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Depigmentierte Allergoide für die allergenspezifische Immuntherapie

Specific immunotherapy with depigmented allergoids

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Zusammenfassung

Die spezifische Immuntherapie (SIT) ist die einzige kausale Therapieform IgE-vermittelter allergischer Erkrankungen. Als Standard gilt die subkutane SIT (SCIT). Dazu werden nichtmodifizierte Allergene als wässrige oder physikalisch gekoppelte (Semidepot)extrakte sowie chemisch modifizierte Extrakte (Allergoide) als Semidepotextrakte eingesetzt. Ein neuartiges Aufreinigungsverfahren besteht in der Depigmentierung und anschließenden Polymerisierung mit Glutaraldehyd. Im Vergleich zu den Rohextrakten zeichnen sich die so modifizierten Allergoide durch eine bessere Verträglichkeit sowohl hinsichtlich lokaler als auch systemischer Nebenwirkungen aus. Sie haben dabei in kontrollierten Studien eine vergleichbar gute Wirksamkeit wie konventionelle Standardextrakte. Nach neueren Befunden ist eine rasche Auftitrierung innerhalb weniger Behandlungstage bis zu einem einzigen Tag (Ultra-Rush-Aufdosierung) sicher möglich.

Abstract

Specific immunotherapy is the only available causative treatment for IgE-mediated allergic conditions. The state of the art is treatment via the subcutaneous route with crude extracts in a water solution, with physically linked (semidepot) extracts or chemically modified semidepot extracts (allergoids). A relatively new purification method combines depigmentation followed by polymerization with glutaraldehyde. This modification results in increased tolerance with a reduction in both local and systemic adverse effects. As controlled clinical trials have shown, the effectiveness is comparable to that of specific immunotherapy with crude allergen extracts. Recent data suggest that the modified polymerized allergoids allow a safe rush titration in a few days or even in 1 day (ultra-rush titration).

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Interessenkonflikt

Die Autoren L. Klimek und O. Pfaar haben im Laufe ihrer wissenschaftlichen Vortragstätigkeit u. a. auch mehrere bezahlte Vorträge für die Firmen Leti/Novartis gehalten. Es besteht jedoch aktuell keine Verbindungen mit einer Firma, deren Produkt in dem Artikel genannt ist, oder einer Firma, die ein Konkurrenzprodukt vertreibt. Die Präsentation des Themas ist unabhängig und die Darstellung der Inhalte produktneutral.

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Authors and Affiliations

  1. Zentrum für Rhinologie und Allergologie, An den Quellen 10, 65183, Wiesbaden, Deutschland

    L. Klimek & O. Pfaar

  2. Universitäts-HNO-Klinik Mannheim, Universität Heidelberg, Mannheim, Deutschland

    C. Thorn & O. Pfaar

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  1. L. Klimek
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  2. C. Thorn
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  3. O. Pfaar
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Correspondence to L. Klimek.

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Klimek, L., Thorn, C. & Pfaar, O. Depigmentierte Allergoide für die allergenspezifische Immuntherapie. HNO 58, 51–56 (2010). https://doi.org/10.1007/s00106-009-2006-0

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