{"id":83,"date":"2022-07-13T07:50:28","date_gmt":"2022-07-13T05:50:28","guid":{"rendered":"http:\/\/apitoxin.sk\/?p=83"},"modified":"2022-07-13T09:19:08","modified_gmt":"2022-07-13T07:19:08","slug":"alergia-imunologicka-liecba-vcelim-jedom","status":"publish","type":"post","link":"http:\/\/d.r5.wbsprt.com\/apitoxin.sk\/2022\/07\/13\/alergia-imunologicka-liecba-vcelim-jedom\/","title":{"rendered":"Alergia &#038; Imunologick\u00e1 lie\u010dba v\u010del\u00edm jedom"},"content":{"rendered":"\n<p><\/p>\n\n\n\n<p>\u200b\u200bKategoricky definuje alergiu, je to chronick\u00e9 ochorenie, ktor\u00e9 m\u00f4\u017ee vies\u0165 k r\u00f4znym sympt\u00f3mom. Jeho pr\u00edznaky sa m\u00f4\u017eu l\u00ed\u0161i\u0165 od jednej osoby k druhej a pod\u013ea ro\u010dn\u00e9ho obdobia. Alergia je gr\u00e9cke slovo, ktor\u00e9 znamen\u00e1 reakciu, ktor\u00e1 bola zmenen\u00e1. Okrem toho, alerg\u00e9n sp\u00fa\u0161\u0165a neprirodzen\u00fa reakciu n\u00e1\u0161ho imunitn\u00e9ho syst\u00e9mu na boj s vonkaj\u0161\u00edmi prvkami. Pod\u013ea v\u00fdskumu sa zistilo, \u017ee existuje viac ako 30 r\u00f4znych horm\u00f3nov, ktor\u00e9 ved\u00fa k alergick\u00fdm reakci\u00e1m. Najv\u00fdraznej\u0161ie s\u00fa leukotri\u00e9ny, prostagland\u00edny a histam\u00edn.\u200b<br>Teraz sa pozrime, ako alergia vyzer\u00e1. Be\u017en\u00e9 pr\u00edznaky alergie s\u00fa opuch a za\u010dervenanie ko\u017ee, astma, ka\u0161e\u013e, \u010derven\u00e9 o\u010di, upchat\u00fd nos, v\u00fdtok z nosa a svrbenie. Takmer 20 % celkovej popul\u00e1cie m\u00e1 nejak\u00fd druh alergick\u00fdch \u0165a\u017ekost\u00ed a takmer 10 % m\u00e1 astmu. Alerg\u00e9ny \u2013 alergick\u00e9 l\u00e1tky \u2013 zodpovedn\u00e9 za spustenie t\u00fdchto pr\u00edznakov sa nach\u00e1dzaj\u00fa v\u0161ade okolo n\u00e1s. Ako niektor\u00e9 potraviny, dom\u00e1ce plesne, cestn\u00e9 ne\u010distoty, rozto\u010de, pe\u013e, aeros\u00f3ly at\u010f.<\/p>\n\n\n\n<p>Existuj\u00fa dve kateg\u00f3rie alergi\u00ed: alergia sprostredkovan\u00e1 IgE a alergia nesprostredkovan\u00e1 IgE. Na lie\u010dbu alergie sa naj\u010dastej\u0161ie predpisuj\u00fa antihistaminik\u00e1 a steroidy ako kortiz\u00f3n. Na zvl\u00e1dnutie z\u00e1va\u017enej alergie sa na kontrolu sympt\u00f3mov pod\u00e1va aj imunoterapia \u2013 v r\u00f4znych d\u00e1vkach.<\/p>\n\n\n\n<p><strong>Terapeutick\u00e9 \u00fa\u010dinky v\u010delieho jedu na imunologick\u00e9 a neurologick\u00e9 ochorenia<\/strong><br>K\u00f3rejci u\u017e dlho pou\u017e\u00edvaj\u00fa V\u010del\u00ed jed na lie\u010dbu z\u00e1palov\u00fdch ochoren\u00ed a na zmiernenie sympt\u00f3mov bolesti. Ned\u00e1vne klinick\u00e9 \u0161t\u00fadie v uspokojivom rozsahu preuk\u00e1zali, \u017ee v\u010del\u00ed jed a jeho deriv\u00e1ty mo\u017eno pou\u017ei\u0165 pri lie\u010dbe Parkinsonovej choroby, autoimunitn\u00fdch a neurodegenerat\u00edvnych chor\u00f4b a imunologick\u00fdch chor\u00f4b.<\/p>\n\n\n\n<p>Pre spr\u00e1vne fungovanie v\u010delieho jedu napom\u00e1haj\u00fa imunitn\u00e9 bunky pr\u00edtomn\u00e9 v gliov\u00fdch bunk\u00e1ch a perif\u00e9rii a neur\u00f3ny centr\u00e1lneho nervov\u00e9ho syst\u00e9mu. V\u010del\u00ed jed sa objavil ako lie\u010debn\u00e1 terapia v starovekej \u010c\u00edne a Gr\u00e9cku. Existuje mno\u017estvo vedeck\u00fdch spr\u00e1v, ktor\u00e9 dokazuj\u00fa protiz\u00e1palov\u00e9 a protireumatick\u00e9 \u00fa\u010dinky v\u010delieho jedu.<\/p>\n\n\n\n<p>Pod\u013ea klinickej \u0161t\u00fadie sa zistilo, \u017ee SIT v\u00fdznamne zvy\u0161uje produkciu IL-10 APC, vr\u00e1tane makrof\u00e1gov, monocytov a B-buniek. \u00da\u010dinnos\u0165 SIT bola zd\u00f4raznen\u00e1 pri respira\u010dn\u00fdch alergi\u00e1ch a alergii na hmyz\u00ed jed.