Gülfinar Çağlar KILIÇ, Bülent KARDEŞ, Ayşe ÇEFLE, Ayten YAZICI, Gülfinar KILIÇ, At ALL.

MEVSİMSEL ALLERJİK RİNİTLİ HASTALARDAMEVSİM ÖNCESİ İMMÜNOTERAPİNİN ETKİNLİĞİ

Amaç: Bu çalışma allerjik rinit (AR) tedavisinde nispeten yeni uygulanmaya başlanmış olan mevsim öncesi immünoterapinin (IT) mevsim sonundaki klinik ve laboratuar etkinliğini değerlendirmek amacı ile tasarlandı. Gereç ve yöntem: Çalışma Kocaeli Üniversitesi Tıp Fakültesi İç Hastalıkları AD Allerji Polikliniği’nde Eylül 2005-Eylül 2006 tarihleri arasında yapıldı. Çalışmaya anamnez, fizik muayene ve farklı laboratuvar yöntemleriyle mevsimsel AR tanısı konulan 20-60 yaşları arasında 27’si kadın, 13’ü erkek toplam 40 hasta alındı. Bu hastalardan rastgele seçilen 20’si kontrol grubuna dahil edildi. Diğer 20 kişiye de mevsim öncesi IT uygulandı. Astım ve kronik metabolik hastalıkları olanlar çalışmaya alınmadı. Bulgular: Mevsim öncesi IT alan hastalarda polen mevsimi boyunca görülen semptomlarda ve buna bağlı olarak ilaç kullanma ihtiyacında azalma gözlendi. Allerjen spesifik IgE düzeylerindeki mevsimsel artış engellendi. Polen allerjenlerine ve histamine olan deri testi duyarlılığında, serum allerjen spesifik IgG6 düzeylerinde, serum ECP ve eozinofil değerlerinde azalma saptandı. Nazal sürüntüdeki eozinofil yüzdesinde ve serum triptaz düzeylerinde artış olduğu görüldü. Sonuç: Sonuç olarak mevsim öncesi uygulanan IT’nin mevsimsel AR tedavisinde güvenilir ve etkili bir yöntem olduğu söylenebilir. Deri testi duyarlılığının azalması, allerjen spesifik IgE’lerin mevsimsel artışının baskılanması ve serum ECP düzeylerindeki azalma klinik etkinlik ile uyumlu bulundu. Mevsim öncesi IT’nin immünolojik etkilerinin erken dönemde ortaya çıktığı gösterildi. Serum allerjen spesifik IgG6 , nazal eozinofil ve serum triptaz sonuçlarının klinik etkinlik ile uyumsuz olduğu görüldü. Kesin yargıya varabilmek için immünizasyonun ilerleyen dönemlerinde de IT’nin etkinliğini değerlendirecek daha ayrıntılı çalışmalara ihtiyaç vardır.

Anahtar Kelimeler:

Allerjik rinit, Immünoterapi, IgE

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