Course of treatment for asitis. How does the procedure work? General principles for selecting a treatment regimen using this technique

Getting rid of allergies is not easy, but modern diagnostic and treatment methods make it possible. Allergen-specific immunotherapy (ASIT) is one of the most effective methods of treating allergies. However, to achieve success, the patient must show endurance and patience, since this treatment lasts several years.

What is allergen-specific immunotherapy

Allergen-specific immunotherapy method(ASIT) is a type of allergy treatment in which the patient is given a salt extract of allergens that cause adverse reactions in increasing doses. allergic symptoms. This treatment was first used in 1911 for hay fever. At one stage of the research, scientists and doctors realized that such therapy would reduce the patient’s sensitivity to natural allergen exposure. For a long time, such treatment was called specific hyposensitization, but with the accumulation of data on the immunological nature of such treatment, the method began to be called allergen-specific immunotherapy.

The introduction of an allergen (causing an allergic reaction) leads to the body's immunological resistance to the action of the allergen. This mechanism has some similarities with vaccination, in which viral components are introduced into the body, to which antibodies are produced. In this regard, the allergen solution itself, which is used for this therapy, is also called an allergen vaccine.

Which is administered to the patient during allergen-specific immunotherapy is called causally significant. However, if under normal conditions the patient comes into contact with such an allergen uncontrollably (which causes illness), then with ASIT this happens according to a clear schedule of the attending physician and in therapeutic doses, which makes it possible to achieve positive dynamics in treatment.

If allergen-specific therapy is successful, then hyposensitization (tolerance) develops. In other words, the body simply gets used to this allergen and stops reacting to it. This increases the adaptive potential of the body. This is akin to hardening, when a person regularly douses himself cold water, then the comfortable temperature range expands.

During the course, allergen- specific therapy the body reacts to usual doses the allergen is less and less, and already at the end of the course, it completely stops reacting to it. The period during which the body completely gets rid of allergies is called remission. According to medical data, in 5% of people after ASIT, allergies disappear forever, and on average, remission after allergen-specific treatment lasts up to 20 years.

Currently, ASIT is used in the treatment of allergies for three groups of patients:

Patients with pollen allergies (hay fever).
Patients with allergies to house dust, animal hair and other household allergens.
People with severe reactions to insect bites.

How does allergen-specific therapy work?

ASIT was first used back in 1911. However, at that time, medicine did not yet have data on cellular and molecular reactions, and therefore the technique was used intuitively, since it gave the desired effect. The first major breakthrough in understanding the molecular cellular mechanisms of allergen-specific therapy occurred in the 60s, when Japanese biologists Teruka and Kimishegi Ishizaka discovered IgE antibodies.

Class E (IgE) are key participants in the allergic response. They are the ones who trigger a hypersensitive reaction to the allergen. Later, scientists found that with allergen-specific immunotherapy, the increase in IgE levels in the blood slows down. And after repeated courses of allergen-specific therapy, the concentration of IgE antibodies even decreases compared to the original. As science and medicine developed, it became clear that ASIT affects not only IgE, but also other parts of the allergic reaction. Thus, the main effects of allergen-specific immunotherapy are the following:

ASIT reduces the level of immunoglobulins E.
When carrying out allergen-specific immunotherapy, antibodies are produced that block class G immunoglobulins. These immunoglobulins bind the allergen, but do not trigger an allergic response. Thus, the more allergen molecules bind to class G immunoglobulins, the fewer of them bind to class E immunoglobulins, and the likelihood of developing an allergic reaction decreases.
With ASIT, the number of mast cells in tissues decreases, which secrete chemokines - substances causing symptoms allergies. The fewer mast cells circulating in the blood, the less chemokines are produced, and therefore allergic symptoms there will be less. In addition, you yourself mast cells with allergen-specific immunotherapy, significantly fewer chemokines are released, which significantly alleviates the allergic reaction.
Allergen-specific immunotherapy also affects other immune cells and molecular complexes. In particular, we're talking about about immune cells Th1 and Th2. The first type of these cells suppresses the allergic response, and the second cells promote its development. As a rule, these cells are in dynamic equilibrium. However, when allergen-specific immunotherapy is carried out, the former cells become significantly more numerous than the latter. This allows for a weaker allergic response.

Medicinal allergens used in ASIT

Throughout the entire period of existence of allergen-specific therapy, water-salt extracts of active active ingredients from various raw materials, upon contact with which certain allergic reactions occur. However, it is worth keeping in mind that allergenic drugs, in addition to the allergens themselves, also contain other components that affect the quality of the drug. Therefore, the resulting water-salt extracts are subsequently subjected to special purification, the methods of which are constantly being improved.

One of the problems of modern allergology is the quality and standardization of drugs for allergen-specific immunotherapy. Different countries have their own quality standards, and this creates certain problems. In this regard, today a general worldwide strategy for the standardization of allergenic drugs is being formed, which provides for mandatory standardization of the allergen according to the following criteria:

allergenic activity;
biological activity;
content of the main allergens in the preparation in units of mass.

It has now become fundamentally possible for different manufacturers determine the content of the main allergens in the preparation, mainly responsible for the increased sensitivity of the body to an allergen with a complex composition. For this purpose, various countries are given international standards(WHO) containing known amounts of the relevant allergens.

Modern technologies for cloning protein molecules make it possible to obtain many important allergenic molecules. This technology significantly facilitates the standardization of allergenic drugs, allowing for strict quantitative determination of the main allergens in a series of dosage forms.

