UA50497A - Method for treating bronchial asthma - Google Patents

Abstract

The method for treating the bronchial asthma provides for specific immunotherapy using the acaridan allergens. The dilution of the corresponding allergen is adjusted employing the method of the allergometric titration with daily subcutaneous injections. The titration starts from 0.1 ml of the maximal dilution. Then every day the dose increases with 0.1ml increment. After the dose of 0.9 ml at a starting dilution another ten-fold more concentrated dilution of the antigen is applied starting from 0.1 ml as earlier. Such cycles are repeated up to 1:10000 dilution. Beginning from such a dilution the dose is incremented by 0.1 ml once in two days. At a dilution 1:100 the dose is incremented by 0.1 ml once a week. The dose increases up to 0.5 providing the satisfactory tolerability and then such a maintenance dose is kept for 1 month with one injection per week, then for further 1 month with two injection per month, and finally – once a month for 3-5 years.

Description

Description of the invention

The invention relates to medicine, namely, pediatrics, allergology, pulmonology, and can be used in the treatment of bronchial asthma.

There are many ways to treat bronchial asthma with drugs, but they are not effective enough, since most of them act only on a certain phase of allergic inflammation, and do not allow to intervene in the essence of the disease - the nature of the immune response in case of sensitization to house dust mites. In addition, pharmacological drugs often lead to a number of side effects. This calls for the development of 70 new methods of treatment.

A well-known method of treatment of bronchial asthma, which consists in prescribing the patient specific immunotherapy (SIT) with factor-significant mite allergens | Allergic diseases in children: diagnostics and treatment" // under the editorship of Roy Patterson, Lesla K. Grommer, Paul A. Grinberger, translated from English by sub-chief editor Academician of the National Academy of Medical Sciences H. G. Chuchalin - M: GZOTAR Medicine - 2000. - S 196 - 202.) 19 The essential features of the analogue and the invention, which coincide, are as follows: - SIT with factor-significant mite allergens in increasing doses according to a defined scheme is performed in patients with bronchial asthma.

This method is not convenient and effective enough, because the pace of reaching the maintenance dose of the allergen slows down, and the duration of treatment slows down. The closest in terms of technical essence and the result achieved is the method, which consists in conducting SI with mite allergens according to a certain scheme

Allergic diseases in children" // edited by M. Ya. Studenykina, I. I. Balabolkina - M: Medicine. - 1998. - p. 141 - 147)

Common essential features of the prototype and the claimed invention are the following: - appointment of SIT to the patient; - appointment of SIT with mite allergens. "

This method is not convenient and effective enough, because it slows down the rate of reaching the maintenance dose of the allergen, and therefore slows down the duration of treatment.

The basis of the invention is the task of improving the method of treatment of bronchial asthma by changing the scheme of introduction of tick-borne allergens, which will ensure an increase in the effectiveness of treatment and a reduction in the time required to achieve maintenance doses of allergens. Ge")

The task is solved by the fact that in the method of treatment of bronchial asthma by conducting SIT with mite allergens, the new thing is that mite allergens are administered according to an accelerated scheme in the initial M dilution, which is determined by allergometric titration, the allergen dose is increased daily before the introduction of dilution 1: 10,000, here the rate of growth of the allergen dose slows down - every 2 days 32 and O.Tml to 0.9ml, when a dilution of 1 : 100 is reached, the allergen dose is increased once a week to 0.5ml with good tolerance, this maintenance dose is initially left 1 time a week for 1 month, then administered twice a month, then once a month for 3 - 5 years.

The cause-and-effect relationship between the set of declared signs and the technical result consists in "such. With 50 SITs of mite allergens, it will reduce sensitivity to the "guilty" allergen and reduce the activity of allergic inflammation due to a long preventive effect after it ends. This is possible thanks to

With" SIT mechanisms, which spread to all links of allergic inflammation, inhibiting both the early and late phases of the immune response. First of all, there is a reorganization of the representation of T-lymphocytes due to an increase in the content of IL-12-producing cells, which, in turn, leads to switching of the immune response. The change in the nature of the immune response is a dose-dependent process, when the introduction of small doses of the allergen reduces the sensitivity of tissues, and the successive introduction of increasing doses switches the synthesis of antibodies of the IDE class to the synthesis of blocking antibodies av | class to and leads to a change in the immune response. Therefore, the improvement of the course of the symptoms of the disease or the long-term therapeutic effect of SIT is due to its effect on the previously formed ZE response in the body and suppression of the signs of allergic inflammation. (Te) 20 Thus, the combination of the above-mentioned positive effects of SIi will allow to increase the effectiveness of treatment, to achieve long-term remission, to limit the expansion of the spectrum of factor-significant allergens, the transition of mild forms of the disease to more severe ones, to reduce the number of complications and relapses, that is, to ease the course of bronchial asthma.

