T.A. TRIFONOVA², L.Yu. POPOVA¹, G.D. ALEMANOVA¹, E.V. BOBKOVA¹

¹Orenburg State Medical University, 6 Sovetskaya St., Orenburg, Russian Federation, 460000
²Orenburg Regional Clinical Hospital №2, 24 Nevelskaya St., Orenburg, Russian Federation, 460018 

Trifonova T.A. — allergologist-immunologist for outpatient consultations of the Regional Children’s Centre of Allergology and Clinical Immunology, tel. +7-950-187-68-37, e-mail: doctrifonova@yandex.ru

Popova L.Yu. — D. Med. Sc., Professor, Head of the Department of Children’s Diseases, tel. +7-903-36-08-781, e-mail: docpopova@yandex.ru

Alemanova G.D. — D. Med. Sc., Associate Professor of the Department of Children’s Diseases, tel. +7-922-84-77-203, e-mail: galina.alemanova@bk.ru

Bobkova E.V. — Assistant Lecturer of the Department of Children’s Diseases, tel. +7-922-53-16-273, e-mail: elena_dokt@mail.ru

We have examined 27 patients with allergic rhinitis (AR) aged 5-16 years. The clinical and economic efficacy of sublingual allergen-specific immunotherapy (SLIT) has been investigated. In 89% of patients with AR there was polyvalent sensitization, in the structure of which the leading component is concomitant sensitization to allergens of trees, meadow plants, cereals and weeds, indicated in 55.5% patients in both groups. The majority of the surveyed children with allergic rhinitis had high tissue sensitivity to pollen allergens of wormwood (81.4%), mixed allergen to weeds (59.2%), mixed allergen to trees (55.5%). After the course of SLIT, excellent and good results were achieved in 72% of patients with AR. In the main group, indicators of symptoms severity decreased by 8 times, in the control group – by 1.5 times (p=0.001). Clinical efficacy of SLIT in children with AR was accomplished by a decline in levels of Ig E and an increase in Ig A and Ig M, which indicates rearranging of the immune response. Application of SLIT with therapeutic allergens in children with AR allowed to reduce the direct cost of treatment by 5.2 times and by 6.5 times per one cured patient.

Key words: allergic rhinitis, children, pollen sensitization, sublingual allergen-specific immunotherapy, clinical and economic efficacy of sublingual allergen-specific immunotherapy.

 

 

REFERENCES

1. Allergologiya i immunologiya, pod red. A.A. Baranova, R.M. Khaitova [Allergology and immunology. Ed. by A.A. Baranov, R.M. Haitov]. Moscow: Soyuz pe-diatrov Rossii, 2011. 256 p.

2. The European Declaration on Immunotherapy. Fight allergies not only on the level of symptoms. Part II. Ros. allergol. zhurn, 2012, no. 3, pp. 37-40 (in Russ.).

3. Lopatin A.S., Chuchueva N.D. Epidemiology of allergic rhinitis in Russia and in the world. Ros. allergol. zhurn, 2013, no. 2, pp. 3-11 (in Russ.).

4. Gushchin I.S., Kurbacheva O.M. Allergiya i allergenspetsificheskaya immunoterapiya [Allergy and allergen immunotherapy]. Moscow: Farmarus Print Media, 2010. 228 p.

5. Allergicheskiy rinit – etiologiya, patogenez, osobennosti farmakoterapii: metod. rek., sost. S.V. Ryazantsev [Allergic rhinitis — etiology, pathogenesis, particularly pharmacotherapy: method. rivers. Comp. S.V. Ryazantsev]. Saint Petersburg: Nats. registr lecheniya sinusitov, 2006. 28 p.

6. Baranov A.A. Pharmacotherapy in pediatrics. Pediatricheskaya farmakologiya, 2006, no. 1, p. 8 (in Russ.).

7. The European Declaration on Immunotherapy. Fight allergies not only on the level of symptoms. Part I. Ros. allergol. zhurn, 2012, no. 2, pp. 45-50 (in Russ.).

8. Stempel D.A., Woolf R. The cost of treating allergic rhinitis. Curr. Allergy Asthma Rep, 2002, vol. 2 (3), pp. 223-230.

9. Aberg N. et al. Prevalence of allergic diseases in schoolchildren in relation to family history, upper respiratory infections, and residential characteristics. Allergy, 1996, vol. 51, pp. 232-237.

10. Sulima V.V. Sravnitel’nyy analiz kliniko-ekonomicheskoy effektivnosti origi-nal’nykh i vosproizvedennykh antigistaminnykh preparatov vtorogo pokoleniya pri leche-nii sezonnogo allergicheskogo rinita: avtoref. dis. … kand. med. nauk [Comparative analysis of the clinical and cost-effectiveness of origi-nal and reproduced antihistamines second generation with leche-nii seasonal allergic rhinitis. Synopsis of dis. PhD med. sciences]. Chelyabinsk, 2009. 23 p.

11. Il’ina N.I. et al. The effect of climatic factors on the range and structure of allergic diseases by the example of the Moscow region. Ros. allergol. zhurn, 2014, no. 2, pp. 25-31 (in Russ.).

12. Torshkhoeva R.M. et al. The allergen immunotherapy in children with hay fever. Vopr. sovremennoy pediatrii, 2014, vol. 13, no. 1, pp. 155-161 (in Russ.).