Allergen-specific immunotherapy: how is treatment carried out?

Allergen-specific immunotherapy consists of three main stages:

Preparatory stage: .
The initiating phase is the stimulation of allergen-specific tolerance.
The maintenance phase is the consolidation of the achieved effect.

First stage: preparation

First of all, an allergist carefully studies the medical history of a particular patient, conducts an examination and makes a preliminary conclusion. Without this, no treatment can be started. After this, a diagnosis is carried out - the cause-dependent allergen is determined, and the body’s sensitivity to it is also determined. This procedure is carried out using skin allergy tests. This is when different allergens (up to 20) are dripped onto the skin or small incisions on the skin (it is slightly scratched so that it does not cause discomfort to the patient). In the area where a visible allergic reaction appeared in the form of swelling, redness, peeling, etc., the desired allergen is located.

There are cases when a patient develops a reaction to several allergens at once. In this case, mixtures of various allergens are used for allergen-specific immunotherapy. Exception in in this case are mutually suppressive allergens. For example, it can be pollen and allergens from house dust mites, cockroaches and molds. With this therapy, allergens are degraded and are not involved in treatment.

Skin tests are considered one of the most accessible methods for diagnosing allergies, but they also have a number of limitations, for example:

The patient must be over 5 years old. This is due to the fact that in children the body can naturally change reactions to many allergens. Therefore, in this case, the risk of a false negative reaction to the sample is very high.
At least 30 days must have passed since the last allergic exacerbation.
1-2 weeks should pass since the last dose (in this case, the timing depends on the specific drug). The thing is that if an antihistamine circulates in the blood, a false negative reaction is also possible.

A more modern (but at the same time expensive) diagnostic method is an allergy test done using a blood test. In this case, doctors determine the level of immunoglobulins in the blood serum, and based on this indicator, the degree of danger and the nature of the development of the allergic reaction are determined. It is noteworthy that with just one sample it is possible to determine how a patient will react to 40 different allergens. To do this, use a specially compiled scale with common allergens.

Second stage: initiating phase

Immediately after diagnosis, the gradual introduction of the allergen into the body begins. Initially introduced minimally safe dose, after which it is gradually increased to the maximum tolerated. This is done in order to “teach” the body to be tolerant to a given allergen.

The most common method of allergen administration is subcutaneous (or SCIT). It is done with an injection in the shoulder. However, children under 5 years of age injection forms introduction of allergens is not practiced.

In pediatric practice, as a rule, a non-injection method of allergen administration is used. Allergen-specific immunotherapy in children is performed sublingually. In this case, the drug is contained in a tablet, which is placed under the tongue for resorption.

Currently, allergists debate which method of allergen administration is better, SCIT or SLIT, but both methods work effectively. In this case, the main thing is to follow the schedule for taking the necessary allergens.

As a rule, the first doses of the allergen are administered every day or every other day. Gradually, the introduction of allergens is carried out less and less. It is noteworthy that standard circuits ASIT does not exist. Based constant monitoring Based on patients and diagnostic data, the doctor independently selects the required dosage and dosage regimen.

The initiation phase of allergen-specific immunotherapy lasts three to six months. During this period, the patient should not take antihistamines. In this regard, such treatment begins in autumn period or in winter, when an allergy sufferer can do without antihistamines.

If the flowering season comes soon, then it is possible to carry out such treatment according to one of the short-term schemes:

Accelerated allergen-specific immunotherapy. This technique treatment is accompanied by subcutaneous injections of the allergen 2-3 times a day. The course of such therapy lasts 10-15 days.
Lightning ASIT. For three days, every 3 hours the patient is injected subcutaneously with drugs in equal dosages along with adrenaline.
Shock method of allergen-specific immunotherapy. Allergen injections are performed every 2 hours in combination with adrenaline. This therapy is carried out throughout the day.

You need to understand that all short-term methods of allergen-specific immunotherapy are associated with great risk and are carried out only in specialized inpatient institutions. Short-term ASIT regimens can also be carried out simultaneously with antihistamines. Thus, tolerance to a particular allergen can be achieved within different time, however, in each case, in order to consolidate the result, it is necessary to go through the last stage of ASIT - supporting.

Third stage: maintenance phase

This is the longest stage allergen-specific therapy, during which the patient must regularly take the allergen. Depending on the various reasons, the doctor selects the duration of the maintenance phase. However, on average it lasts from 3 to 5 years, and during all this time the allergy sufferer needs to visit the doctor every 2-4 weeks to take the allergenic drug.

As a rule, therapy is stopped 1-2 weeks before the start of the flowering period, and a repeat course of ASIT begins in the fall, after pollen with causative allergens disappears from the air. If the allergy is not seasonal (for example, an allergy to mites), then allergen-specific therapy is carried out without strict reference to the time of year.

What is the effectiveness of allergen-specific immunotherapy

For more than 100 years of existence allergen-specific immunotherapy thousands were carried out various studies Worldwide. According to medical observations, ASIT is effective in more than 90% of cases. Moreover, cases of unsuccessful treatment are usually associated with insufficient discipline of the patient, who must follow all the instructions of the allergist. So, if a patient wants to get the maximum effect from ASIT, then he should:

Arrive at your doctor's appointments on time. For the first 3-6 months, the patient should come 1-2 times a week. Over the next 3-5 years, this should be done once a week or once a month. Agree, this requires endurance, and not everyone will be able to comply with all the instructions.
During the entire treatment period, the patient should observe and carefully monitor hypoallergenic conditions, strictly following all the doctor’s instructions.

