ALERGEN SPECIFIČNA IMUNOTERAPIJA U LIJEČENJU ALERGIJSKIH BOLESTI. (Bosnian)

Allergen-Specific Immunotherapy (ASIT) is the only etiological therapy of allergic diseases that potentially modifies the course and progression of the disease. It has been shown to be effective in treating allergic rhinitis with/without conjunctivitis, allergic asthma and anaphylactic hypersensitivity to hymenoptera sting. Although, even if it has been used to treat allergic diseases for more than 100 years, and despite of its proven effectiveness, ASIT is often under-administered in treating of these diseases. It is performed by using a standardized allergen extract, most commonly applied under the skin, and in recent years increasingly as sublingual immunotherapy. Indications, application, implementation and follow up of ASIT are set by a physician, subspecialist in allergy and clinical immunology. Since the subcutaneous application of ASIT carries the risk of occurrence of anaphylaxis, it should be carried out in specialized facilities that are additionally equipped and the staff are further educated. Decisions on the introduction and continuation of ASIT should be made case-by-case, taking into account the specificities of each patient (personalized approach) such as allergen avoidance, efficacy of pharmacological treatment, quantity and type of medication needed to achieve disease control, side effects of pharmacological treatment, patient motivation, etc. This article will show mechanisms, indications and contraindications for the introduction of ASIT, patient selection criteria, application methods, safety and efficacy, as well as novel therapeutic approach of ASIT in the treatment of allergic diseases in children. [ABSTRACT FROM AUTHOR]

Alergen-specifična imunoterapija (ASIT) je jedino etiološko liječenje alergijskih bolesti koje može modificirati tijek i progresiju bolesti. Dokazano je učinkovita u liječenju alergijskog rinitisa s/bez konjunktivitisa, alergijske astme i anafilaktične preosjetljivosti na otrove opnokrilaca. Iako se koristi u liječenju alergijskih bolesti više od 100 godina, te unatoč dokazanoj djelotvornosti, alergen-specifična imunoterapija se u liječenju navedenih bolesti nedovoljno primjenjuje. Provodi se primjenom standardiziranog alergenskog ekstrakta najčešće apliciranjem ispod kože, a zadnjih godina sve više kao sublingvalna imunoterapija. Indikaciju, način primjene, provođenje i praćenje alergen-specifične imunoterapije postavlja liječnik, subspecijalist alergologije i kliničke imunologije. Budući da subkutana alergen-specifična imunoterapija nosi rizik pojave anafilaksije, ista se treba provoditi u specijaliziranim ustanovama koje su dodatno opremljene i imaju dodatno educirano osoblje. Odluke o uvođenju i nastavku alergen-specifične imunoterapije treba donositi od slučaja do slučaja, uzimajući u obzir posebnosti svakog pacijenta (personalizirani pristup), kao što su mogućnosti izbjegavanja alergena, djelotvornost farmakološkog liječenja, količina i vrsta lijekova koji su potrebni za postizanje kontrole bolesti, nuspojave farmakološkog liječenja, motiviranost pacijenta, itd. U ovom članku će se prikazati mehanizmi, indikacije i kontraindikacije za uvođenje alergen-specifične imunoterapije, kriteriji odabira bolesnika, metode primjene, sigurnost i djelotvornost, te nove terapijske mogućnosti primjenu alergen-specifične imunoterapije u liječenju alergijskih bolesti u djece. [ABSTRACT FROM AUTHOR]

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