<\/p>\n\n\n\n<p>Imunoterapia jedom podporuje aktiv\u00e1ciu monocytov, ktor\u00e1 je \u010falej charakterizovan\u00e1 oneskorenou nadprodukciou tumor nekrotizuj\u00faceho faktora alfa a IL_12. Lie\u010dba v\u010del\u00edm jedom tie\u017e generovala IL_10 a transformovala rastov\u00fd faktor-beta, ktor\u00fd v\u00fdrazne zv\u00fd\u0161il IgA a IgG4 a zn\u00ed\u017eil IgE.<\/p>\n\n\n\n<p>V K\u00f3rei boli tis\u00edce \u00faspe\u0161n\u00fdch pr\u00edpadov terapie v\u010del\u00edm jedom. A \u013eudia sa vylie\u010dili z ko\u017en\u00fdch chor\u00f4b, astmy, pulp\u00f3znej herni\u00e1cie jadra, artrit\u00eddy, reumatizmu a dokonca aj rakoviny. To v\u0161etko v\u010faka akt\u00edvnym prvkom ako histam\u00edn, apam\u00edn, melitt\u00edn, fosfolip\u00e1za at\u010f.<\/p>\n\n\n\n<p><strong>466 Imunoterapia v\u010del\u00edm jedom so \u0161tandardizovan\u00fdm extraktom, komunik\u00e1cia v dvoch pr\u00edpadoch a klinick\u00fd pokrok<\/strong><br>Imunoterapia v\u010del\u00edm jedom je \u00fa\u010dinn\u00e1 a bezpe\u010dn\u00e1 lie\u010dba pre t\u00fdch pacientov, ktor\u00ed maj\u00fa v anamn\u00e9ze siln\u00e9 systematick\u00e9 reakcie na v\u010del\u00ed jed. Ke\u010f u\u017e hovor\u00edme o Mexiku, neexistuje \u017eiadny homog\u00e9nny extrakt v\u010delieho jedu na lie\u010dbu pacientov. Mexiko je v\u0161ak zn\u00e1me svojou akt\u00edvnou v\u010del\u00e1rskou praxou, preto\u017ee ro\u010dne vyprodukuje viac ako 70 ton medu. Rovnak\u00fdm sp\u00f4sobom je pod\u013ea zozbieran\u00fdch \u00fadajov ka\u017ed\u00fd rok hl\u00e1sen\u00fdch takmer 17 500 pr\u00edpadov bodnutia v\u010delou.<\/p>\n\n\n\n<p>Pod\u013ea v\u00fdskumu uskuto\u010dnen\u00e9ho na 2 pacientoch, ktor\u00ed mali v anamn\u00e9ze siln\u00fa systematick\u00fa reakciu na pracovn\u00fa expoz\u00edciu a boli jed, obaja s preuk\u00e1zanou senzibiliz\u00e1ciou vykazovali odli\u0161n\u00e9 reakcie. Absolvovali \u0161peci\u00e1lny proces imunoterapie, po\u010das ktor\u00e9ho im bol pod\u00e1van\u00fd Alk-US len 100 mcg (\u0161tandardn\u00fd extrakt) t\u00fd\u017edenne pod\u013ea normy udr\u017eiavacieho cyklu. Klinick\u00fd kurz prebiehal \u0161tyri roky.<\/p>\n\n\n\n<p>Od niektor\u00fdch generalizovan\u00fdch a\u017e po lok\u00e1lnu reakciu bola lie\u010dba tolerovan\u00e1 uspokojivo. Dospelo sa k z\u00e1veru, \u017ee imunoterapia m\u00f4\u017ee by\u0165 dobre tolerovan\u00e1 a jej \u00fa\u010dinnos\u0165 je u pacientov tie\u017e vysok\u00e1. U senzibilizovan\u00fdch pacientov pom\u00e1ha predch\u00e1dza\u0165 rozvoju ak\u00fdchko\u013evek \u017eivot ohrozuj\u00facich reakci\u00ed.<\/p>\n\n\n\n<p><strong>Kombin\u00e1cia omalizumabu a imunoterapie v\u010del\u00edm jedom: Funguje to?<\/strong><br>B-VIT (imunoterapia v\u010del\u00edm jedom) sa m\u00f4\u017ee zmie\u0161a\u0165 s omalizumabom na kontrolu systematick\u00fdch reakci\u00ed, ktor\u00e9 vznikaj\u00fa v d\u00f4sledku samotnej imunoterapie v\u010del\u00edm jedom. Tu je pr\u00edpad pacienta, ktor\u00e9mu boli pod\u00e1van\u00e9 obe terapie s\u00fa\u010dasne \u2013 b-VIT aj omalizumab.<\/p>\n\n\n\n<p>Pacient m\u00e1 tie\u017e v anamn\u00e9ze hypotenziu, d\u00fdchavi\u010dnos\u0165, angioed\u00e9m a \u017eih\u013eavku po u\u0161tipnut\u00ed v\u010delou medonosnou. Ko\u017en\u00fd prick test potvrdil senzibiliz\u00e1ciu na apis mellifera. Injekcia s 0,4 ml \u0161tvrtej liekovky (100 000 SQ jednotiek\/ml) bola podan\u00e1 pacientovi a po piatich min\u00fatach sa u neho rozvinula anafylaxia.<\/p>\n\n\n\n<p>Po jednom t\u00fd\u017edni sa podal IT s iba 0,1 ml \u0161tvrtej liekovky. Znova sa vyskytla podobn\u00e1 epiz\u00f3da anafylaxie. Uskuto\u010dnila sa s\u00e9ria podobn\u00fdch o\u0161etren\u00ed zmenou d\u00e1vky a na\u010dasovania, ale reakcia zostala rovnak\u00e1.<\/p>\n\n\n\n<p>Nesk\u00f4r sa s IT kombinoval aj omalizumab 150 mg (15 dn\u00ed). Zistilo sa, \u017ee omalizumbad plus IT neviedli k anafylaxii. Nesk\u00f4r sa pod\u00e1vanie omalizumabu preru\u0161ilo aj po 30 d\u0148och od ukon\u010denia udr\u017eiavacej f\u00e1zy.