For his part, the doctor undertakes:

Carry out an accurate and correct diagnosis.
Identify the causative allergen.
Apply standardized commercial medicinal forms allergens.
Set up the patient for long and painstaking work to achieve maximum effect.

If all the conditions on the part of the doctor and the patient are met, then with a high degree of probability we can talk about success, since ASIT works great.

People's is growing every year. The reason for this is - genetic inheritance, pollution environment, consumption of unnatural products, use of chemical products in everyday life and much more.
Doctors fight for the health of patients, resorting to 3 types of solutions to the problem:

ASIT therapy. What it is?

Allergy is a word familiar to many. Reason - individual characteristics reactions of our immunity. Thanks to the protection of the immune system, the body is able to fight viruses and bacteria on its own, but with allergies, even seemingly ordinary things can become enemies to health: dust, wool, food products. Histamine, which is produced during allergies, causes swelling and spasms.

Many have heard about this method of treatment as ASIT therapy. What it is?

The method has been used in medicine for more than 100 years. During this time received positive results firmly established this technique. ASIT works to treat allergies, to identify the cause, and not just the consequences. With this therapy, allergens are introduced to a person, gradually increasing the dose. The body gradually produces antibodies to substances that previously provoked an allergic reaction. Real and complete resolution of allergies is what ASIT therapy is aimed at. The scheme of the method is quite simple.

Methodology

The system includes 2 systematic stages.

Allergen introduction stage. The initiating phase includes taking doses, the concentration of which gradually increases to the limit.

The second phase lasts a long time. Over the course of several years, the patient systematically receives maximum dose allergen, but with long breaks. Typically the treatment period is 3-5 years.

Therapy is divided into 3 types

Year-round. This scheme is used when chronic manifestations, for example, if you are allergic to wool or dust.

Pre-season. Characterized by seasonal allergic reactions, for example, to the flowering of certain plants.

Pre-season.

The allergist-immunologist selects the correct choice of treatment regimen.

Allergy symptoms

Sneezing.
Cough.
Watery eyes.
Skin manifestations.

Consequences

Sleep disturbance.
Chronic fatigue.
Low performance.
Various health problems.

What and how is it used?

Preparations for ASIT therapy are based on water-salt extracts, as well as various forms medicinal allergens. In Russia, standardization occurs based on the number of units of protein nitrogen in the preparation.

Reception methods

The vaccine can be administered in several ways.

Intradermal administration (injections).

Drops under the tongue or sublingual method.

Dissolving tablets.

Allergists-immunologists are inclined to believe that the most effective methods- these are injections and drops under the tongue.

Sublingual method It is considered the most convenient for everyone and has many advantages compared to injections.

Injections must be carried out in a specially equipped sterilized room, under the supervision of a doctor. Not everyone has time to constantly visit the hospital. Drops under the tongue are a very convenient way to treat at home.
The sublingual method has the minimum possible adverse reactions compared to others.
A great way for children who are afraid of injections.

Relationship between ASIT and other branches of medicine

If we analyze the methodology, it becomes clear that it is partially borrowed from homeopathy and vaccination. Homeopathy offers to treat, as they say, wedge with wedge, allergies - with their own allergens. Small doses of allergens that cause allergies in larger doses can improve immunity and create antibodies. From vaccination ASIT acquired proper preparation to implementation foreign organisms, as well as the correct concentration.

Advantages

The technique has enough advantages.

Reduction and disappearance of symptoms of the disease.

Protects the patient from complications and the transition of allergies to a more severe level.

Prevention.

Reduces the need to use other antiallergic medications that reduce symptoms.

Long-term remission, which often turns into lifelong.

A person’s quality of life improves due to the complete disappearance of symptoms.

Not all methods are ideal, including ASIT therapy. Side effects include possible itching and redness at the injection site. This goes away on its own or with the help of ice. Sometimes an allergic reaction to the composition of the administered drug occurs: runny nose, redness of the mucous membranes, hives or swelling. To avoid this, you need to carefully select your doctor. An allergist-immunologist monitors the effects of the vaccine for 30 minutes to prevent possible negative consequences.

Indications

Bronchial asthma.

Hay fever.

Allergies to dust, insect bites, flowering plants, etc.

Contraindications

Presence of cancer.

Mental disorders.

Pregnancy at any stage.

Diseases of internal organs.

Children under 5 years old.

Immunodeficiency.

Chronic diseases in the acute stage.

Infectious diseases.

Blood diseases.

ASIT can be combined with pharmacological therapy during the period of acute allergy, when the symptoms are most pronounced.

Entrust all injection procedures to professionals in medical institutions and remain there for some time after the procedures for examination.

Talk to your allergist about all your body's reactions.

For sublingual and other methods that do not require physician manipulation, follow the instructions and recommendations exactly.

