Synonym(s)
Hyposensitization; SIT
DefinitionThis section has been translated automatically.
Subcutaneous (SCIT) and sublingual specific immunotherapy (SLIT) is used in daily practice for pediatric patients with allergies to inhalation allergens or insect venoms, and current estimates suggest that up to 5% of children affected by allergic rhinitis and/or AB receive specific immunotherapy (SIT; approx. 75% SCIT, 25% SLIT).
Pharmacodynamics (Effect)This section has been translated automatically.
The required proof of clinical efficacy of an SIT should be documented in placebo-controlled, randomized studies in sufficiently large patient populations by reducing standardized symptom scores and drug consumption. Only pediatric studies with a high scientific standard are available in small numbers. However, the 10-year data of the Preventive Allergen Treatment (PAT) study indicate that the risk of allergic floor change, i.e. the manifestation of bronchial asthma in patients with allergic rhinitis, can be reduced in the long term by SIT.
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Field of application/useThis section has been translated automatically.
- Inhalation allergy in childhood
- Insecticide allergy in childhood
IndicationThis section has been translated automatically.
- Detection of IgE-mediated sensitization by skin prick testing or in vitro diagnostics
- Clear correlation of the proven sensitization with clinical symptoms and/or a corresponding provocation test
- Availability of standardised or high quality allergen extracts
- Impossibility of adequate allergenicity
- Proof of effectiveness of the planned SIT for the respective indication
- Use of SLIT in children and adolescents only if SCIT is not an option:
- phobic fears of the patient of injections
- General refusal of subcutaneous injection
- Fear of (rare) systemic anaphylactic reactions
- No time for the repeated injection appointments
Undesirable effectsThis section has been translated automatically.
Serious side effects occur very rarely under correctly performed and adequately monitored SIT.
ContraindicationThis section has been translated automatically.
- Uncontrolled bronchial asthma or persistent bronchial asthma with a FEV1 <70% of the setpoint
- Severe autoimmune diseases or immunodeficiencies
- Malignant neoplasias with current disease status
- Lack of compliance
- Additionally in SLIT: inflammation in the oral cavity with severe symptoms
LiteratureThis section has been translated automatically.
- Ott H, Bufe A, Merk HF (2011) Indications and study situation for specific immunotherapy in childhood and adolescence. dermatologist 62(9): 671-676
Prof. Dr. med. Peter Altmeyer