<\/p>\n\n\n\n<p>V druhej f\u00e1ze udr\u017eiavacej d\u00e1vky; svrbenie, d\u00fdchavi\u010dnos\u0165, ka\u0161e\u013e a \u017eih\u013eavka sa objavili hne\u010f po 15 min\u00fatach od podania omalizumbadu plus IT injekcie. Na kontrolu sympt\u00f3mov sa s kr\u00e1tkymi prest\u00e1vkami pod\u00e1val difenhydram\u00edn 45,5 mg, adrenal\u00edn 0,5 mg a metylprednizol\u00f3n a IM 40 mg.<\/p>\n\n\n\n<p>Nesk\u00f4r, po 15 d\u0148och, bol pacientovi najsk\u00f4r podan\u00fd omalizumab 150 mg a potom IT s odstupom \u0161tyroch hod\u00edn. D\u00e1vka IT sa zn\u00ed\u017eila na 0,4 ml \u0161tvrtej liekovky. Po pol hodine sa u pacienta rozvinuli sympt\u00f3my podobn\u00e9 posledn\u00e9mu experimentu.<\/p>\n\n\n\n<p>Dospelo sa k z\u00e1veru, \u017ee pozit\u00edvny v\u00fdsledok IT injekcie nie je potrebn\u00fd u pacientov, u ktor\u00fdch sa vyskytuj\u00fa pretrv\u00e1vaj\u00face systematick\u00e9 reakcie. To ist\u00e9 plat\u00ed pre omalizumbad plus IT injekciu. Po vykonan\u00ed nieko\u013ek\u00fdch \u010fal\u0161\u00edch o\u0161etren\u00ed je potrebn\u00e9 presk\u00fama\u0165 s\u00favisiace rizik\u00e1.<\/p>\n\n\n\n<p><strong>Omalizumab: U\u017eito\u010dn\u00fd n\u00e1stroj na vyvolanie tolerancie k imunoterapii v\u010del\u00edm jedom<\/strong><br>Imunoterapia jedom je \u00fa\u010dinn\u00e1 lie\u010dba anafylaxie u\u0161tipnut\u00edm, ktor\u00e1 sa vyskytuje u takmer 3 % dospel\u00fdch. D\u00f4vodom je, \u017ee VIT m\u00e1 p\u00f4sobiv\u00e9 percento \u00faspe\u0161nosti 98%, zatia\u013e \u010do BVIT (imunoterapia v\u010del\u00edm jedom) m\u00e1 tie\u017e uspokojiv\u00e9 percento 85%. BVIT (imunoterapia v\u010del\u00edm jedom) m\u00e1 vy\u0161\u0161ie percento ne\u017eiaducich a ne\u017eiaducich systematick\u00fdch reakci\u00ed, ktor\u00e9 s\u00fa hl\u00e1sen\u00e9 na \u00farovni 14 %.<\/p>\n\n\n\n<p>Dvaja pacienti vo veku 12 rokov a 17 rokov zaznamenali siln\u00e9 systematick\u00e9 reakcie po bodnut\u00ed v\u010delou. Chlapec vo veku 12 rokov, vyvinut\u00fd angioed\u00e9m s d\u00fdchavi\u010dnos\u0165ou a ka\u0161\u013eom a systematickou urtik\u00e1riou. Zatia\u013e \u010do u druh\u00e9ho chlapca sa vo veku 17 rokov objavila vyr\u00e1\u017eka a stratil vedomie. Obaja mali v anamn\u00e9ze astmu a alergick\u00fa rinit\u00eddu.<\/p>\n\n\n\n<p>U\u017e\u00edvali cetiriz\u00edn 10 mg a antileukotrienciu 10 mg denne. Na \u010fal\u0161ie uskuto\u010dnenie lie\u010dby sa obom pod\u00e1val BVIT s pou\u017eit\u00edm \u0161tandardizovan\u00e9ho pr\u00edpravku jedu pod\u013ea spr\u00e1vneho rozvrhu.<\/p>\n\n\n\n<p>BVIT (imunoterapia v\u010del\u00edm jedom) bola zastaven\u00e1 po poslednej d\u00e1vke 25 mcg; pod\u00e1van\u00e9 v 4 r\u00f4znych d\u00e1vkach 1 mcg, 3 mcg, 6 mcg a 15 mcg s odstupom tridsiatich min\u00fat. D\u00f4vodom bol v\u00fdskyt astmy, hypotenzie a angioed\u00e9mu tv\u00e1re. Okam\u017eite bola podan\u00e1 urgentn\u00e1 lie\u010dba na b\u00e1ze hydrokortiz\u00f3nu 500 mg a klorfeniram\u00ednu 10 mg. Spirometrick\u00fd respira\u010dn\u00fd parameter uk\u00e1zal pokles hlad\u00edn FEV1 u oboch pacientov. Nesk\u00f4r sa pacienti v\u00fdrazne zotavili po podan\u00ed adrenal\u00ednu 0,5 ml.<\/p>\n\n\n\n<p>Pod\u013ea v\u00fdsledkov d\u00e1vkovacej sch\u00e9my, ktor\u00e1 bola odvoden\u00e1 po zhode telesnej hmotnosti a celkovej d\u00e1vky IgE, prv\u00fd chlapec dost\u00e1val omalizumab 525 mg a druh\u00fd chlapec dost\u00e1val omalizumab 450 mg ka\u017ed\u00fdch 15 dn\u00ed. Vy\u0161\u0161ie uveden\u00e9 pr\u00edpady ukazuj\u00fa, \u017ee omalizumab je ur\u010dite perfektnou terapeutickou mo\u017enos\u0165ou na prevenciu reakci\u00ed s\u00favisiacich s imunoterapiou BVIT.