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MEVSİMSEL ALLERJİK RİNİTLİ HASTALARDA MEVSİM ÖNCESİ İMMÜNOTERAPİNİN ETKİNLİĞİ

EFFICACY OF PRESEASONAL IMMUNOTHERAPY IN PATIENTS WITH SEASONALALLERGIC RHINITIS

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Abstract (2. Language): 
Objective: Preseasonal immunotherapy (IT) is a relatively new form of treatment in allergic rhinitis (AR). In the present study we aimed to evaluate the clinical and laboratory efficacy of IM in patients with AR at the end of the season. Materials and methods: The study was conducted in Kocaeli University Medical Faculty, Department of Internal Medicine, Division of Allergy between September 2005-September 2006. Fourty patients(age:20-60 years; female/ male:27/13), who were diagnosed with seasonal AR on the basis of history, physical examination and different laboratory methods, were enrolled in the study. Of them, 20 were randomized into the control group. The remaining 20 were treated with preseasonal IT. Individuals with asthma or metabolic diseases were excluded from the study. Results: In the group of patients treated with IT, symptoms during the polen season were decreased with a concomitant decrease in the need for other medications. The seaseonal increase in the level of allergen spesific IgE antibodies was prevented. Skin tests showed that the sensitivity of the skin against polen allergens and histamine was decreased; also, serum levels of allergen spesific IgG6, ECP and eosinophil counts were lower in the IT group. The percentage of the eosinophils in the nasal smear and serum tryptase levels were found to be increased. Conclusions: In conclusion, it can be stated that preseasonal ITis a safe and efficient treatment in seasonal AR. Decreased skin sensitivity, suppression of the seaseonal increase in allergen spesific IgE antibodies and decreased serum ECP levels correlated with clinical efficacy. We demonstrated that the immmunological effects of IT occur early after initiation of therapy. There was no correlation between clinical efficiacy and serum levels of allergen spesific IgG6, nasal eosinophil counts and serum tryptase levels. For a firm conclusion, further studies are needed to evaluate the efficiacy of IT in the later phase of immunisation.
Abstract (Original Language): 
Amaç: Bu çal›flma allerjik rinit (AR) tedavisinde nispeten yeni uygulanmaya bafllanm›fl olan mevsim öncesi immünoterapinin (IT) mevsim sonundaki klinik ve laboratuar etkinli¤ini de¤erlendirmek amac› ile tasarland›. Gereç ve yöntem: Çal›flma Kocaeli Üniversitesi T›p Fakültesi ‹ç Hastal›klar› AD Allerji Poliklini¤i’nde Eylül 2005-Eylül 2006 tarihleri aras›nda yap›ld›. Çal›flmaya anamnez, fizik muayene ve farkl› laboratuvar yöntemleriyle mevsimsel AR tan›s› konulan 20-60 yafllar› aras›nda 27’si kad›n, 13’ü erkek toplam 40 hasta al›nd›. Bu hastalardan rastgele seçilen 20’si kontrol grubuna dahil edildi. Di¤er 20 kifliye de mevsim öncesi IT uyguland›. Ast›m ve kronik metabolik hastal›klar› olanlar çal›flmaya al›nmad›. Bulgular: Mevsim öncesi IT alan hastalarda polen mevsimi boyunca görülen semptomlarda ve buna ba¤l› olarak ilaç kullanma ihtiyac›nda azalma gözlendi. Allerjen spesifik IgE düzeylerindeki mevsimsel art›fl engellendi. Polen allerjenlerine ve histamine olan deri testi duyarl›l›¤›nda, serum allerjen spesifik IgG6 düzeylerinde, serum ECP ve eozinofil de¤erlerinde azalma saptand›. Nazal sürüntüdeki eozinofil yüzdesinde ve serum triptaz düzeylerinde art›fl oldu¤u görüldü. Sonuç: Sonuç olarak mevsim öncesi uygulanan IT’nin mevsimsel AR tedavisinde güvenilir ve etkili bir yöntem oldu¤ u söylenebilir. Deri testi duyarl›l›¤›n›n azalmas›, allerjen spesifik IgE’lerin mevsimsel art›fl›n›n bask›lanmas› ve serum ECP düzeylerindeki azalma klinik etkinlik ile uyumlu bulundu. Mevsim öncesi IT’nin immünolojik etkilerinin erken dönemde ortaya ç›kt›¤› gösterildi. Serum allerjen spesifik IgG6, nazal eozinofil ve serum triptaz sonuçlar› n›n klinik etkinlik ile uyumsuz oldu¤u görüldü. Kesin yarg›ya varabilmek için immünizasyonun ilerleyen dönemlerinde de IT’nin etkinli¤ini de¤erlendirecek daha ayr›nt›l› çal›flmalara ihtiyaç vard›r

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