immunotherapy (desensitization, hyposensitization for allergies) reduces or eliminates the symptoms of the disease by correcting disorders in the immune system. This long-term treatment can be used when other remedies have failed and the cause of the allergy has been identified.

During therapy, allergen injections are injected into the body with a gradual increase in dose. Thus, the immune system is “accustomed” to the presence of the allergen, and it stops reacting violently to it.

The state of reduced sensitivity of the body to the allergen, as well as a set of measures aimed at reducing sensitivity, is called hyposensitization. The term "desensitization", meaning "destruction of sensitivity" is not accurate, since it is almost impossible to achieve complete insensitivity of the body to the allergen.

Allocate specific and nonspecific hyposensitization.

Specific hyposensitization

This method is based on the introduction to the patient of the allergen, which provoked the disease in him, in gradually increasing doses. This changes the reactivity of the body, normalizes the functions of the neuroendocrine system and metabolism. As a result, the body's sensitivity to the allergen decreases - hyposensitization develops.

Allergens can be administered by subcutaneous injection, by mouth, under the tongue, by instillation into the eyes or nose. Every day or every other day, the patient is injected with 0.1-0.2 ml - 0.4 ml-0.8 ml of the allergen. Gradually use doses of the allergen at higher concentrations. The course of treatment depends on the type of allergy. So, with pollinosis, treatment should be started 4-5 months in advance, and completed 2-3 weeks before the flowering of plants. In case of dust allergy, it is indicated to receive maintenance doses of allergens 1 time in 2 weeks for 3-5 years.

Nonspecific hyposensitization

This type of hyposensitization is based on a decrease in sensitivity to an allergen using any factors other than the use of a specific allergen.

For this purpose, preparations of salicylic acid and calcium, ascorbic acid, the introduction of histaglobulin, plasma, physiotherapy procedures (UV irradiation, electrophoresis, UHF, diathermy, etc.), spa treatment, physiotherapy exercises are used.

Who can benefit from hyposensitization?

This method of treatment is indicated when it is impossible to avoid contact with the allergen (for example, with hay fever, allergy to house dust). With an allergy to insect bites, this is the only method of preventing and treating anaphylactic shock.
For patients with food or drug allergies, this method is recommended in cases where it is impossible to exclude the provocative product from the diet (for example, milk from the baby's diet), and taking the medicine is vital.

Hyposensitization comes to the aid of people who have occupational allergies to animal hair and skin, but do not want or cannot change jobs (for example, veterinarians, livestock specialists).

The method is also effective in the infectious-allergic form of bronchial asthma.

Specific hyposensitization is carried out only in special rooms under the supervision of allergists.
The introduction of allergens can sometimes be accompanied by local or systemic complications up to anaphylactic shock. In such cases, the exacerbation is stopped and either the dose of the administered allergen is reduced or the treatment is interrupted.

Contraindications

Specific hyposensitization is contraindicated in case of exacerbation of the underlying disease, prolonged treatment with glucocorticoids, with organic changes in the lungs with bronchial asthma, with a complication of the underlying disease with rhinitis, bronchitis, sinusitis, bronchiectasis. In addition, this method cannot be used in patients with rheumatism and tuberculosis in the active phase, with malignant neoplasms, circulatory failure II and III degree, with gastric and duodenal ulcers, during pregnancy.

Allergy Natalya Yurievna Onoyko

Immunotherapy (specific hyposensitization)

Immunotherapy is the introduction of allergens (allergen) to an allergic patient by injection in order to reduce the body's hypersensitivity to this type of allergen. With this method of treatment, the causative allergen is first introduced in very small doses, and then the administered doses are gradually increased. As a result, by the end of the course of treatment, there is a decrease in the manifestations of allergies in the patient when they encounter allergens. Thus, the disease progresses more easily. Sometimes recovery occurs, but more often than not, complete desensitization does not occur.