Efficiency

Improvements appear after several months of treatment. Often therapy is prescribed in a series of repeated courses to consolidate the result. The consequences of ASIT therapy will be:

ASIT therapy. Reviews from doctors and patients

Based on patient reviews, you can evaluate all the advantages of this method of treating allergies, such as ASIT therapy. Not all people who want to get rid of allergies know what it is and the consequences of the modern method. Patients are advised by qualified people who work in hospitals every day and bring relief to people with such an unpleasant and uncomfortable disease. Some time after the start of therapy, patients already feel the first positive changes in their health, allergic symptoms are alleviated or go away for good. From the experience of people who have undergone treatment, it becomes clear that one should not rush in such a matter as ASIT therapy. What does it mean? Complete completion of treatment is required, which may take considerable time. You should be patient and follow all the doctor’s recommendations.

Patients are especially pleased with the opportunity to choose the use of medications. If earlier therapy was carried out only with the help of injections, now there are other, convenient and painless methods, for example, drops.

Doctors urge their patients not to be afraid of treatment and to go through all stages of ASIT therapy. According to doctors, this is an effective assistant in the fight against allergies, not only its symptoms, but also the cause itself. They won't have that effect. regular medications, which, in fact, only weaken the manifestations of the disease.

Previously, no one could imagine that such a method of treating allergies as ASIT therapy would ever appear. They found out what it was in 1911. Since then, ASIT has been successfully used in medicine. Age-old practice has proven high efficiency this method. Therapy not only helps to remove severe symptoms, but also to achieve complete remission. Doctors should study in detail the causes of allergies and prescribe appropriate doses, which will be systematically increased during the first phase of treatment. The main thing is to systematically follow the rules and doses of the drug prescribed by the attending physician. An allergist-immunologist must have an appropriate higher medical education and experience in this treatment. Patients who follow the above instructions are satisfied with the result and forget about the problem.

Many specialists in the field of allergology believe that complete relief from allergies can only be achieved with the help of allergen-specific immunotherapy. They attribute this to the fact that AIT therapy does not affect individual symptoms disease, but on its root causes. The essence of ASIT is the introduction of small doses of an allergen in a certain mode or a whole mixture of allergens that cause a reaction in patients.

This technique has several different names, for example: specific immunotherapy, specific hyposensitization, allergy vaccination, specific desensitization, allergy vaccine therapy or allergen immunotherapy. However, the very essence this method the name does not change. Its main principle is to reduce hypersensitivity to a specific allergen. In most cases, therapy is successful.

The reception is conducted by

One of the main unresolved problems of allergology today remains the progressive nature of the development of allergic diseases. In this case, the initial stage is characterized by the presence of allergic rhinitis. Since it is not treated properly, over time it will most likely develop allergic conjunctivitis, and bronchial asthma may also develop.

Medicines that only relieve visible symptoms, however, over time they stop working. In addition, the allergist-immunologist may notice a deterioration - an extension of the patient's response season. Thus, at the initial stage of the disease, the patient experiences a reaction only when the maximum concentration of pollen in the air is reached, but over time, the patient develops a reaction during the entire flowering period. This may also include a reaction to other irritants, which complicates treatment and aggravates the course of the disease.

For achievement best results It is important that the maximum possible communication is established between the patient and the attending physician. trusting relationship, since the patient must strictly adhere to all recommendations. Please note that treatment may last for 3-5 years, so do not stop there initial stage, even if there are no visible results.

Optimal conditions for ASIT therapy:

The sooner treatment is started, the more lasting the effect of such therapy will be.
The patient must strictly adhere to the dosage regimen medicines and specialist recommendations.
Usage medical supplies, cleared of impurities and extraneous irritants.

The ASIT technique has been used for many years all over the world, and until now it is considered the most effective in the fight against allergies.

In cases where ASIT therapy is not prescribed or carried out, the following complications inevitably occur:

rhinitis can turn into asthma;
having symptoms worsen;
efficiency decreases drug therapy;
sensitivity to new, unrelated allergens appears.

Note! Specific immunotherapy can only be prescribed by a specialist, based on the results skin tests against the background of manifestations of the disease, and it should be carried out under the strict supervision of an allergist.

Benefits of specific hyposensitization

After a course of specific therapy in 9 out of 10 patients with diagnosed allergic rhinitis or hay fever, the elimination of individual allergic symptoms, a decrease in their severity, or full recovery. The result of this treatment was a reduction in the need to take medications, as well as the transition of allergies to low degree her activity.

With the help of ASIT therapy, you can significantly reduce or completely eliminate symptoms for quite a long time, as well as significantly delay the period of remission. After this course, the need to take symptomatic anti-allergy drugs is significantly reduced.

Allergy vaccination is in the best possible way preventing the expansion of the range of allergens. It also prevents the transition of rhinitis to bronchial asthma.

Features of ASIT action

The basis of therapy is the use special drugs, which contain causative allergens. Such drugs are regularly introduced into the patient’s body in a certain dosage, and their choice depends on the results of the studies.

Regimens and protocols used in immunotherapy treatment

Treatment regimens are always selected individually and are unique for each case. A separate regimen is used for each individual drug. Moreover, all protocols include two phases:

set the maximum dosage that the body can tolerate;
maintaining the selected dose.

There are three types of ASIT therapy based on duration:

pre-season, year-round and pre-season.

For preseason-seasonal protocols, sublingual agents are used. Therapy is carried out a couple of months before flowering begins, and it continues throughout the entire period. The endobronchial and intranasal method of drug administration is used in the most in rare cases As a rule, the practice is to use the subcutaneous or sublingual method (introduction under the tongue).

Year-round protocols are used when allergies have chronic clinical manifestations, for example, allergies to house dust. In this case, the use of Fostal - “Tree pollen allergen” or Staloral “Mite allergen” is justified.