<\/p>\n\n\n\n<p><strong>Epitopovo \u0161pecifick\u00e1 tolerancia T-buniek na fosfolip\u00e1zu A2 vo v\u010delom jede Imunoterapia a zotavenie pomocou IL-2 a IL-15 in vitro<\/strong><br>Hlavn\u00fd alerg\u00e9n \u2013 fosfolip\u00e1za z v\u010delieho jedu m\u00e1 glykopeptidov\u00fd T-bunkov\u00fd epitop a tri peptidy, s ktor\u00fdmi sa stret\u00e1vaj\u00fa nealergick\u00e9 aj alergicky senzibilizovan\u00e9 subjekty. Pre t\u00fato klinick\u00fa \u0161t\u00fadiu sa pred a po imunoterapii WBV sk\u00famali T-bunky \u0161pecifick\u00e9 pre PLA a jednoduch\u00e1 PLA a cytok\u00ednov\u00e1 odpove\u010f v PBMC pacientov po bodnut\u00ed v\u010delou.<\/p>\n\n\n\n<p>Bolo zaznamenan\u00e9, \u017ee prolifer\u00e1cia T-bunkov\u00e9ho epitopov\u00e9ho peptidu a PLA \u2013 \u0161pecifick\u00fdch T buniek bola v\u00fdznamne potla\u010den\u00e1. Rovnak\u00fdm sp\u00f4sobom bola zru\u0161en\u00e1 peptidom indukovan\u00e1 emisia IL-4, IL-13 a IL-5 a IFN-gama a IL-2 cytok\u00ednov.<\/p>\n\n\n\n<p>Zatia\u013e \u010do prolifer\u00e1cia a produkcia cytok\u00ednu indukovan\u00e9ho tetanov\u00fdm toxoidom zostala nezmenen\u00e1. Kultiv\u00e1cia Ag s PBMC v pr\u00edtomnosti IL-15 a IL-2 odozvy T buniek by sa mohla \u013eahko obnovi\u0165, pokia\u013e ide o \u0161pecifick\u00fa sekr\u00e9ciu a prolifer\u00e1ciu IFN-gama, IL-2 a T buniek typu 1.<\/p>\n\n\n\n<p>Na druhej strane IL-13, IL-5 a IL-4 zostali potla\u010den\u00e9. Tieto zistenia ukazuj\u00fa, \u017ee terapia v\u010del\u00edm jedom vytv\u00e1ra stav tolerancie v T bunk\u00e1ch, ktor\u00e9 s\u00fa \u0161pecifick\u00e9 pre alerg\u00e9n, ale nie v \u0161pecifick\u00fdch B bunk\u00e1ch.<\/p>\n\n\n\n<p><strong>Klinick\u00e1 \u00fa\u010dinnos\u0165 imunoterapie jedom blanokr\u00eddleho hmyzu: perspekt\u00edvna observa\u010dn\u00e1 multicentrick\u00e1 \u0161t\u00fadia Eur\u00f3pskej akad\u00e9mie alergol\u00f3gie a klinickej imunol\u00f3gie z\u00e1ujmovej skupiny o hypersenzitivite jedu hmyzu<\/strong><br>V tejto skupine bolo hodnoten\u00fdch 357 pacientov, ktor\u00ed mali alergiu na jed ve\u0161ej alebo v\u010del\u00ed jed. \u00da\u010dinnos\u0165 VIT  (imunoterapia v\u010del\u00edm jedom) bola overen\u00e1 pacientmi, ktor\u00ed sa sami hl\u00e1sili a provoka\u010dn\u00fdm testom. Takmer 22 pacientov vykazovalo generalizovan\u00e9 sympt\u00f3my po u\u0161tipnut\u00ed v ter\u00e9ne alebo po stimul\u00e1cii bodnut\u00edm. Takmer 10 % pacientov, ktor\u00ed trpeli alergiou na jed blanokr\u00eddlovcov, vykazovalo zv\u00fd\u0161en\u00fa koncentr\u00e1ciu trypt\u00e1zy. Pri \u010fal\u0161om z\u00fa\u017een\u00ed rozsahu \u0161t\u00fadie boli analyzovan\u00ed iba pacienti, ktor\u00ed preuk\u00e1zali potenci\u00e1l VIT.<\/p>\n\n\n\n<p>Udr\u017eiavacia d\u00e1vka bola udr\u017eiavan\u00e1 na 100 ug pre pacientov, ktor\u00ed mali norm\u00e1lne sympt\u00f3my. Zatia\u013e \u010do pacientom so z\u00e1va\u017en\u00fdmi ved\u013eaj\u0161\u00edmi \u00fa\u010dinkami bolo podan\u00fdch 200 ug po\u010das udr\u017eiavacej f\u00e1zy. Zistilo sa, \u017ee BTC a frekvencia lie\u010dby nemali po\u010das udr\u017eiavacej f\u00e1zy \u017eiadnu s\u00favislos\u0165. N\u00e1rast BTC v\u0161ak st\u00e1le projektuje nieko\u013eko men\u0161\u00edch negat\u00edvnych \u00fa\u010dinkov na percento \u00faspe\u0161nosti VIT.<\/p>\n\n\n\n<p>D\u00e1vkov\u00e1 z\u00e1vislos\u0165 ochrany pred syst\u00e9mov\u00fdmi reakciami na imunoterapiu jedom omalizumabom<br>Ak\u00fdko\u013evek druh systematickej reakcie na lie\u010dbu jedom je pomerne zriedkav\u00fd. St\u00e1le v\u0161ak existuje \u0161anca na v\u00fdskyt systematick\u00fdch reakci\u00ed. Miera systematick\u00fdch reakci\u00ed je vy\u0161\u0161ia u v\u010diel medonosn\u00fdch v porovnan\u00ed s VIT vespid.<\/p>\n\n\n\n<p><strong>Pacienti, ktor\u00ed maj\u00fa opakovan\u00e9 systematick\u00e9 reakcie na VIT, s\u0165a\u017euj\u00fa ur\u010denie konkr\u00e9tnej \u00fa\u010dinnej d\u00e1vky v\u010delieho jedu. V tak\u00fdchto pr\u00edpadoch je vo v\u0161eobecnosti indikovan\u00fd re\u017eim pred lie\u010dbou omalizumbou.