The method is carried out as follows. 25 After skin testing with allergens, we compare its data with the patient's complaints and data in objective examination to accurately determine the "culprit" allergen, as IT is effective only if the results of the allergological examination match the clinical data. SIT begins with the introduction of mite allergens in that dilution, with which a negative result was obtained when performing skin tests in comparison with the previous positive result after the use of allergens of a different dilution. Most often, SIT started 60 with a dilution of 1:100,000,000 or 1:1,000,000.

SIT begins with the subcutaneous injection of 0.1 ml of a selected dilution of allergens into the outer surface of the middle part of the shoulder. If the first injection of allergens was well tolerated (absence of a systemic allergic reaction, the local reaction was insignificant), the next injection was given daily, increasing each injected dose of the allergen by 0. Tml. After the introduction of allergens, one dilution (0.9 ml) was transferred to another, which contains about 10 times greater concentration of allergens. When the concentration of allergens in a dilution of 1:10,000 was reached, the allergen dose was increased every 2-3 days. and when a dilution of 1:100 is reached, allergens are injected in increasing doses of 0.1 ml | once a week, with good tolerance, bring it to 0.5 ml and leave this maintenance dose at first 1 time a week for 1 month, then 1 time every 2 weeks for 1 month, then 1 time a month for 3 - 5 years. The growth rate of the administered dose of medicinal allergens in each specific case may vary depending on the tolerability of the drug. A contraindication for increasing the doses of allergens administered is the occurrence of a local reaction larger than 2 cm in diameter and a systemic allergic reaction. These complications indicate the need to suspend the increase in the allergen dose (in such cases, it is better to reduce it and slow down the growth rate of the allergen dose). If during SIT the introduction of 7/o allergens was interrupted for 4 weeks, it is necessary to re-introduce the previous dose of the allergen. The occurrence of weak manifestations of the symptoms of the main allergic disease (a small amount of dry wheezing in the lungs) is not a contraindication for SIT. The appointment of adequate therapy in such cases makes it possible to remove the allergic manifestations that have arisen and to continue SIT. The maintenance dose of the allergen in most cases is

O, bml of the allergen in a dilution of 1: 100, but in some patients it may be smaller. It depends on 15 individual tolerance.

If there are positive changes in the course of bronchial asthma within 1 year of SIT, it is recommended to conduct it within 3-5 years.

Example. Patient C, born in 1987, was hospitalized in the city hospital on 13.03.98 with the diagnosis: "Bronchial asthma, moderate course, period of remission", medical history No. 3137. After examination, including 20 allergy tests, SIT was prescribed factor-significant house dust mite allergens according to the proposed method, namely: subcutaneous injection of mite allergens, starting with a dilution of 1: 1,000,000 and a dose of 0.1 ml, daily the dose of the allergen was increased by 0.1 ml to 0.9 ml, then the dilution was reduced by several times and the allergen was administered in the same doses every day, and after reaching a dilution of 1 : 10,000, the allergen doses were increased every 2 days; upon reaching a dilution of 1:100, the dose of allergen was increased from 0.1 ml by O/1 ml and administered once a week to 0.5 ml. This dose proved to be supportive and the patient received it at first once a week for 1 month, then twice a month. - 1 month, then once a month. The patient was under constant medical observation: examination of the injection site, monitoring of the function of external breathing with the help of an individual peak flow meter, physical examination of the respiratory organs. The method of treatment of bronchial asthma by carrying out SIT with mite allergens in this patient turned out to be effective, he did not have any complications, after 15 days the boy began to receive SIT on an outpatient basis, he has been receiving it for 3 years. The course of bronchial asthma has significantly eased, asthma attacks are provoked only by SARS, they pass easily, they are removed at home by one or two inhalations of salbutamol. "E"c)

Claims (1)

The formula of the invention of IS c) The method of treatment of bronchial asthma by carrying out specific immunotherapy with mite allergens, which differs in that the immunotherapy is carried out after selection by the method of allergometric titration of the appropriate dilution of the allergen according to the scheme of its daily subcutaneous administration, starting with 0.1 ml « 70 of the maximum dilution, daily increase the dose of the allergen by 0.1 ml, after the introduction of 0.9 ml of the starting solution, the dilution is reduced 10 times and the introduction of the allergen is again started with 0.1 ml, the dose is again increased by 0.1 ml to 0.9 ml, and so on until the dilution is reduced to 1:10,000, starting from this dilution, the allergen "c" is administered in increasing doses of 0.1 ml after 2 days, the dose is brought up to 0.9 ml, with a dilution of 1:100, the allergen dose is increased by 0.1 ml 1 time per week, brought to a maximum of 0.5 ml with good tolerance, and this maintenance dose is left at first 1 time per week for 1 month, then 1 time per 2 weeks for the next month, then 1 time per month for 3-5 years old o Official Bulletin "Industrial Property". Book 1 "Inventions, useful models, topographies of integrated circuits", 2002, M 10, 15.10.2002. State Department of Intellectual Property of the Ministry of Education and Science of Ukraine. se) what R 60 b5