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Authors
Sverrir Gauti RíkarðssonYrsa B. Löve
Björn Rúnar Lúðvíksson
Davíð Gíslason
Björn Rúnar Lúðvíksson
Issue Date
2010-07-01
Metadata
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Allergen immunotherapy in Iceland 1977-2006Citation
Læknablaðið 2010, 96(7-8):463-8Abstract
INTRODUCTION: The prevelance of allery and asthma has increased rapidly over the last 3 decades and is now estimated that 25-30% of population in Western industrialized countries show symptoms of allergy or asthma. The aim of this study was to reveal the success of allergen immunotherapy (AIT) in Landspitali from 1977-2006. MATERIAL AND METHODS: During the study period a total number of 289 individuals underwent immunotherapy in outpatient clinic of allergy and asthma in Landspítali. A total number of 169 individuals were contacted, of whom 128 (76%) accepted to participate in the study. The evaluation was based on medical records, standardized questionnaire and skin-prick tests. RESULTS: Patients were evaluated on the average of 20 years after finishing treatment. 118 (92%) patients were desensitized to grass pollen, to birch pollen (30%), cat dander (30%) and dust mite (28%). At the time of the study 67% reported to be asymptomatic or with greatly improved allergy symptoms. Males had better response to AIT than women (p=0.04). Participants with positive family history of allergy and/or asthma in first degree relatives also reported better response to AIT (p=0.02). Furthermore, AIT to grass pollen and dust mite seemed to be more effective than AIT to cat dander and birch (p=0.04). AIT was also shown to reduce asthma. CONCLUSION: AIT for 3-5 years provides significant beneficial effect of allergy and asthma symptoms in patients who undergo such therapy. Finally, it s findings support the notion that AIT may reduce the risk of new allergic manifestations.Inngangur: Tíðni ofnæmis hefur farið ört vaxandi á síðastliðnum þremur áratugum og er nú talið að allt að 25-30% íbúa iðnríkjanna sýni einkenni ofnæmis í einhverri mynd. Tilgangur rannsóknarinnar var að varpa ljósi á árangur afnæmismeðferðar yfir 30 ára tímabil á Íslandi. Efniviður og aðferðir: Á rannsóknartímabilinu frá 1977 til 2006 hófu 289 einstaklingar afnæmismeðferð á göngudeild astma- og ofnæmissjúkdóma á Landspítalanum. Haft var samband við 169 manns og samþykktu 128 (76%) þátttöku í rannsókninni. Upplýsinga var aflað með stöðluðum spurningalista og aflestri sjúkraskráa. Sjúklingar voru að auki húðprófaðir. Niðurstöður:Að meðaltali voru 20 ár liðin frá lokum afnæmismeðferðar þegar árangur hennar var metinn í þessari rannsókn. Alls voru 118 (92%) einstaklingar afnæmdir gegn vallarfoxgrasi, 39 (30%) gegn birki, 38 (30%) gegn köttum og 36 (28%) gegn rykmaurum. Við endurmat sjúklinga reynust 86 (67%) vera einkennalausir eða betri. Karlmenn svöruðu að jafnaði meðferð betur en konur (p=0,04). Ættarsaga um ofnæmi eða astma í fyrstu gráðu ættingjum hafði jákvæð áhrif á árangur afnæmismeðferðar (p=0,02). Að auki var sýnt fram á að afnæmismeðferð gegn vallarfoxgrasi og rykmaurum skilaði betri árangri en afnæming gegn birki og köttum (p=0,04). Meðferðin dró úr líkum á astma síðar meir. Ályktanir:Afnæmismeðferð sem stendur yfir í 3-5 ár að meðaltali dregur almennt úr einkennum ofnæmissjúklinga til lengri tíma. Þá má leiða líkur að því að afnæmismeðferð minnki líkur á þróun nýs ofnæmis.
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