<\/strong><\/p>\n\n\n\n<p>Vyskytol sa pr\u00edpad \u017eeny, 47 rokov, ktor\u00e1 vykazovala alergick\u00e9 pr\u00edznaky na v\u010del\u00ed jed. Dvakr\u00e1t za\u017eila \u0165a\u017ek\u00e9 reakcie po tom, \u010do dostala v\u010delie bodnutie. Okrem toho boli systematick\u00e9 reakcie z\u00e1va\u017en\u00e9 aj v pr\u00edpade VIT.<\/p>\n\n\n\n<p>Predbe\u017en\u00e1 lie\u010dba kortikosteroidmi a antihistaminikami spolu s omalizumabom 300 mg pomohla kontrolova\u0165 v\u00fdskyt systematick\u00fdch reakci\u00ed.<\/p>\n\n\n\n<p>Nakoniec d\u00e1vka 450 mg omalizumabu a 200 mcg v\u010delieho jedu pomohla ochr\u00e1ni\u0165 subjekt pred systematick\u00fdmi reakciami na VIT. Najn\u00e1ro\u010dnej\u0161ou ot\u00e1zkou je ur\u010denie presnej d\u00e1vky omalizumabu, ktor\u00fa pacient potrebuje pod\u013ea z\u00e1va\u017enosti reakcie a jej kompatibility s VIT.<\/p>\n\n\n\n<p>Na vyvinutie imunoterapeutick\u00e9ho re\u017eimu, ktor\u00fd ochr\u00e1ni pacientov pred ak\u00fdmko\u013evek druhom \u017eivot ohrozuj\u00facich systematick\u00fdch reakci\u00ed, je potrebn\u00e1 adekv\u00e1tna klinick\u00e1 \u0161t\u00fadia VIT plus omalizumab.<\/p>\n\n\n\n<p><strong>Komponentovo vyrie\u0161en\u00e9 hodnotenie obsahu hlavn\u00fdch alerg\u00e9nov v terapeutick\u00fdch extraktoch pre \u0161pecifick\u00fa imunoterapiu\u2026<\/strong><br>Na lie\u010dbu v\u010delieho jedu bola \u0161pecifick\u00e1 imunoterapia pre alergiu op\u00edsan\u00e1 ako najlep\u0161ia lie\u010debn\u00e1 lie\u010dba. Pom\u00e1ha pri ochrane pred ak\u00fdmiko\u013evek \u010fal\u0161\u00edmi siln\u00fdmi anafylaktick\u00fdmi reakciami na bodnutie. Pod\u013ea ned\u00e1vnej anal\u00fdzy vykonanej na molekul\u00e1rnej \u00farovni sa zistilo, \u017ee HBV predstavuje komplexn\u00fd zdroj alerg\u00e9nov, ktor\u00fd obsahuje aj relevantn\u00e9 alerg\u00e9ny. Obsah alerg\u00e9nov v terapeutick\u00fdch extraktoch sa m\u00f4\u017ee l\u00ed\u0161i\u0165 v d\u00f4sledku r\u00f4znorod\u00e9ho materi\u00e1lu z pr\u00edrodn\u00fdch zdrojov a odli\u0161n\u00fdch strat\u00e9gi\u00ed n\u00e1sledn\u00e9ho spracovania, ktor\u00e9 vykon\u00e1vaj\u00fa v\u00fdrobcovia.<\/p>\n\n\n\n<p>V tejto laborat\u00f3rnej \u0161t\u00fadii sa na imunoterapiu pou\u017eili HBV r\u00f4zneho terapeutick\u00e9ho stup\u0148a. Pou\u017eit\u00edm alerg\u00e9n-\u0161pecifick\u00fdch protil\u00e1tok bola stanoven\u00e1 \u00faloha hlavn\u00fdch alerg\u00e9nov ako Api m 3, Api m 5, Api m 10 v terapeutick\u00fdch extraktoch.<\/p>\n\n\n\n<p>Polyklon\u00e1lne protil\u00e1tky so \u0161pecifickos\u0165ou pre hlavn\u00e9 alerg\u00e9ny Api m 2, Api m 3 a Api m 10 boli vytvoren\u00e9 imuniz\u00e1ciou kr\u00e1likov alerg\u00e9nmi CCD (cross-reactive sacharidov\u00fd determinant). Na detekciu Api m5 sa pou\u017eila rekombinantn\u00e1 monoklon\u00e1lna protil\u00e1tka IgE. V\u0161etky kr\u00e1liky vykazovali vynikaj\u00facu reaktivitu s rekombinantn\u00fdmi alerg\u00e9nmi.<\/p>\n\n\n\n<p>V\u0161etky protil\u00e1tky sa tie\u017e uk\u00e1zali ako extr\u00e9mne \u0161pecifick\u00e9 pre prirodzen\u00e9 alerg\u00e9ny v HBV. \u00darove\u0148 citlivosti detekcie bola stanoven\u00e1 pomocou riediaceho z\u00e1va\u017en\u00e9ho surov\u00e9ho jedu. V\u00fdsledkom bolo, \u017ee takmer v\u0161etky protil\u00e1tky preuk\u00e1zali spr\u00e1vnu detekciu pr\u00edslu\u0161n\u00fdch cie\u013eov\u00fdch alerg\u00e9nov.<\/p>\n\n\n\n<p>Zozbieran\u00e9 \u00fadaje preuk\u00e1zali rozdiely v kvalite terapeutickej d\u00e1vky HBV v kontexte obsahu r\u00f4znych d\u00f4le\u017eit\u00fdch alerg\u00e9nov. Spr\u00e1vna \u0161tandardiz\u00e1cia d\u00e1vky terapeutick\u00e9ho extraktu jedu sa m\u00f4\u017ee vykona\u0165 po ur\u010den\u00ed skuto\u010dnej alerg\u00e9nnej sily. Treba kon\u0161tatova\u0165, \u017ee alerg\u00e9n-\u0161pecifick\u00e9 protil\u00e1tky nes\u00fa cenn\u00e9 inform\u00e1cie, ktor\u00e9 m\u00f4\u017eu pom\u00f4c\u0165 pri rie\u0161en\u00ed probl\u00e9mov s terapeutick\u00fdmi extraktmi na molekul\u00e1rnej \u00farovni.