Allergy Vaccine for Asthma - lmmuno Therapy:
Asthma, Allergy & immuno Therapy (specific immuno Therapy or SIT) synonyms for this treatment-desensitisation, hyposensitization, allergy shots, allergy vaccines and allergen injection therapy.
Certain facts about Asthma.
- has become a world heatth probtem.
- lt is a non contagious disease.
- Around 10 to 15% of the population suffer from asthma and the incidence being equa in children & adults.
- Approximately 30 crores of people in the world suffer from asthma.
- There is approximately 140 Lakh days schoot absentism is occurring in the world due to episodes of asthma.
- children exposed to passive smoking becomes the strongest risk factor, for development of asthma.
- children of pregnant woman smokers are more likely prone for asthma.
- Recurrent chest infections during childhood are more prone for the development of asthma.
- Children due to passive smoking is the strongest risk factor for the development of Asthma in Future
Various Triggers of Asthma:
- Air conditioners usage
- Exposure to Dust, cement
- House dust
- Dust mite which harbours blankets, pillow covers(microscopic insects - Thaviti purugulu)
- Old Books, papers
- Pet animals - cats, dogs, hens
- Sea Food
- Hair dyes
- Mosquito coils, allout, burning camphor while doing pooja
- sudden change in environment _ cloudy atmosphere
- Certain Pain Releiving drugs(Non steroidal anti inflammatory drugs Like Brufen, Analgin,Aceclofenac.
- Face powder, soaps
- Smell - oil, scent spray Jasmine Smell
- Coloring agents used in food stuffs and certain additives like added h Hot drinks (Brandy etc)
- Approximately 40% of allergic rhinitis patients will turn into Asthma in due course of time
- EmotionaI upsets
- Exercise - exercise inducted asthma
- GERD - Gastro Esophageal Reflux Disease.
Bronchial Asthma is a chronic inflammatory disease of lungs, involving Bronchioles/Bronchi causing inflammatory swelling in the inside walls of bronchi with smooth muscle construction of bronchi offering resistance to the passage of air, there by causing breathlessness, wheezing (musical) sounds, tightness chest, cough & sputum production, sometimes only dry cough, pain chest, associated with coryza, sneezing with itching of throat, nose, eyes, chest.
1) History of allergy, seasonal, wheezing sounds, early onset/late onset also sometimes associated nasal & Bronchial allergy - familial, incidence, History of cold, sneezing.
2) Spirometry - with the help of computerized spirometer, pulmonary function tests can be done, pre & post bronchodilator inhalation, results can be taken and reversibility of 20% is noted.
1) Consult your nearest chest physician. Inhalation therapy is the standard line of treatment of Bronchial asthma.
2) Allergen avoidance if possible.
3) SIT : Specific lmmuno therapy - involves the subcutaneous injection of allergen extracts in increasing concentrations, twice a week, once a week, and later once in 2 weeks.
AIM of SIT is to induce a state of hyposensitisation with a diminished clinical response on re exposure to the allergens to which the patient is sensitive, thus decrease in symptoms of asthma - Cough, Breathlessness etc... Medication witt onty suppress the symptoms and prevents exacerbation of asthma. But SIT at present the only specific disease modifying, cost effective treatment option. Usage of allergy vaccines for the treatment of allergic asthma, allergic Bronchitis, allergic rhinitis etc... is not a substitute for the therapy for asthma with medication. lt is only an addtion to the treatment of Allergic diseases.
The following patients can undergo specific immunotherapy.
1) Allergic BronchiaI asthma whether seasonaI or perennial.
