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Allergivaksinasjon

Sist revidert:
Sist revidert av:


Definisjon:
Allergivaksinasjon er langvarig allergenspesifikk immunterapi hvor allergener enten adminstreres subkutant eller peroralt som dråper eller tabletter hos pasienter som ikke får tilfredsstillende symptomlindring ved ordinær behandling
Forekomst:
Økende bruk på grunn av mulighet for peroral administrering 
Indikasjoner:
Allergisk rhinitt eller allergisk rhinokonjuktivitt på grunn av allergi mot pollen, midd, mugg eller katt/hund. I tillegg allergisk reaksjon på bi- eller vepsestikk
Behandling:
Daglig inntak av allergen i form av dråper eller tabletter i tre år, alternativ subkutane injeksjoner med opptrapping over få uker, deretter vedlikeholdsinjeksjoner i 3 år 
  1. Cox L. The role of allergen immunotherapy in the management of allergic rhinitis. Am J Rhinol Allergy 2016; 30: 48-53. pmid:26867530 PubMed  
  2. Huggins JL, Looney RJ. Allergen immunotherapy. Am Fam Physician 2004; 70: 689-96. PubMed  
  3. Hansen TK, Svendsen UG. Allergenspecifik immunterapi. Ugeskr Læger 2005; 167: 666-71. PubMed  
  4. Øymar K. Allergivaksinasjon i Norge. Tidsskr Nor Lægeforen 2007; 127: 1036-8. PubMed  
  5. Allergen immunotherapy: therapeutic vaccines for allergic diseases. Geneva: January 27-29, 1997. Allergy 1998; 53(44 suppl): 1-42.
  6. Radulovic S, Calderon MA, Wilson D, Durham S. Sublingual immunotherapy for allergic rhinitis. Cochrane Database of Systematic Reviews 2010, Issue 12. Art. No.: CD002893. DOI: 10.1002/14651858.CD002893.pub2 DOI  
  7. Calderon MA, Alves B, Jacobson M, Hurwitz B, Sheikh A, Durham S. Allergen injection immunotherapy for seasonal allergic rhinitis. Cochrane Database of Systematic Reviews 2007, Issue 1. Art. No.: CD001936. DOI: 10.1002/14651858.CD001936.pub2. DOI  
  8. What are the benefits and harms of sublingual immunotherapy compared with placebo in people with allergic rhinitis? Elie Mulhem (MD) (on behalf of Cochrane Clinical Answers Editors). Cochrane Clinical Answers 2014. DOI: 10.1002/cca.237.
  9. Rak S, Yang WH, Pedersen MR, Durham SR. Once-daily sublingual allergen-specific immunotherapy improves quality of life in patients with grass pollen-induced allergic rhinoconjunctivitis: a double-blind, randomised study. Qual Life Res 2007; 16: 191-201. PubMed  
  10. Barr JG, Al-Reefy H, Fox AT, et al. Allergic rhinitis in children. BMJ. 2014 ;349:g4153. doi: 10.1136/bmj.g4153 DOI  
  11. Calderon MA, Penagos M, Sheikh A, et.al. Sublingual immunotherapy for treating allergic conjunctivitis. Cochrane Database of Systematic Reviews 2011, Issue 7. Art. No.: CD007685. DOI: 10.1002/14651858.CD007685.pub2. DOI  
  12. Golden DBK, Kagey-Sobotka A, Norman PS, Hamilton RG, Lichtenstein LM. Outcomes of allergy to insect stings in children, with and without venom immunotherapy. N Engl J Med 2004; 351: 668-74. New England Journal of Medicine  
  13. Boyle RJ, Elremeli M, Hockenhull J, Cherry MG, Bulsara MK, Daniels M, Oude Elberink J. Venom immunotherapy for preventing allergic reactions to insect stings. Cochrane Database of Systematic Reviews 2012, Issue 10. Art. No.: CD008838. DOI: 10.1002/14651858.CD008838.pub2. DOI  