<\/p>\n\n\n\n<p><strong>Zdroje:<\/strong><br><a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC5647995\/\">Component-resolved evaluation of the content of major allergens in therapeutic extracts for specific immunotherapy&#8230;<\/a><br><a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC4738458\/\">Elevated and cross\u2010responsive CD1a\u2010reactive T cells in bee and wasp venom allergic individuals<\/a><br><a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC5145209\/\">In Vitro\u00a0and\u00a0In Vivo\u00a0Anti-Allergic and Anti-Inflammatory Effects of eBV, a Newly Developed Derivative of\u00a0Bee Venom&#8230;<br>\u200b<\/a><a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC4864742\/\">Quality-of-life in insect venom allergy: validation of the Turkish version of the \u201cVespid Allergy Quality of Life Questionnaire\u201d<\/a><br><a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC4499103\/\">9\u03b1,11\u03b2-PGF2, a Prostaglandin D2\u00a0Metabolite, as a Marker of Mast Cell Activation in\u00a0Bee Venom-Allergic Patients<\/a><br><a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC5346112\/\">Six years of INSTAND e.\u2009V. sIgE proficiency testing:\u00a0An evaluation of in vitro allergy diagnostics<\/a><br><a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pubmed\/26210895\" target=\"_blank\" rel=\"noreferrer noopener\">Testing the &#8222;toxin hypothesis of allergy&#8220;: Mast cells, IgE, and innate and acquired immune responses to venoms<\/a><br><a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC5009563\/\" target=\"_blank\" rel=\"noreferrer noopener\">Proceedings of the Canadian society of allergy and clinical immunology annual scientific meeting&#8230;<\/a><br><a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC3512666\/\" target=\"_blank\" rel=\"noreferrer noopener\">88 Clinical Features and Diagnostic Value of Specific IGE to Component Allergen in\u00a0Bee Venom Allergy in Korea<br>\u200b<\/a><a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC4516920\/\">Therapeutic Effects of\u00a0Bee Venom\u00a0on Immunological and Neurological Diseases<\/a><br><a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC3512747\/\">466 Bee venom\u00a0Immunotherapy with Standardized Extract, Two Case Comunication and Clinical Progress<\/a><br><a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC5796962\/\">Combination of omalizumab and\u00a0bee venom\u00a0immunotherapy: does it work?<\/a><br><a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC5806845\/\">Omalizumab: A useful tool for inducing tolerance to\u00a0bee venom\u00a0immunotherapy<\/a><br><a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC507602\/\">Epitope-specific T cell tolerance to phospholipase A2 in\u00a0bee venom\u00a0immunotherapy and recovery by IL-2 and IL-15 in vitro.<\/a><br><a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC3659083\/\">Clinical Effectiveness of Hymenoptera Venom Immunotherapy: A Prospective Observational Multicenter Study of the European Academy of Allergology and Clinical Immunology Interest Group on Insect Venom Hypersensitivity<\/a><br><a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC5078942\/\">Dose-dependence of protection from systemic reactions to venom immunotherapy by omalizumab<\/a><\/p>\n","protected":false},"excerpt":{"rendered":"<p>\u200b\u200bKategoricky definuje alergiu, je to chronick\u00e9 ochorenie, ktor\u00e9 m\u00f4\u017ee vies\u0165 k r\u00f4znym sympt\u00f3mom. Jeho pr\u00edznaky sa m\u00f4\u017eu l\u00ed\u0161i\u0165 od jednej osoby k druhej a pod\u013ea ro\u010dn\u00e9ho obdobia. Alergia je gr\u00e9cke slovo, ktor\u00e9 znamen\u00e1 reakciu, ktor\u00e1 bola zmenen\u00e1. Okrem toho, alerg\u00e9n sp\u00fa\u0161\u0165a