Seasonal allergies are treated using protocols based on water-salt extracts. Treatment begins several months before the start of the flowering season of plants that cause allergic reactions, and ends at the beginning of flowering. When correct implementation immunotherapy, most likely hay fever will not annoy the patient during the dangerous period.

Subcutaneous administration of drugs has been practiced for more than 85 years as part of ASIT therapy, while sublingual administration has been practiced for less than 20 years. Some allergists-immunologists consider the sublingual method of administering the drug safer, but in each specific case the decision is made by a specialist, based on the medical history, etc. One way or another, timely treatment is the first and main step on the path to recovery.

Drugs used in ASIT therapy

To carry out immunotherapy, drugs based on water-salt extracts are used, as well as deposited and modified forms of allergens, which are less allergenic but more immunogenic. Enough wide application received drugs that are produced by formaldehyde polymerization of the allergen. Deposited allergens in the form of suspensions are also often used.

Diagnostic and therapeutic allergens produced in Russia are standardized based on the content of protein nitrogen units (PNU) in them. Each new test of a specific allergen in patients who are sensitive to it helps determine the level of allergenic activity of a particular drug. Thus, provided that the number of protein units is the same, the amount of allergens required for immunization may change, which, in turn, complicates the work with Russian drugs, since it is quite difficult to predict the patient’s reaction to them.

For the above drugs Fostal and Staloral, a system of standardization of the IR - reactivity index is used, which ensures the stability of immunological reactivity. Based on this index, a standard is created - a drug with which all other series of drugs can be compared.

Advantages of using the drugs Fostal and Staloral

These allergens are considered standard and are recommended for use in clinical practice WHO and ARIA experts, since the preparations have undergone appropriate standardization and are capable of ensuring stable activity of allergens at the immunological level, regardless of the time of year and the place where the necessary raw materials are collected.

By prescribing these drugs, the allergist can be sure of the patient’s reaction, as well as the effectiveness of this method, unlike most domestic drugs.

Specialists from the Institute of Immunology of the FMBA Russian Federation We are convinced that deposited allergy vaccines have two clear advantages:

· the use of such vaccines as part of this therapy is more convenient than other drugs;

· ASIT reduces the risk of more severe systemic reactions.

The thing is that the adjuvant that is part of these drugs promotes the release of the allergen directly into the body, preventing the shock effect, so the body quickly gets used to the administered reagent.

Indications for ASIT therapy

ASIT is prescribed when there is a history of IgE-dependent confirmed allergic diseases. Treatment is carried out using exclusively standardized medications, the safety and effectiveness of which have been proven in practice.

An allergist-immunologist prescribes ASIT if there is a history of confirmed IgE-dependent allergic diseases. Treatment is carried out using standardized drugs, the effectiveness and safety of which have been proven in practice.

The use of ASIT is justified in the following cases:

If it is not possible to stop contact with the allergen (allergy to insects and household dust);
If clinical manifestations clearly confirmed by the influence of a specific allergen;
The presence of an IgE-dependent mechanism of sensitization has been confirmed by relevant studies;
The number of allergens does not exceed three positions;
At allergic rhinitis and rhinoconjunctivitis;
In mild or moderate forms of asthma, when FEV1 values after adequate pharmacotherapy exceed 70%;
When the possibility of controlling the symptoms of the disease by eliminating allergens is excluded, or when a total exclusion of all contacts with allergens is impossible;

Specific immunotherapy is prescribed, with certain exceptions, to patients aged 5-50 years, and also if pharmacotherapy causes the appearance of side effects.

Contraindications to ASIT therapy:

collagenoses, diseases circulatory system;
severe form of bronchial asthma, poorly controlled pharmaceuticals, obstructive syndrome if FEV is less than 70% after treatment;
age less than 5 years;
severe pulmonary emphysema, 2 and 3 degrees of cardiac pulmonary failure, accompanied by bronchiectasis; asthma;
diabetes decompensated form, with the exception of specific desensitization to insulin;
pregnancy: if pregnancy occurs, therapy is not prescribed, but if it occurs after the course has been prescribed, it is not canceled;
presence of a history of anaphylactic shock on ASIT (for subcutaneous administration);
if the patient has ever been treated with beta blockers;
if it is impossible to adhere to the treatment regimen;
severe immunopathological condition or immunodeficiency;
severe somatic diseases: active rheumatism, decompensated rheumatic heart disease, decompensated kidney and liver diseases, thyrotoxicosis, etc.;
exacerbation of various chronic diseases;
hypersensitivity to the excipient of the drug used for ASIT;
severe forms mental disorders;
active cancer (tumors that have been under control for a sufficiently long time are not a contraindication);
acute and septic infectious diseases.

Temporary contraindications to specific desensitization:

fever;
allergic manifestations of an unstable nature, for example, unstable asthma, progressive allergic rhinitis, generalized urticaria, etc.;
open wounds in the oral cavity;
exacerbation of intercurrent diseases (ASIT therapy is prescribed only during their remission);
Immunotherapy is not carried out on the same day as preventive vaccination.

Contraindications for the sublingual method of drug administration for ASIT

· erosions, ulcers and other persistent damage to the mucous membrane oral cavity;
· persistent periodontal diseases;
· recent surgical manipulations in the oral cavity;
· gingivitis with characteristic bleeding gums;
· diseases of the oral mucosa that are inflammatory in nature.

