One of the key strategic ways of allergic diseases treatment is the update of methodology and creation of new immunothropic drugs for sublingual immunotherapy or SLIT, that determine mucosal tolerance development process. Combination of allergic rhinitis and palindromic herpetic infection (HSV and/or ÑMV) is usually characterized by rapid mucosal immunity barrier function violation, mucosal barrier permeability change and inevitable progress of allergic disease. Taking in consideration high prevalence of herpetic infection spread among patients, suffering from allergic diseases, search of optimal SLIT treatment schemes is becoming significantly important.
Purpose of the current study is to evaluate SLIT effectiveness among immunocompromised patients, suffering from allergic rhinitis, using up-to-date tableted allergen extract (produced in Kazakhstan).
Methods
Within open prospective research effectiveness and tolerance of SLIT course, maintained using up-to-date tableted allergen extract, produced in Kazakhstan was analyzed among 30 patients aged 18 to 40, suffering from allergic rhinitis (3 to 10 years) and herpetic infection (HSV and/or ÑMV). Among SLIT effectiveness criteria: VAS – visual analog scale, SMS - symptom medication score, patients’ adherence to treatment continuation. Laboratory effectiveness evaluation was conducted using profile cytokine evaluation (immunoenzyme method, proinflammatory - α-TNF – tumor necrosis factor, IL-8, γ – INF, antiphlogistic - IL-4 of serum and local fractions. Material for study – blood serum, taken fasting from ulnar vein and nasal lavage.
Results
Assessment result - excellent and good effect was stated among 73% (21) patients. Among them, 20 patients (68,9%) noted the decrease in pharmaco-medicine need when contacting corresponding allergen., overall health status improvement - 21 patients (73%). None of the patients claimed main disease flow worsening.
Cytokine profile research after treatment showed IL-4 and ϒ – INF content level normalization both in local and serum fractions. Among 5 patients (16,6%) rapid increase of IL-8 è TNF – α in local fractions was stated before treatment, and it was the key reason to change SLIT mode and to add immunomodulating therapy. 27 patients (93%) agreed to continue treatment next year.
Conclusions
Full SLIT course was successfully implemented to all patients using modern tableted allergen extract (produced in Kazakhstan), despite violations in virus defense system and mucosal immunity system. Stated change in α-TNF and IL-8 content level among a group of patients allowed to change SLIT mode and complete the course successfully.
SLIT using modern tableted medicine among immunocompromised (problematic) patients, suffering from allergic diseases is a successful and high effective method and complies with all criteria of rational pharmacotherapy.