neprirodzen\u00fa reakciu n\u00e1\u0161ho imunitn\u00e9ho syst\u00e9mu na boj s vonkaj\u0161\u00edmi prvkami. Pod\u013ea v\u00fdskumu sa zistilo, [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":90,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_mi_skip_tracking":false,"ngg_post_thumbnail":0},"categories":[7],"tags":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v19.14 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>Alergia &amp; Imunologick\u00e1 lie\u010dba v\u010del\u00edm jedom - apitoxin.sk<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"http:\/\/apitoxin.sk\/2022\/07\/13\/alergia-imunologicka-liecba-vcelim-jedom\/\" \/>\n<meta property=\"og:locale\" content=\"sk_SK\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Alergia &amp; Imunologick\u00e1 lie\u010dba v\u010del\u00edm jedom - apitoxin.sk\" \/>\n<meta property=\"og:description\" content=\"\u200b\u200bKategoricky definuje alergiu, je to chronick\u00e9 ochorenie, ktor\u00e9 m\u00f4\u017ee vies\u0165 k r\u00f4znym sympt\u00f3mom. Jeho pr\u00edznaky sa m\u00f4\u017eu l\u00ed\u0161i\u0165 od jednej osoby k druhej a pod\u013ea ro\u010dn\u00e9ho obdobia. Alergia je gr\u00e9cke slovo, ktor\u00e9 znamen\u00e1 reakciu, ktor\u00e1 bola zmenen\u00e1. Okrem toho, alerg\u00e9n sp\u00fa\u0161\u0165a neprirodzen\u00fa reakciu n\u00e1\u0161ho imunitn\u00e9ho syst\u00e9mu na boj s vonkaj\u0161\u00edmi prvkami. Pod\u013ea v\u00fdskumu sa zistilo, [&hellip;]\" \/>\n<meta property=\"og:url\" content=\"http:\/\/apitoxin.sk\/2022\/07\/13\/alergia-imunologicka-liecba-vcelim-jedom\/\" \/>\n<meta property=\"og:site_name\" content=\"apitoxin.sk\" \/>\n<meta property=\"article:published_time\" content=\"2022-07-13T05:50:28+00:00\" \/>\n<meta property=\"article:modified_time\" content=\"2022-07-13T07:19:08+00:00\" \/>\n<meta property=\"og:image\" content=\"http:\/\/apitoxin.sk\/wp-content\/uploads\/2022\/07\/skumakvky.png\" \/>\n\t<meta property=\"og:image:width\" content=\"287\" \/>\n\t<meta property=\"og:image:height\" content=\"288\" \/>\n\t<meta property=\"og:image:type\" content=\"image\/png\" \/>\n<meta name=\"author\" content=\"admin\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:label1\" content=\"Autor\" \/>\n\t<meta name=\"twitter:data1\" content=\"admin\" \/>\n\t<meta name=\"twitter:label2\" content=\"Predpokladan\u00fd \u010das \u010d\u00edtania\" \/>\n\t<meta name=\"twitter:data2\" content=\"12 min\u00fat\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\/\/schema.org\",\"@graph\":[{\"@type\":\"WebPage\",\"@id\":\"http:\/\/apitoxin.sk\/2022\/07\/13\/alergia-imunologicka-liecba-vcelim-jedom\/\",\"url\":\"http:\/\/apitoxin.sk\/2022\/07\/13\/alergia-imunologicka-liecba-vcelim-jedom\/\",\"name\":\"Alergia & Imunologick\u00e1 lie\u010dba v\u010del\u00edm jedom - apitoxin.sk\",\"isPartOf\":{\"@id\":\"http:\/\/apitoxin.sk\/#website\"},\"datePublished\":\"2022-07-13T05:50:28+00:00\",\"dateModified\":\"2022-07-13T07:19:08+00:00\",\"author\":{\"@id\":\"http:\/\/apitoxin.sk\/#\/schema\/person\/3432b72e01828705a1bdf176a0c88c35\"},\"breadcrumb\":{\"@id\":\"http:\/\/apitoxin.sk\/2022\/07\/13\/alergia-imunologicka-liecba-vcelim-jedom\/#breadcrumb\"},\"inLanguage\":\"sk-SK\",\"potentialAction\":[{\"@type\":\"ReadAction\",\"target\":[\"http:\/\/apitoxin.sk\/2022\/07\/13\/alergia-imunologicka-liecba-vcelim-jedom\/\"]}]},{\"@type\":\"BreadcrumbList\",\"@id\":\"http:\/\/apitoxin.sk\/2022\/07\/13\/alergia-imunologicka-liecba-vcelim-jedom\/#breadcrumb\",\"itemListElement\":[{\"@type\":\"ListItem\",\"position\":1,\"name\":\"Home\",\"item\":\"http:\/\/apitoxin.sk\/\"},{\"@type\":\"ListItem\",\"position\":2,\"name\":\"Alergia &#038; Imunologick\u00e1 lie\u010dba v\u010del\u00edm jedom\"}]},{\"@type\":\"WebSite\",\"@id\":\"http:\/\/apitoxin.sk\/#website\",\"url\":\"http:\/\/apitoxin.sk\/\",\"name\":\"apitoxin.sk\",\"description\":\"Slovensk\u00fd