  14. Normansell R, Kew KM, Bridgman AL. Sublingual immunotherapy for asthma. Cochrane Database of Systematic Reviews 2015, Issue 8. Art. No.: CD011293. DOI: 10.1002/14651858.CD011293.pub2. DOI  
  15. Romantsik O, Tosca MA, Zappettini S, Calevo MG. Oral and sublingual immunotherapy for egg allergy. Cochrane Database of Systematic Reviews 2018, Issue 4. Art. No.: CD010638. DOI: 10.1002/14651858.CD010638.pub3. DOI  
  16. Tam H, Calderon MA, Manikam L, Nankervis H, García Núñez I, Williams HC, Durham S, Boyle RJ. Specific allergen immunotherapy for the treatment of atopic eczema. Cochrane Database of Systematic Reviews 2016, Issue 2. Art. No.: CD008774. DOI: 10.1002/14651858.CD008774.pub2. DOI  
  17. Lockey RF, Nicoara-Kasti GL, Theodoropoulos DS, Bukantz SC. Systemic reactions and fatalities associated with allergen immunotherapy. Ann Allergy Asthma Immunol 2001; 87(1 suppl 1): 47-55.
  18. Steinsvåg SK, Florvaag E. Allergivaksinasjon - hvorfor og hvordan. Tidsskr Nor Lægeforen 2005; 125: 1489-90. PubMed  
  19. Bolle R, Berstad A, Florvaag E, Steinsvåg S. Praktisk veileder i allergivaksinasjon. Norsk Forening for Allergologi og Immunpatologi. Utgave2, 2011. legeforeningen.no  
  20. Dhami S, Nurmatov U, Arasi S, et al. Allergen immunotherapy for allergic rhinoconjunctivitis: A systematic review and meta-analysis. Allergy. 2017;72(11):1597-1631. Pmid: 28493631 PubMed  
  21. Elliott J, Kelly SE, Johnston A, Skidmore B, Gomes T, Wells GA. Allergen immunotherapy for the treatment of allergic rhinitis and/or asthma: an umbrella review. CMAJ Open. 2017 May 10;5(2):E373-E385. PMID: 28495938 PubMed  
  22. Moller C, Dreborg S, Ferdousi HA, Halken S, Host A, Jacobsen L, et al. Pollen immunotherapy reduces the development of asthma in children with seasonal rhinoconjunctivitis (the PAT-study). J Allergy Clin Immunol 2002; 109: 251-6. PubMed  
  23. Grembiale RD, Camporota L, Naty S, Tranfa CM, Djukanovic R, Marsico SA. Effects of specific immunotherapy in allergic rhinitic individuals with bronchial hyperresponsiveness. Am J Respir Crit Care Med 2000; 162: 2048-52. PubMed  
  24. Durham SR, Walker SM, Varga EM, Jacobson MR, O'Brien F, Noble W, et al. Long-term clinical efficacy of grass-pollen immunotherapy. N Engl J Med 1999; 341: 468-75. New England Journal of Medicine  
  25. Jacobsen L, Nüchel Petersen B, Wihl JA et al. Immunotherapy with partially purified and standardized tree pollen extracts. IV. Results from long-term (6-year) follow-up. Allergy 1997; 52: 914-20. PubMed  
  26. Frølund L, Durham SR, Calderon M, et al. Sustained effect of SQ-standardized grass allergy immunotherapy tablet on rhinoconjunctivitis quality of life. Allergy 2009; : PMID: 17033900. PubMed  
  • Ingard Løge, spesialist allmennmedisin, redaktør NEL

Tidligere fagmedarbeidere

  • Kurt Østhuus Krogh, spesialist i barnesykdommer, Barne- og ungdomsklinikken, St. Olavs Hospital, Trondheim
  • Malcolm Sue-Chu, dr. med., overlege, Lungeavdelingen, St Olavs Hospital, Trondheim