When diagnosing a patient hypersensitivity to several allergens at once, a mixture of allergens is used, but in this case ASIT does not guarantee quick results treatment. To enhance the effect, immunomodulatory treatment is additionally carried out.

Why should you contact the International Multidisciplinary Center for allergy treatment?

We offer our patients comprehensive examination directly on the day of contacting a specialist. As a result of the research, appropriate treatment will be prescribed in the shortest possible time, regardless of what exactly the patient needs: symptomatic drugs or ASIT therapy.

We guarantee improvement in the patient’s condition within a few days, depending on the stage of the disease. In our clinic you can get answers to all your questions about the therapy used.

Rest assured that with us you will finally be able to breathe deeply, regardless of the time of year and surrounding allergens!

Allergy treatment is a long process and not always effective. Allergy gradually turns into a constant companion of a person, periodically worsening the quality of life and forcing one to take potent drugs.

Methodology ASIT (allergen-specific immunotherapy) consists of an individually developed list of measures for long-term elimination of allergy manifestations. This is the only effective way to gain control over allergic manifestations or completely get rid of reactions of this kind.

What is allergen-specific immunotherapy?

The treatment regimen involves gradually introducing a person with a provoking serum of a specific allergen. A gradual increase in dosage causes the body to become addicted, thus relieving the problem. The ASIT method is a derivative of vaccination and homeopathy; it was created on a similar principle, taking as a basis the following main points:

from the field of homeopathy - the principle of treating like with like: or relief lies in microdoses of the allergen, in large quantities causing allergies;
from vaccination - preparing the immune system to accept a foreign element: a low concentration of the allergen before introducing large dosages is the key to successfully overcoming the problem.

The mechanism of action of the technique is a sequence of multicomponent reactions to normalize the immune response. The course of treatment sometimes lasts for months and even years, but after its completion a long respite is guaranteed, which can provide immunity to a given allergen, in some cases forever.

Specific immunotherapy for allergies has proven effective in the treatment of rhinitis and conjunctivitis, asthma and dermatitis, reactions to insect bites if they are caused by allergic reactions.

What allergens are used?

Doses of the allergen are injected into the patient's body, increasing with each injection.

Treatment is preceded by a full examination of the patient to identify indications and contraindications.

The administration of serum is carried out only under the supervision of specialists - in specially prepared departments and rooms.

The extracts used are obtained from the poison of insects, mushrooms, grains and weeds, and house dust.

The results of an allergy examination reveal the allergen vaccine that provokes the reaction.

If sensitivity to several allergens is detected, the course is carried out with several vaccines at once.

The patient is examined before the vaccine is administered. After the injection, his condition is monitored for an hour.

The vaccination is done in the shoulder area, subcutaneously.

If necessary, if the patient’s condition is assessed as aggravated, and for the treatment of allergies according to an accelerated scheme (lasting up to 2 weeks), a course of ASIT is carried out in a hospital.

Treatment improves the condition of patients, facilitates the course of allergies and the prognosis. Timely use of the technique prevents the transition of diseases from mild to severe forms.

With allergic rhinitis, the risk of developing bronchial asthma is reduced.

When reacting to insect venom, the likelihood of life-threatening situations occurring decreases.

As a rule, clinical improvement occurs after the second course of ASIT for allergies. The effect of treatment lasts for a long time.

Advantages of the technique

With successful completion of the ASIT course, the frequency of allergy manifestations is significantly reduced, often to zero. Effectiveness lasts for several years.
The technique prevents polyvalent allergies.
Development decreases more than severe forms reactions.
The need for anti-allergy medications decreases and sometimes disappears completely for a while.

The opinions of doctors and reviews of patients who have undergone treatment coincide - in most cases, one course is not enough to obtain a lasting result, although the severity clinical symptoms decreases.

Overall, the success rate of the technique is more than 90%.

How is the vaccine administered?

The purified allergen can be introduced in different ways:

Injections are given subcutaneously under the skin of the forearm - the most common method;
the patient can drink the vaccine - orally;
drops or a tablet can be placed under the tongue - sublingual method;
when inhaled through an inhaler - inhalation method;
the vaccine can be dripped into the nose - intranasal method.

Indications and contraindications

This procedure, like any other, has its own indications. Not everyone with allergies can use it.

ASIT therapy is prescribed in the following cases:

At hay fever;
Severe reactions to animal hair and house dust;
Conjunctivitis due to allergies;
Bronchial asthma;
Hives;
For some manifestations of food allergies;
When the patient is ready to undergo treatment.

If pregnancy occurs during treatment, there is no need to interrupt the course, but treatment should not be started during pregnancy.

When should the ASIT course not be used? An obstacle to treating allergies using this method is:

Immunodeficiency;
Diseases of blood vessels and heart;
Bronchial asthma in severe form;
Oncological pathology;
Use of beta blockers;
The presence of infections and diseases in acute form;
Mental disorders.

The use of the technique is also not recommended for children under 5 years of age.

During treatment, allergies may occur, but if all recommendations are followed and standardized vaccines are used, side effects are practically eliminated. This method today is the only recognized and proven safe for treating allergies. The timely start of treatment has an impact on achieving a lasting effect.

Where to do ASIT?

