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15.06.2019 | Asthma bronchiale | Übersicht

Entwicklung der subkutanen Allergen-Immuntherapie (Teil 2): präventive Aspekte der SCIT und Innovationen

verfasst von: Ludger Klimek, Randolf Brehler, Eckard Hamelmann, Matthias Kopp, Johannes Ring, Regina Treudler, Thilo Jakob, Margitta Worm, Prof. Dr. Oliver Pfaar

Erschienen in: Allergo Journal | Ausgabe 4/2019

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Zusammenfassung

Hintergrund

Die allergenspezifische Immuntherapie (AIT) durch subkutane Injektionen (SCIT) des relevanten Allergens ist die klassische kausale Behandlungsmethode IgE-vermittelter allergischer Atemwegserkrankungen und wird bereits seit über 100 Jahren erfolgreich eingesetzt.

Methoden

Für die vorliegende Publikation wurde eine selektive Literaturrecherche in Pubmed und Medline durchgeführt. Zusätzlich wurden aktuelle Publikationen deutschsprachiger Zeitschriften analysiert, die nicht in Literaturdatenbanken verfügbar sind. Diese Literaturrecherche erfasste Original- und Reviewarbeiten in deutscher oder englischer Sprache.

Ergebnisse

Für die SCIT wurden primäre, sekundäre und tertiäre Präventionseigenschaften nachgewiesen, die aber noch weiter evaluiert werden müssen. In Kombination mit Biologika kann die Sicherheit der SCIT gesteigert werden, teilweise auch die Wirksamkeit.
Adjuvanzien scheinen ein enormes Entwicklungspotenzial für die SCIT zu bergen. Bereits heute werden Aluminiumsalze, Mikrokristallines Tyrosin (MCT) und Monophosphoryl Lipid A (MPL) in kommerziellen SCIT-Präparaten eingesetzt. Parallel wird an weiteren Adjuvanzien geforscht, beispielsweise Liposomen, Mikrosphären, CpG-Motiven oder „virus-like particles“ (VLPs). Auch die Therapieextrakte selbst werden weiterentwickelt, unter anderem als rekombinante Allergene, hypoallergene Varianten wie „site-directed mutants“ (SDM), Konformationsvarianten, Allergenfragmentierungen, Allergenoligomeren, Deletionsmutanten oder Hybridallergene/Mosaikantigene.

Schlussfolgerung

SCIT-Präparationen gehören zu den innovativsten Therapiemöglichkeiten in der Immuntherapie allergischer Erkrankungen. Aufgrund zahlreicher immunologischer Ansätze werden sie die Therapie in Zukunft effektiver und sicherer machen, und das bei reduziertem Aufwand.
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Metadaten
Titel
Entwicklung der subkutanen Allergen-Immuntherapie (Teil 2): präventive Aspekte der SCIT und Innovationen
verfasst von
Ludger Klimek
Randolf Brehler
Eckard Hamelmann
Matthias Kopp
Johannes Ring
Regina Treudler
Thilo Jakob
Margitta Worm
Prof. Dr. Oliver Pfaar
Publikationsdatum
15.06.2019
Verlag
Springer Medizin
Erschienen in
Allergo Journal / Ausgabe 4/2019
Print ISSN: 0941-8849
Elektronische ISSN: 2195-6405
DOI
https://doi.org/10.1007/s15007-019-1847-4

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