13. Kozulina I.E., Pavlova K.S., Kurbacheva O.M. The structure of allergic diseases among the young population. Ros. allergol. zhurn, 2013, no. 1, pp. 85-86 (in Russ.).

14. Etiologicheskaya struktura, klinicheskoe techenie i metody lecheniya pollinozov v Orenburgskoy oblasti: inform. pis’mo [The etiological structure, clinical course and treatment of pollinosis in Orenburg region: Inf. letter]. Orenburg, 2003. 11 p.

15. Zlodeeva E.A. Vliyanie ekologicheskikh faktorov na rasprostranennost’ allergicheskikh zabolevaniy u detey i podrostkov na selitebnykh territoriyakh Orenburgskoy oblasti [The impact of environmental factors on the prevalence of allergic diseases in children and adolescents in the residential areas of the Orenburg]. Materialy XIII mezhregional’noy nauchno-prakticheskoy konferentsii, Penza, 25-26 oktyabrya 2007 g. GOU DPO Penzenskiy institut usovershenstvovaniya vrachey Federal’nogo agentstva po zdravookhraneniyu i sotsial’nomu razvitiyu. Penza, 2007. Pp. 108-110.

16. Bousquet J. et al. Allergic Rhinitis and its Impact on Asthma (ARIA) 2008 update in collaboration with the World Health Organization, GA2LEN and AllerGen. Allergy, 2008, vol. 63, suppl. 86, pp. 8-160.

17. Canonica G.W. et al. Sublingual immunotherapy: World Allergy Organization position paper 2013 update. World Allergy Organization Journal, 2014, 7, 6, available at: http://www.waojournal.org/content/7/1/6 (accessed: 14.06.2015)

18. The safety profile when used sublingual Asit preparations. Aktu-al’naya i kachestvennaya informatsiya dlya spetsialistov v oblasti allergologii. Informa-tsionnyy servis, 2014, iss. 4, pp. 13-14 (in Russ.).

19. Kurbacheva O.M. Sublingval’naya allergen-spetsificheskaya immunoterapiya — metod sistemnogo lecheniya atopicheskikh zabolevaniy [Sublingual allergen-specific immunotherapy — a method of systemic treatment of atopic diseases]. Sublingval’naya allergen-spetsificheskaya immunoterapiya: sb. temat. st. Moscow: Farmarus print media, 2007. Pp. 3-15.

20. Revyakina V.A., Arsent’eva N.A., Filatova T.A. Effektivnost’ allergen-spetsificheskoy immunoterapii peroral’nymi allergenami “Vesennyaya smes’ rannyaya” u detey s pollinozami [The effectiveness of allergen-specific immunotherapy with oral allergens «Spring mixture of early» in children with hay fever]. Sublingval’naya allergen-spetsificheskaya immunoterapiya: sb. te-mat. st. Moscow: Farmarus print media, 2007. Pp. 31-38.

21. Bzhedugova E.R., Nenasheva N.M. Effektivnost’ i bezopasnost’ sublingval’noy allergenspetsificheskoy immunoterapii allergenami kleshchey domashney pyli [The efficacy and safety of sublingual allergen immunotherapy allergens from house dust mites]. Sublingval’naya allergen-spetsificheskaya immunoterapiya: sb. temat. st. Moscow: Farmus print media, 2010. Pp. 18-27.

22. Manzhos M.V., Molotilov B.A., Myagkova M.A. Effektivnost’ peroral’noy spetsifi-cheskoy immunoterapii allergenom “Osennyaya smes’ trav” (“Sevafarma”, Chekhiya) u bol’-nykh pollinozom [The effectiveness of oral-spec cal allergen immunotherapy «Autumn blend of herbs» («Sevafarma», Czech Republic) in the pain-tion hay fever]. Immunitet i bolezni: ot teorii k terapii: Materialy Mezhdunar. kongr. Moscow, 2005. P. 245.

23. Ukhanova O.P. Kompleksnaya otsenka effektivnosti patogeneticheskoy i vosstanovi-tel’noy terapii bol’nykh sezonnym allergicheskim rinitom: avtoref. dis. … dokt. med. nauk [Comprehensive evaluation of the pathogenetic and raise-tional therapy in patients with seasonal allergic rhinitis. Synopsis of dis. Dr med. sciences]. Moscow, 2010. 40 p.

24. Malygina K.V. Kliniko-immunologicheskaya kharakteristika, optimizatsiya profilak-tiki i lecheniya pollinozov u detey: avtoref. dis. … kand. med. nauk [Clinical and immunological characteristics, optimization of preven-tics and treatment of hay fever in children. Synopsis of dis. PhD med. sciences]. Perm, 2010. 23 p.

25. Bezrukova E.V. Kliniko-immunologicheskaya effektivnost’ allergen-spetsificheskoy immunoterapii pri sochetannykh formakh sensibilizatsii u bol’nykh pollinozom: avtoref. dis. … kand. med. nauk [Clinical and immunological efficacy of allergen-specific immunotherapy with combined forms of sensitization in patients with hay fever. Synopsis of dis. PhD med. sciences]. Moscow, 2011. 24 p.

26. Gayduk I.M., Korostovtsev D.S., Trusova O.V. The use of sublingual allergen-specific immunotherapy for the treatment of children with hay fever caused by pollen of trees. Pediatricheskaya farmakologiya, 2008, vol. 5, no. 6, pp. 52-56 (in Russ.).

27. Ado A.D. Obshchaya allergologiya [General Allergology]. Moscow: Meditsina, 1978. 428 p.