Treatment can be carried out in Moscow, in a specialized allergological office of the Central Clinical Hospital of the Russian Academy of Sciences. The scheme is selected individually after full examination. Depending on the type of allergy, it can be used year-round or seasonally. The cost of the course of treatment and the price of the vaccine are given in the price list. Answers to all your questions can be obtained by calling.

Elena Petrovna 10,497 views

Most qualified allergists say that it is impossible to completely overcome allergies. Moreover, mild allergic reactions can develop into more severe pathologies.

When using this method of treatment, complex reactions occur in the immune system, which ultimately leads to the fact that the immune system stops responding to allergens as foreign proteins.

ASIT therapy is often referred to in medicine by other terms - the most famous of them are:

allergen immunotherapy;
specific hyposensitization;
allergy vaccination;
specific immunotherapy.

The duration of ASIT therapy is calculated at least two years; at the end of the course of treatment, a long-term remission occurs or allergy symptoms decrease so much that the sick person no longer needs to take it.

When was the ASIT method first used?

The first mention of specific immunotherapy occurs in medical literature, dating from the beginning of the 20th century.

At this time, allergen immunotherapy began to be actively used to eliminate allergies that arise after contact with mite and dust irritants.

ASIT therapy has been successfully used a hundred years ago to treat patients with asthma, year-round rhinitis, etc.

The first therapeutic allergens were water-salt extracts of the identified allergen.

Today, when carrying out specific hyposensitization, more advanced drugs with a prolonged mechanism of action are used.

Compared to previously used water-salt extracts, modern therapeutic allergens have many advantages:

They are virtually free of side effects;
They have an enhanced therapeutic effect on the body;
They have a minimal degree of allergenicity.

An example can be given.

Drugs for ASIT therapy are selected individually for each patient with allergies.

They can be:

injection;
in the form of drops or tablets;
for sublingual administration.

ASIT principle

When conducting ASIT therapy, a microscopic dose of an allergen extract, that is, a substance to which the body is hypersensitive, is introduced into the human body in different ways.

The dose of the allergen is increased gradually and this helps reduce hypersensitivity.

It has been established that an allergic reaction occurs as a consequence of certain changes in the human immune system. At the same time it comes out into the blood a large number of immunoglobulins IgE and antibodies from class E, which are specific for each specific allergen.

The contact of immunoglobulins and antibodies with the allergen causes the development of all allergy symptoms.

Allergen immunotherapy causes several changes in the body. This treatment method causes the activation of lymphocytes responsible for the production of positive immunoglobulins IgE, and at the same time reduces the production of those lymphocytes that form antibodies.

As a result, the connection between the allergen and immunoglobulin is blocked, and conditions that contribute to the triggering of a hypersensitivity reaction are eliminated.

ASIT therapy:

Eliminates allergy symptoms;
Improves quality of life;
Provides long-term remission;
Prevents the transition of mild forms of allergic reactions to more severe ones - anaphylactic shock, Quincke's edema, asthma;
It prevents the occurrence of hypersensitivity to other types of allergens;
Leads to a dose reduction and, in mild cases, allows one to completely abandon antiallergic treatment.

The effect of specific hyposensitization is determined by a dozen factors, including the individual reaction of each person.

In some patients, a noticeable improvement in general well-being appears after completing the first course of ASIT therapy.

For others only after a few years course treatment stable remission occurs.

But repeated courses of treatment with therapeutic allergens are always necessary; their duration and frequency are determined by an allergist.

Specific immunotherapy is carried out in two stages:

The first stage is the initiating phase. The main task at this stage is to achieve the maximum tolerated dose of the therapeutic allergen. The patient is gradually injected with increasing concentrations of the allergen drug at short intervals.
The second phase, supporting. The goal is to achieve stable remission. At this stage, the time intervals between which the maximum, always stable, dose of the allergen is introduced are expanded.

Indications for Asit therapy

The effectiveness of allergen immunotherapy has been proven in the treatment of patients with:

Seasonal allergies and hay fever;
Year-round rhinitis allergic origin;
An allergic reaction to the poison secreted by Hymenoptera;
Bronchial asthma.

ASIT therapy is prescribed for following conditions:

If complete cessation of contact with the allergen is impossible. This applies to cases of allergies to pollen, reactions to.
The allergen has been accurately identified;
Allergies develop when the body is exposed to no more than three allergens.

Contraindications

Specific hyposensitization, like any other treatment method, has its contraindications.

TO absolute contraindications ASIT therapy includes:

Active malignant process in the body;
Severe pathologies of the immune and cardiovascular systems;
Mental illness;
Somatic diseases in the stage of decompensation;
Pregnancy. However, if immunotherapy for allergies was started before pregnancy, it is not recommended to interrupt its course;
The patient's age is up to 5 years.

ASI therapy is not prescribed to patients if they have:

, that is, allergies develop from exposure to more than three types of irritants;
Urticaria and Quincke's edema;
Allergy to fungal spores, mold, ;
Allergic reaction to non-pathogenic microflora.

With the pathologies and diseases listed above, the load on the immune system is increased several times, and additional stimulation of the immune system can lead to undesirable consequences.

By whom and where is ASIT therapy performed?

ASIT therapy should be carried out in medical institution. The injections are administered by a nurse with the appropriate certificate. An allergist should monitor the patient’s condition.

Order of conduct

The effectiveness of hyposensitization of the body and the absence of side effects from treatment depends on how correctly all stages of allergen immunotherapy are followed.

The doctor must tell the patient how to prepare the body, during what period the medications can be used, and what needs to be done after their administration.

