E Cserháti1, G Mezei. 1. 1st Department of Paediatrics, Semmelweis Medical University, Budapest, Hungary.
Abstract
UNLABELLED: Subcutaneous specific immunotherapy has a considerable risk of side effects, including severe life-threatening ones or even death. The disadvantages and problems of this kind of therapy gave rise to looking for new ways of hyposensitization. In allergic rhinitis the local (nasal) immunotherapy may be effective. We studied the efficacy of local nasal immunotherapy (Allerkin) in grass and ragweed allergic children suffering from seasonal atopic rhinitis. PATIENTS: 36 children (12 with grass pollen, 12 with ragweed pollen immunotherapy, 12 controls). METHODS: nasal provocation tests with increasing doses of Allerkin, skin prick test, diary cards. Schedule of the investigations: enrollment of the patients and nasal provocation tests; grass pollen and ragweed pollen preseasonal immunotherapy with increasing doses of Allerkin; during pollen season registration by symptoms and drug consumption; after the season nasal provocation tests. RESULTS: grass immunotherapy: nasal provocation threshold increased (P < 0.01), symptoms became fewer (P < 0.01) and drug consumption was less in the active group compared to control. Similar but less expressed tendencies were seen in the ragweed group. After the second year of immunotherapy the need for steroid treatment was significantly (P < 0.05) fewer in the immunotherapy group than in the control group. No side effects appeared during the course of immunotherapy, but some patients suffered from mild sneezing or nasal discharge after the Allerkin application. CONCLUSION: local (nasal) immunotherapy is an effective, safe and not troublesome alternative to systemic immunotherapy.
UNLABELLED: Subcutaneous specific immunotherapy has a considerable risk of side effects, including severe life-threatening ones or even death. The disadvantages and problems of this kind of therapy gave rise to looking for new ways of hyposensitization. In allergic rhinitis the local (nasal) immunotherapy may be effective. We studied the efficacy of local nasal immunotherapy (Allerkin) in grass and ragweed allergic children suffering from seasonal atopic rhinitis. PATIENTS: 36 children (12 with grass pollen, 12 with ragweed pollen immunotherapy, 12 controls). METHODS: nasal provocation tests with increasing doses of Allerkin, skin prick test, diary cards. Schedule of the investigations: enrollment of the patients and nasal provocation tests; grass pollen and ragweed pollen preseasonal immunotherapy with increasing doses of Allerkin; during pollen season registration by symptoms and drug consumption; after the season nasal provocation tests. RESULTS: grass immunotherapy: nasal provocation threshold increased (P < 0.01), symptoms became fewer (P < 0.01) and drug consumption was less in the active group compared to control. Similar but less expressed tendencies were seen in the ragweed group. After the second year of immunotherapy the need for steroid treatment was significantly (P < 0.05) fewer in the immunotherapy group than in the control group. No side effects appeared during the course of immunotherapy, but some patients suffered from mild sneezing or nasal discharge after the Allerkin application. CONCLUSION: local (nasal) immunotherapy is an effective, safe and not troublesome alternative to systemic immunotherapy.