CAP FS TNSMS / TNSMS. IgE CAP. cry j 1 cha o 1. IgE. IgE

Transcription

1 : : SLIT CAP QOL QOL FS TNSMS : SLIT TNSMS FS0 FS TNSMS / : : cry j 1 cha o 1 IgE IgE CAP IgE

2 /cm /cm 1 CAP QOL JRQLQ No1 quality of lifeqol QOL QOL JRQLQ No1 total nasal symptom medication score : TNSMS Wilcoxon R

3 JRQOL No1 QOL

4 QOL JRQOL No1 JRQLQ No1 QOL QOL QOL QOL QOL 2

5 FS0 FS FS FS0 FS1 FS2 FS3 FS4 FS0 FS1 3 cry j 1 cha o 1 cry j 2 cha o 2 VAS /cm /cm QOL

6 Osada cha o 3 cha o 3 cha o 3 IgEELISA cha o 3 cha o 3 cha o 3 cha o 3 cha o 3 cha o 3 cha o 3 cha o 3

7 cha o 3 minimal persistent inflammation minimal persistent inflammation minimal persistent inflammation QOL Okamoto Y, Okubo K, Yonekura S, et al : Efficacy and safety of sublingual immunotherapy for two seasons in patients with Japanese cedar pollinosis. Int Arch Allergy Immunol 2015 ; 166 : ,,, :. ; :.,,, :. ; :. Ohno N, Ide T, Sakaguchi M, et al : Common anti genicity between Japanese cedarcryptomeria japonica pollen and Japanese cypress Chamaecyparis obtusa pollen, II. Determination of the crossreacting Tcell epitope of Cry j 1 and Cha o 1 in mice. Immunology 2000 ; 99 : :. ; :.,,, :. ; :.,,, : QOL. ; :. :.,.,,, :. ; :. Okubo K, Gotoh M : Sublingual immunotherapy for Japanese cedar pollinosis. Allergol Int 2009 ; 58 : Osada T, Harada T, Asaka N, et al : Identification and gene cloning of a new major allergen Cha o 3 from Chamaecyparis obtusajapanese cypresspollen. J Allergy Clin Immunol 2016 ; 138 : Canonica GW, Compalati E : Minimal persistent inflammation in allergic rhinitis : implications for current treatment strategies. Clin Exp Immunol 2009 ; 158 : ,,, :. ; :.,,, :. ; :.

8 Clinical Efficacy of Sublingual Immunotherapy with Japanese Cedar Pollen During the Cypress Pollen Season Atsushi Yuta, M.D., Yukiko Ogawa, M.D., Hitomi Ogihara, M.D. Yusuke Suzuki, M.D., Nobuo Ohta, M.D., Masahiko Arikata, M.D. Hideaki Kozaki, M.D. and Takeshi Shimizu, M.D. Yuta Clinic Department Otorhinolaryngology, Shiga Medical University Otsu Division of Otolaryngology, Kuwana East Medical Center, Kuwana Department of Otolaryngology, Head and Neck Surgery, Yamagata University Faculity of Medicine, Yamagata Division of Otolaryngology, Tohoku Medical and Pharmaceutical University, Sendai We studied the clinical efficacy during the Cypress season by allergenspecific sublingual immunotherapyslitof cedar pollen. Methods : The subjects were 180 patients with combined cedar and cypress pollinosis treated by SLIT with cedar pollen. There were 105 males and 75 females, with a mean age of the subjects of 37.0 ± 17.0 years. The clinical efficacy of the SLIT was studied in the moderate cedar and cypress pollenscattering year of The scores on the quality of life and face scalefsof the Japanese rhinoconjunctivitis QOL questionnairejrqlq No. 1and the total nasal symptommedication scoretnsmswere assessed by the patients during both the cedar pollen and cypress pollen seasons. A postseasonal survey of the efficacy of SLIT was performed after each of the cedar pollen and cypress pollen seasons. Results : According to the survey, in the patients who had not yet been started on the SLIT, the symptoms were more severe during the cedar pollen season than during the cypress pollen season. The percentages of patients in whom the SLIT was judged to be effective by the patients themselves was 68.7% during the cedar pollen season, and 38.7% during the cypress pollen season. When the patients compared the efficacy of the SLIT between the two pollen seasons, 42.2% answered that their symptoms were equivalent during both seasons, and 54.9% said that the symptoms became worse in the cypress pollen season. There were no differences in the average scores on each item examined between the two pollen seasons, the changes in the scores varied among individual cases. The TNSMS became worse by 1 point in 27.2% of all cases. Of the group of patients with a FS score of 1 point during the cedar pollen season, which is considered as indicative of the treatment efficacy, 43.3% showed worsening of the FS score during the cypress pollen season. In the group of patients who indicated that their symptoms were similar during both the cedar and cypress pollen seasons before the SLIT, 30.4% showed worsening of the TSNMS during the cypress pollen season. However, 8 of the %patients who indicated that their symptoms were more severe during the cypress pollen season than during the cedar pollen season before the SLIT showed improved scores in the cypress pollen season after the start of the SLIT. Conclusion : This result revealed both cases where SLIT was effective and those where it was insufficiently effective during the cypress pollen season, even among cases where the therapy was effective during the cedar pollen season. Keywords : Sublingual immunotherapy, Cedar pollinosis, Cypress pollinosis, Allergen, clinical efficacy Nippon Jibiinkoka Gakkai KaihoTokyo120 : , 2017