Patient preparation.

The timing of ASIT therapy is planned in advance. The start of drug administration should occur during the period of remission of the disease.

If we are talking about seasonal allergies, then allergen immunotherapy is usually prescribed for the autumn-winter months.

For year-round reactions to allergens, treatment is carried out against the background of a basic course of therapy, but remission of the disease must be achieved.

Patient preparation includes:

Conducting to identify a specific allergen;
Avoiding contact (or reducing it to the bare minimum) with the identified allergen;
Discontinuation antihistamines. For mild forms of allergies, it is recommended to stop taking medications 7 days before ASIT therapy; for severe forms, 3 days before.

During the period of administration of therapeutic allergens, a person must be absolutely healthy.

Rules that must be followed.

To minimize possible negative reactions for therapeutic allergens must be observed following rules:

Carry out the procedure strictly in a medical office, where everything is available medications to provide emergency care. This point is especially mandatory when carrying out the first manipulations.
Stay in a medical facility under the supervision of a nurse or doctor for at least an hour after the drug is administered.
Inform medical staff about any, even minor, changes in your health.
When using allergen extracts on your own, strictly follow all the recommendations of your doctor.

Schemes for ASIT therapy.

Allergen immunotherapy regimens are selected individually, but any of them is divided into simulating and maintenance phases.

Hyposensitization courses are repeated several times. Usually three or four courses are carried out.

Forms of treatment with ASIT therapy.

Therapeutic allergens are currently administered in two ways: subcutaneous injections and sublingually.

With the subcutaneous method of ASIT therapy, allergens are administered once every 2-6 weeks.

The sublingual method involves the use of solutions or sublingual tablets.

Today, sublingual ASIT therapy is considered the most effective and safe.

Tablets and solutions are more easily tolerated by small children, and the therapeutic allergen is quickly absorbed by the mucous membrane and immediately activates the immune system.

But for the sublingual method, in addition to the main ones listed, there are a number of contraindications, these are:

Ulcerative lesions and erosion of the oral cavity;
Periodontal diseases;
Rehabilitation period after surgical interventions in the oral cavity;
Inflammatory diseases organs of the oral cavity;
Gingivitis with bleeding gums.

To enhance ASIT therapy, in some cases immunomodulatory drugs are prescribed.

What are special prolonged allergens?

Long-acting allergens are those drugs whose effect lasts for a long time.

That is, they will affect immune system a person for a sufficiently long period of time, which allows the specific immune response to foreign proteins to change to normal.

The introduction of prolonged allergens is different least amount adverse reactions. Therefore, these drugs are suitable for prescribing ASIT therapy even to overly sensitive patients.

When to expect the effect of the procedure.

Carrying out immunotherapy with allergens in most patients improves general health after the end of the initial course, that is, after a few months.

A series of courses of ASIT therapy over several years sometimes leads to the complete elimination of allergic reactions.

In allergology, a number of indicators are used, the assessment of which will help determine the effectiveness of allergen-specific immunotherapy. This is primarily a decrease in IgE compared to tests performed before the start of therapy.

The use of ASIT therapy allows you to achieve:

Relieving symptoms of allergic reactions. The severity of the disease decreases with each course, and the reaction to the allergen may completely disappear after several years of treatment;
Reducing the frequency of use of antiallergic drugs;
Transition of severe forms of allergies to milder ones;
Significant improvement vitality and well-being.

Age restrictions.

ASIT therapy is not given to children under 5 years of age. The upper limit of restrictions on age category no, but it is still better to carry out this treatment for people no older than 60 years.

Possible adverse reactions

Therapeutic allergens undergo controlled studies and are released into production only with a small percentage of identified side effects.

But this does not guarantee that an individual intolerance reaction will not occur; it can be local and systemic.

Local manifestations of side effects of ASIT therapy include the appearance of changes at the injection site, these are:

Swelling;
Hyperemia;

The systemic reaction manifests itself:

Quincke's edema;
Anaphylactic shock;
An attack of bronchial asthma.

In addition, it is often observed general deterioration well-being, expressed by headache, aches in muscles and joints, discomfort all over the body.

A systemic reaction is considered dangerous to the body, which is why it is so important to be under medical supervision for the first 60 minutes after administration of the drug.

If a healthcare professional detects signs indicating hypersensitivity to therapeutic allergens, he will quickly provide the necessary medication assistance, it is:

In applying a tourniquet above the injection site;
By applying adrenaline directly to the area of the previous injection;
When administering aminophylline into a vein for bronchospasm;
In the intravenous administration of antishock and antihistamine drugs.

If symptoms of systemic intolerance develop outside the walls of a medical institution, then it is imperative to call ambulance.

Measures to reduce adverse reactions

In order to reduce the likelihood of side effects, it is necessary to comply with all conditions for ASIT therapy.

First of all, it is necessary to establish the absence of all contraindications to treatment; it is imperative to find out the causative allergen.

During the period of immunotherapy with allergens, the patient must be completely healthy.

Allergists advise starting to follow hypoallergenic therapy a few days before ASIT therapy. It is advisable to adhere to it throughout the course of treatment.

Symptomatic drugs prescribed in addition

During specific hyposensitization, the allergist must monitor the patient and evaluate any changes in well-being.

If necessary, the doctor prescribes additional medications, these may be:

In addition to these medications, the allergist may prescribe other medications to help cope with negative side reactions.