2).When allergen avoidance is not possible and appropriate medication fails to control symptom of Allergic Asthma
3) Allergic rhinitis
4) Allergic rhinitis with Asthma - Naso Bronchial Allergy
Specific immuno Therapy
This treatment is intended for all allergic diseases such as Allergic rhinitis, allergic conjunctivitis,
Allergic Bronchitis and Allergic Bronchial Asthma
This Specific immuno Therapy or SIT has been accepted as the cornerstone of treatment for allergic diseases
This Modality of Treatment I have taken up to treat the following patients since 10-1-1992 till today
And contuing the Patients suffering from following diseases are taken up for this Immuno Theraphy
1)Bronchial Astham Allergic
Bronchail Asthma Allergic is complaints of Cough,breathlessness, & Sputum production, wheezing,(Sounds Musical Sounds) from chest heard by the patient & sometimes by the neighboring persons. Mostly Seasonal mostly in winter, rainy seasons and sometimes perennial. Sometimes Patients of asthma will be complaining of only dry cough mostly nocturnal patients will be complaining of tightness in chest ,anxiety and pain in chest and exhaustion. Agravating can be elicited from the patient from Example expose to cool air, dust, pollution and sometimes expose to pet animals like cat, dog, hen. which may be a
Allergic responsible for the asthmatic attacks in that particular Individual. Astham is non contagious diseases about 10 to 15% of the population are suffering from Bronchial asthma .As a chest physician
I underwent training in allery skin testing at delhi is finding out the various allergiens to which patient is sensitive.the Various aero allergiens are pollen.fungi,dust,insects,animal dander,cotton,fabric,and food substances.
(1)(i)Allergen Avoidance(if known and if possible) and
only 2 specific treatrnents are avaitabre to the aaergic patient;
(ii)Medication with aerosol therapy will surppress the symptoms and also prevents the asthmatic attacks by using steroid inhalers under the prescriptions of chest physician.Specific Immuno therapy is at present the only specific ,diseases modifying cost effective treatment option added to the therapy to the allerigic diseases
2)Allergy Brochitis - Patience suffering from non productive cough,mostly seasonal,agravated by inhaling dust,fungus etc..,and also in winter due to cool air and cool atmosphere.These patients will be having iritable cough mostly night,dustubing sleep and occationally patience will be hearing wheezing sounds from the trachea or chest and sometimes the musical sounds will be heard by the neighboring persons mostly they will be all right during the summer.Sometimes these patience will be falling down and become unconscious due to less blood supply to the brain during coughing-cough syncope.
3)Allergic Conjunctivitis- Mostly these patience will have redness eyes with itching eyes ,watering and itching over face .
As a chest physician,I underwent training in allergy skin testing at Delhi in finding out the various allergies to which the patient is sensitive.The various aero allergeirs are pollan,fungi ,insects,animal dander,cotton,fabric and food substances
Specific immuno therapy is at present the only specific,desease-modifing,cost-effective treatement option
How Allergy Testing is done
Various allergen extracts of aero allergen-pollen,fungi,insects,dust,animal dander,cotton and food substances are available.About 30 to 40 allergen extracts are injected over the forearm of the patient ,using superfine 30G short needle(insulin syringe)intradermally-only the point of the needle is inserted intradermally and about 0.01ml of the allergen injected to raise a bleb.Normal saline control is used .After injecting the various allergens,the depending on the size of induration at the sight of the allergen injected is noted and various allergens to which the patient is sensitive is noted and accordingly precription chart is prepared and send into the company for manufacturing the mixture of various allergens to which the patient is sensitive in different concentrations and these patience antigen extracts are sent to us,on the name of individual patient names seperately.
Once we receive the patient’s antigens(allergen extracts)(4 vials) and a schedule chart is prepared with instructions printed,to betaken injections subcuntaneously once in 3 days,later once in a week and the patience are asked to take the allergen vaccines at their villages from their family doctors.This is the procedure I am doing.
The results of recovering made after undergoing specific immunotherapy by the patients are :
1) Maximum reduction in the symptoms and frequency of symptoms.
2) Usage of drugs are much reduced after immunotherapy.
3) Quatity of life improved, work efficiency improved.
4) Few patients are not getting symptoms even when they have stopped immunotherapy, even after 7years after stopping allergy vaccine.
5) Decrease in acute exacerbations of asthma & hospitalization.
6) Benefit from immuno therapy continues even after it has been discontinued following a 3-year
course of treatment.
Safety of lmmuno Therapy
1) In my study only few patients complained of itching over the body & urticaria which subsided after taking anti histamine & prednisolone.
2) Nil anaphylactic reactions & nit fatalities and nil hospitalizations during the course of
allergic/allergen vaccine injection are noted till today.
3) lmmuno Therapy injection can be continued safety during pregnancy also.
In my study most of the patients are sensitive to pollen, fungi, dust, animal dander. Vaccine for food allergy is not advocated as it is ineffective and only avoidance is advised.