It is known from practice that this method is most effective for allergies to plant pollen, house dust, animal hair and stings from bees and wasps. Treatment with specific hyposensitization of patients with allergies is carried out in cases where it is impossible to completely eliminate the causative allergen from the environment and the patient's contact with it is inevitable (plant pollen, house dust, and so on). If it is possible to remove the allergen from the patient's environment (for example, food, pets, etc.), then the best therapeutic effect is the method of eliminating the allergen. Special studies have shown that in cases of respiratory allergy, the method of immunotherapy is effective in an average of 30% of patients.

But, despite these optimistic figures, the course of immunotherapy still has a number of negative aspects. Firstly, it is quite expensive, secondly, it is extended in time, and most importantly, it is fraught with local or general complications (urticaria, asthma attack, anaphylactic shock, etc.). Therefore, the method of specific hyposensitization is recommended only for severe forms of allergy.

These include protracted (from several weeks to several months) bouts of allergies; solid "experience" of an allergic disease (at least 2 years); failure of all other treatments. Thus, both indications and schemes for immunotherapy are strictly individual.

Immunotherapy is contraindicated in the following cases:

- with an exacerbation of the underlying disease;

- with an active tuberculous process;

- with collagenoses (diseases of the connective tissue), diseases of the liver, kidneys and other organs;

- with SARS and other acute diseases;

- with mental illness;

- while carrying out preventive vaccinations;

- with rheumatism, pregnancy, peptic ulcer of the stomach and duodenum, oncological diseases.

The severity of the local skin reaction is important: redness and swelling of the skin with a diameter of more than 2-3 cm are a signal of the possible development of a general reaction. In accordance with this, the attending physician prescribes treatment. Immunotherapy can be given year-round (eg, in case of hypersensitivity to house dust) or pre-seasonal (eg, in winter and autumn, before the flowering period of the respective plants). If there is a positive effect, treatment is carried out for at least 2-4 years (the period during which there are clear signs of recovery). If these deadlines are not met, a person again runs the risk of experiencing allergy manifestations. In addition to the above-described classical application of injections of aqueous solutions of allergens, more convenient methods have recently begun to be used. Their meaning is to use long-acting drugs (Alpiral, Cintanal), and the frequency of injections is 1 time per week and 1 time per month. As a rule, these methods are used for pollen allergies in adults. Along with this method, the inhalation method of immunotherapy is used, as well as the method of percutaneous electrophoresis. As a rule, with a reasonable assessment of indications and contraindications, specific hyposensitization proceeds without complications. But sometimes there are local and general reactions that require appropriate therapeutic measures. That is why a person who has received an allergen injection should be observed by medical personnel for 1 hour. The patient himself should be well informed about the possible consequences. All people receiving immunotherapy receive a special memo.

During this type of treatment, it is impossible to carry out preventive vaccinations, it is necessary to exclude physical and emotional overload, hypothermia and overheating.

Physiotherapy and climate treatment

In the treatment of allergic diseases, both physiotherapeutic and climatic methods of treatment are widely used. These are aerosol therapy, electrophoresis of medicinal substances, ultraviolet irradiation, ultrasound, etc. These methods are used everywhere: in hospitals, at home, in clinics, in sanatoriums, but always as prescribed by a doctor. Aerosol therapy is used, in particular, in the treatment of bronchial asthma in the attack and interictal periods. Carry out the spraying of the appropriate drugs using various inhalers. The advantage of aerosol therapy is that drugs are injected directly into the respiratory system. As a result, a person receives the desired concentration of them in the respiratory tract. In the complex therapy of bronchial asthma, electrophoresis of calcium, histamine, adrenaline, aminophylline and other drugs is widely used. In the complex treatment of an attack of bronchial asthma, especially at home, hot hand and foot baths can be used, causing an antispasmodic effect. The water temperature during this procedure gradually rises from 38 ° C to 40-42 ° C. The procedure itself lasts from 7 to 15 minutes, depending on age and individual sensitivity. Adrenal inductothermia (electrotherapy method) is indicated to stimulate the weakened function of the adrenal cortex, especially as a result of long-term hormonal therapy. In autumn and winter, as a rule, general ultraviolet irradiation is carried out in order to increase the body's defenses.

