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Allergenspezifische Immuntherapie bei oralem Allergiesyndrom: Gibt es Evidenz für die Effektivität?

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Zusammenfassung

Hintergrund

Der Großteil der IgE-vermittelten Nahrungsmittelallergien (NMA) bei Erwachsenen basiert auf einer Sensibilisierung gegenüber Pollen mit anschließenden Kreuzreaktionen auf strukturverwandte Allergene in Obst, Gemüse und Gewürzen. Der Einfluss einer allergenspezifischen Immuntherapie (AIT) gegen Pollen auf die pollenassoziierte NMA ist nicht abschließend geklärt.

Methoden

Studienübersicht zur AIT bei pollenassoziierter NMA

Ergebnisse

Publizierte Studien zeigen große Unterschiede im Design (u. a. Probandenzahl, Therapiedauer, Applikationsweise, Allergengehalt, orale Provokationstestung), sodass eine Bewertung und ein Vergleich schwierig sind. Nur in einem Teil der Studien konnte eine Besserung der pollenassoziierten NMA durch eine AIT mit Pollenallergenen gezeigt werden.

Schlussfolgerung

Gesicherte Empfehlungen zum Einsatz einer AIT mit Pollenallergenen bei pollenassoziierter NMA sind bisher nicht möglich. Bei einem Teil der Patienten mit Birkenpollenallergie scheint die AIT mit Birkenallergenen positive Aspekte auf die begleitende NMA zu entfalten.

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Abbreviations

AIT:

Allergenspezifische Immuntherapie

BASALIT:

Birkenassoziierte Sojaallergie und Immuntherapie

DBPCFC:

Doppelblinde, placebokontrollierte orale Provokationstestung

FAQLQ-AF:

„Food Allergy Quality of Life Questionnaire-Adult Form“

HPT:

Hautpricktest

IgA:

Immunglobulin A

IgE:

Immunglobulin E

IgG:

Immunglobulin G

ISAC:

„Immuno solid-phase allergen chip“

LOAEL:

„Lowest observed adverse effect level“

NMA:

Nahrungsmittelallergie

OAS:

Orales Allergiesyndrom

OPT:

Orale Provokationstestung

sIgE:

Spezifisches Immunglobulin E

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Author information

Authors and Affiliations

  1. Leipziger Interdisziplinäres Centrum für Allergologie — LICA-CAC Klinik für Dermatologie, Venerologie und Allergologie, Universität Leipzig, Philipp-Rosenthal-Straße 23, 04103, Leipzig, Deutschland

    Regina Treudler

  2. Zentrum für Rhinologie und Allergologie, Wiesbaden, Deutschland

    Ludger Klimek

Authors
  1. Regina Treudler
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  2. Ludger Klimek
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Correspondence to Regina Treudler.

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Interessenkonflikt

RT erhielt Honorare für Beratungstätigkeiten, Vorträge, Reisekostenübernahmen oder Studienunterstützungen von folgenden Firmen: Allergopharma J. Ganzer KG, ALK-Abello, Novartis, Shire, Sanofi. LK hat Gelder für Studiendurchführung, Berater- und/oder Gutachtertätigkeit, Vortrags- und/oder Schulungstätigkeiten und/oder bezahlte Mitarbeit in einem wissenschaftlichen Beirat erhalten von: ALK-Abelló, Allergopharma, Bencard, Bionorica, Biomay, Boehringer Ingelheim, Cytos, Circassia, Euroimmun, Dr. Fooke, HAL, GSK, Leti, Lofarma, MEDA/Mylan, Novartis, Stallergenes, Thermofisher und Roxall. Der Verlag erklärt, dass die inhaltliche Qualität des Beitrags von zwei unabhängigen Gutachtern geprüft wurde. Werbung in dieser Zeitschriftenausgabe hat keinen Bezug zur CME-Fortbildung. Der Verlag garantiert, dass die CME-Fragen frei sind von werblichen Aussagen und keinerlei Produktempfehlungen enthalten. Dies gilt insbesondere für Präparate, die zur Therapie des dargestellten Krankheitsbildes geeignet sind.

Zitierweise

Treudler R, Klimek L. Allergen immunotherapy for oral allergy syndrome: what is the evidence for efficacy? Allergo J Int 2019;28:50–6 https://doi.org/10.1007/s40629-018-0081-z

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Treudler, R., Klimek, L. Allergenspezifische Immuntherapie bei oralem Allergiesyndrom: Gibt es Evidenz für die Effektivität?. Allergo J 28, 28–36 (2019). https://doi.org/10.1007/s15007-019-1794-0

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