Specific immunotherapy for allergic rhinitis Allergic diseases, also known as allergic diseases, are among the most common chronic diseases in the world, including allergic rhinitis, allergic asthma and atopic dermatitis, etc. Epidemiological surveys show that the prevalence of allergic diseases is as high as 22% worldwide, of which the prevalence of allergic rhinitis is 17%. Allergic asthma has exceeded 20 million. Allergic rhinitis is a global health problem that can lead to many diseases and can affect people of all countries, races and ages, affecting social life, sleep, school and work, and causing a heavy economic burden on society.
Dust mite is the main inhalant allergen The etiology of allergic rhinitis mainly includes genetic and environmental factors, patients are allergic, most of them have a family history of allergy; there can be clear allergens, including inhalant allergens (such as: mites, pollen, fungi, animal dander, etc.) and ingested allergens (such as: milk, fish, shrimp, crab, etc.). Common allergens include pollen, dust mites, food, drugs, etc. in the spring and autumn. With the modernization of social life and the continuous change of people’s indoor living environment, the incidence of dust mite allergic diseases is increasing and has become the number one inhalant allergen in China, which mainly causes allergic rhinitis and allergic asthma. The most common dust mites are house dust mite and dust mite. An authoritative research study in China shows that more than half of Chinese patients are allergic to dust mites, and 80.4% of them are allergic to both house dust mite and dust mite. Dust mites feed on human or animal dander, nails, and hair, and prefer to grow in mattresses, pillows, carpets, clothes, and hairy toys, and are most prevalent in late summer and early autumn; because their metabolites are light in size, they easily fly in the air, so dust mites are everywhere. The diagnosis of allergic rhinitis is based on the typical allergic history and the results of consistent diagnostic tests, including specific allergen skin prick test, allergen nasal mucosal excitation test and in vitro serum specific IgE test. Among them, allergen skin prick test is the most commonly used, with high safety, easy and fast operation (10-15 minutes to produce results); high sensitivity, good clinical relevance; almost painless for patients and acceptable for children; low cost, the best in vivo diagnostic method, and now the most convenient and effective allergen diagnosis method recognized in Europe and the United States. Specific immunotherapy (desensitization) is recognized as one of the effective treatment methods at home and abroad. It includes sublingual specific immunotherapy and subcutaneous injection specific immunotherapy. The World Health Organization (WHO) recommends the “Four Bodies One” optimal treatment protocol for allergic diseases, which includes proper diagnosis and avoidance of allergens, standardized specific immunotherapy (desensitization), good patient education and appropriate use of symptomatic medications. Desensitization is recognized as the only allopathic treatment available today that can influence the course of allergic diseases and should be used as early as possible to prevent irreversible damage to the mucous membranes of the affected organs; the principle is to search for allergens by skin prick tests or serum specific IgE tests and to administer the allergen to patients with allergic rhinitis in gradually increasing doses at regular intervals to achieve The allergic allergens are administered in increasing doses at regular intervals to achieve a significant reduction or absence of symptoms upon re-exposure. Allergens are identified through skin prick tests or blood tests; the drug is administered sublingually once a day or subcutaneously once a week in gradually increasing doses to achieve desensitization; the duration of treatment is generally 2 years or more, and the longer the duration, the better the outcome. Patients can still achieve sustained clinical efficacy after effective immunotherapy has been discontinued.
Desensitization therapy induces immune tolerance to allergens, has long-term effects and prevents further development of allergic diseases, while improving the quality of life of patients with allergic diseases. Studies have shown that desensitization not only prevents the development of single allergies into multiple allergies, but also reduces the risk of allergic rhinitis developing into bronchial asthma by up to 50%.
Allergic rhinitis treatment status In order to standardize the treatment of allergic rhinitis, the Department of Otolaryngology and Head and Neck Surgery of our hospital has taken the lead in carrying out allergen skin prick test and sublingual specific immunotherapy exclusively in Anqing area. At the same time, it can be judged as negative, weak positive, positive, strong positive, etc. based on the size of the skin mass, according to the test results to clarify the clinical diagnosis, in order to further carry out targeted treatment. Its clinical characteristics are accurate, reliable, fast and non-invasive, and low cost.
Sublingual specific immunotherapy is a new treatment for allergic diseases such as allergic rhinitis and asthma advocated by the World Allergy Organization (WAO) in recent years, and is recommended for use in the early stages of the disease. This therapy is to allow patients to take sublingual desensitization preparations at low doses, gradually increase the dose, and continue for a sufficient duration after reaching the maintenance dose, in order to regulate the body’s immune system to produce tolerance to allergens, so that patients no longer have allergic symptoms or allergic symptoms are significantly reduced when they are exposed to allergens again, thus completely curing allergic diseases from the cause. Sublingual desensitization is now widely used in Europe, South Asia, the Middle East, South Africa, Australia, and Hong Kong and Taiwan in China.