In the treatment of allergic dermatoses, ultraviolet radiation is most often used, since it has a beneficial effect on the state of many systems, including the nervous and immune systems. Electrosleep has a normalizing effect on the central nervous system (the effect on the brain of a weak electric current). It is used in the treatment of eczema, neurodermatitis.

With the same pathology, ultrasound therapy is also successfully used. Warm baths (with neurodermatitis, eczema) with the addition of starch, tannin, decoction of oak bark, chamomile, succession, St. John's wort have an antipruritic effect, a calming effect on the central nervous system, and a local anti-inflammatory effect. Water temperature - about 37-38 ° C, duration - 8-10 minutes, per course - 10-12 baths, daily or every other day.

Ozokerite and paraffin applications are widely used in the treatment of neurodermatitis. In the complex of healing treatment of chronic foci of infection, with allergies, UHF or the Luch-2 apparatus are successfully used on the area of ​​the paranasal sinuses. The course is prescribed 8-10 procedures daily or every other day. UHF, microwave, ultrasound are also used. In the complex of therapeutic measures for allergic diseases, the role of climatic and resort factors is important. A huge healing effect is given by walks in the fresh air, especially in the countryside (but not during the flowering season of "allergenic" plants). At the same time, walks also play the role of hardening activities, which is especially important for children. Walks in cool and cold weather should be started several times a day for 30 minutes, gradually increasing their duration to several hours. It is useful to organize daytime and even nighttime sleep in the air (for example, on the veranda) for children with allergies.

It must be remembered that allergy patients are more sensitive to cooling, so any hardening procedures should be carried out carefully. For hardening to be effective, it must be carried out constantly. The most effective hardening procedures are water (rubbing, dousing, foot baths). First, the water temperature should not be lower than 34-33 ° C, and the duration of the procedure should not exceed 2-3 minutes. Every 3-4 days the water temperature is reduced by 1 °C, but not lower than 22 °C. After the water procedure, the corresponding skin area is rubbed dry with a towel. Bathing in the sea or river is an even more active method of hardening, as it combines the action of water temperature, air, sunlight, and active movements. The best time for swimming in the south is from 9 am to 11 am, and in the middle lane - from 10 am to 12 pm.

The bathing procedure for patients with allergies is very individual, since it is necessary to avoid hypothermia with its undesirable consequences. With caution should be used by allergy sufferers and sunbathing to avoid overheating and the harmful effects of solar radiation. Sunbathing is contraindicated in case of increased nervous excitability, exacerbation of the skin process, with photosensitivity (increased sensitivity to solar radiation). Most allergy sufferers are recommended to stay in the local climatic zone, in local sanatoriums, where there is proper medical supervision, rational nutrition (hypoallergenic diet), physiotherapy and physiotherapy complexes. But there are situations when the harsh local climate needs to be changed to another, more suitable for a given disease (for example, the Crimea, the Caucasus or Central Asia - for a patient with bronchial asthma).

The mountain climate with its clean air, low humidity and pressure has a positive effect on the health of patients with respiratory allergies. Breathing becomes more productive, adrenal function and metabolism improve. Mountain conditions can be successfully recreated in a pressure chamber. But getting used to new climatic conditions is not always easy: headaches, sleep disturbance, exacerbation of allergic diseases are possible. These individual characteristics must be taken into account when prescribing spa treatment.

At many resorts, mineral waters are used for the treatment of allergic diseases, different in composition: sea, brine, hydrogen sulfide, carbon dioxide, oxygen, etc. Mud therapy is also used in the form of local applications (gentle method). In Transcarpathia, Georgia and Kyrgyzstan, sanatoriums use the method of speleotherapy, that is, the treatment of respiratory diseases, including those of allergic origin, in former salt mines. Salt aerosols contained in the air of these mines, the constancy of temperature and humidity, and the absence of allergens have a healing effect here. A general contraindication to referral to sanatorium treatment is an exacerbation of the disease. Sanatorium treatment is possible only during the period of cessation of the disease.