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High dose pollen in...
High dose pollen intralymphatic immunotherapy: Two RDBPC trials question the benefit of dose increase
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- Hellkvist, L. (författare)
- Karolinska Institute,Karolinska Institutet,Karolinska University Hospital
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- Hjalmarsson, E. (författare)
- Karolinska Institute,Karolinska Institutet
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Weinfeld, D. (författare)
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- Dahl, Åslög, 1955 (författare)
- University of Gothenburg,Gothenburg University,Göteborgs universitet,Institutionen för biologi och miljövetenskap,Department of Biological and Environmental Sciences
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- Karlsson, A. (författare)
- Karolinska Institute,Karolinska University Hospital
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- Westman, M. (författare)
- Karolinska Institute
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- Lundkvist, K. (författare)
- Karolinska Institute
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- Winqvist, O. (författare)
- Karolinska Institute
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- Georen, S. K. (författare)
- Karolinska Institute,Karolinska Institutet
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- Westin, Ulla (författare)
- Lund University,Lunds universitet,Laryngoesofagologi, allergi och livskvalitet,Forskargrupper vid Lunds universitet,Laryngoesophagology, Allergy and Life Quality,Lund University Research Groups,Skåne University Hospital
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- Cardell, L. O. (författare)
- Karolinska Institute,Karolinska Institutet,Karolinska University Hospital
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(creator_code:org_t)
- 2021-08-29
- 2022
- Engelska.
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Ingår i: Allergy. - : Wiley. - 0105-4538 .- 1398-9995. ; 77:3, s. 883-96
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Abstract
Ämnesord
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- Background The same dosing schedule, 1000 SQ-U times three, with one-month intervals, have been evaluated in most trials of intralymphatic immunotherapy (ILIT) for the treatment of allergic rhinitis (AR). The present studies evaluated if a dose escalation in ILIT can enhance the clinical and immunological effects, without compromising safety. Methods Two randomized double-blind placebo-controlled trials of ILIT for grass pollen-induced AR were performed. The first included 29 patients that had recently ended 3 years of SCIT and the second contained 39 not previously vaccinated patients. An up-dosage of 1000-3000-10,000 (5000 + 5000 with 30 minutes apart) SQ-U with 1 month in between was evaluated. Results Doses up to 10,000 SQ-U were safe after recent SCIT. The combined symptom-medication scores (CSMS) were reduced by 31% and the grass-specific IgG4 levels in blood were doubled. In ILIT de novo, the two first patients that received active treatment developed serious adverse reactions at 5000 SQ-U. A modified up-dosing schedule; 1000-3000-3000 SQ-U appeared to be safe but failed to improve the CSMS. Flow cytometry analyses showed increased activation of lymph node-derived dendritic but not T cells. Quality of life and nasal provocation response did not improve in any study. Conclusion Intralymphatic immunotherapy in high doses after SCIT appears to further reduce grass pollen-induced seasonal symptoms and may be considered as an add-on treatment for patients that do not reach full symptom control after SCIT. Up-dosing schedules de novo with three monthly injections that exceeds 3000 SQ-U should be avoided.
Ämnesord
- MEDICIN OCH HÄLSOVETENSKAP -- Medicinska och farmaceutiska grundvetenskaper -- Immunologi inom det medicinska området (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Basic Medicine -- Immunology in the medical area (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Lungmedicin och allergi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Respiratory Medicine and Allergy (hsv//eng)
Nyckelord
- clinical immunology
- immunotherapy and tolerance induction
- pollen
- rhinitis
- allergen-specific immunotherapy
- recombinant allergens
- young-adults
- clinical-use
- efficacy
- route
- rhinoconjunctivitis
- injections
- rhinitis
- asthma
- Allergy
- Immunology
Publikations- och innehållstyp
- ref (ämneskategori)
- art (ämneskategori)
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Allergy
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Till lärosätets databas
- Av författaren/redakt...
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Hellkvist, L.
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Hjalmarsson, E.
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Weinfeld, D.
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Dahl, Åslög, 195 ...
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Karlsson, A.
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Westman, M.
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visa fler...
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Lundkvist, K.
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Winqvist, O.
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Georen, S. K.
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Westin, Ulla
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Cardell, L. O.
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Allergy
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Göteborgs universitet
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Karolinska Institutet
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Lunds universitet