v\u00fdrobca lapa\u010dov v\u010delieho jedu\",\"potentialAction\":[{\"@type\":\"SearchAction\",\"target\":{\"@type\":\"EntryPoint\",\"urlTemplate\":\"http:\/\/apitoxin.sk\/?s={search_term_string}\"},\"query-input\":\"required name=search_term_string\"}],\"inLanguage\":\"sk-SK\"},{\"@type\":\"Person\",\"@id\":\"http:\/\/apitoxin.sk\/#\/schema\/person\/3432b72e01828705a1bdf176a0c88c35\",\"name\":\"admin\",\"image\":{\"@type\":\"ImageObject\",\"inLanguage\":\"sk-SK\",\"@id\":\"http:\/\/apitoxin.sk\/#\/schema\/person\/image\/\",\"url\":\"http:\/\/0.gravatar.com\/avatar\/06dd689f8b2c0a42278f99d7607e0cb1?s=96&d=mm&r=g\",\"contentUrl\":\"http:\/\/0.gravatar.com\/avatar\/06dd689f8b2c0a42278f99d7607e0cb1?s=96&d=mm&r=g\",\"caption\":\"admin\"},\"sameAs\":[\"http:\/\/apitoxin.sk\"],\"url\":\"http:\/\/d.r5.wbsprt.com\/apitoxin.sk\/author\/trix\/\"}]}<\/script>\n<!-- \/ Yoast SEO plugin. -->","yoast_head_json":{"title":"Alergia & Imunologick\u00e1 lie\u010dba v\u010del\u00edm jedom - apitoxin.sk","robots":{"index":"index","follow":"follow","max-snippet":"max-snippet:-1","max-image-preview":"max-image-preview:large","max-video-preview":"max-video-preview:-1"},"canonical":"http:\/\/apitoxin.sk\/2022\/07\/13\/alergia-imunologicka-liecba-vcelim-jedom\/","og_locale":"sk_SK","og_type":"article","og_title":"Alergia & Imunologick\u00e1 lie\u010dba v\u010del\u00edm jedom - apitoxin.sk","og_description":"\u200b\u200bKategoricky definuje alergiu, je to chronick\u00e9 ochorenie, ktor\u00e9 m\u00f4\u017ee vies\u0165 k r\u00f4znym sympt\u00f3mom. Jeho pr\u00edznaky sa m\u00f4\u017eu l\u00ed\u0161i\u0165 od jednej osoby k druhej a pod\u013ea ro\u010dn\u00e9ho obdobia. Alergia je gr\u00e9cke slovo, ktor\u00e9 znamen\u00e1 reakciu, ktor\u00e1 bola zmenen\u00e1. Okrem toho, alerg\u00e9n sp\u00fa\u0161\u0165a neprirodzen\u00fa reakciu n\u00e1\u0161ho imunitn\u00e9ho syst\u00e9mu na boj s vonkaj\u0161\u00edmi prvkami. Pod\u013ea v\u00fdskumu sa zistilo, [&hellip;]","og_url":"http:\/\/apitoxin.sk\/2022\/07\/13\/alergia-imunologicka-liecba-vcelim-jedom\/","og_site_name":"apitoxin.sk","article_published_time":"2022-07-13T05:50:28+00:00","article_modified_time":"2022-07-13T07:19:08+00:00","og_image":[{"width":287,"height":288,"url":"http:\/\/apitoxin.sk\/wp-content\/uploads\/2022\/07\/skumakvky.png","type":"image\/png"}],"author":"admin","twitter_card":"summary_large_image","twitter_misc":{"Autor":"admin","Predpokladan\u00fd \u010das \u010d\u00edtania":"12 min\u00fat"},"schema":{"@context":"https:\/\/schema.org","@graph":[{"@type":"WebPage","@id":"http:\/\/apitoxin.sk\/2022\/07\/13\/alergia-imunologicka-liecba-vcelim-jedom\/","url":"http:\/\/apitoxin.sk\/2022\/07\/13\/alergia-imunologicka-liecba-vcelim-jedom\/","name":"Alergia & Imunologick\u00e1 lie\u010dba v\u010del\u00edm jedom - apitoxin.sk","isPartOf":{"@id":"http:\/\/apitoxin.sk\/#website"},"datePublished":"2022-07-13T05:50:28+00:00","dateModified":"2022-07-13T07:19:08+00:00","author":{"@id":"http:\/\/apitoxin.sk\/#\/schema\/person\/3432b72e01828705a1bdf176a0c88c35"},"breadcrumb":{"@id":"http:\/\/apitoxin.sk\/2022\/07\/13\/alergia-imunologicka-liecba-vcelim-jedom\/#breadcrumb"},"inLanguage":"sk-SK","potentialAction":[{"@type":"ReadAction","target":["http:\/\/apitoxin.sk\/2022\/07\/13\/alergia-imunologicka-liecba-vcelim-jedom\/"]}]},{"@type":"BreadcrumbList","@id":"http:\/\/apitoxin.sk\/2022\/07\/13\/alergia-imunologicka-liecba-vcelim-jedom\/#breadcrumb","itemListElement":[{"@type":"ListItem","position":1,"name":"Home","item":"http:\/\/apitoxin.sk\/"},{"@type":"ListItem","position":2,"name":"Alergia &#038; Imunologick\u00e1 lie\u010dba v\u010del\u00edm jedom"}]},{"@type":"WebSite","@id":"http:\/\/apitoxin.sk\/#website","url":"http:\/\/apitoxin.sk\/","name":"apitoxin.sk","description":"Slovensk\u00fd v\u00fdrobca lapa\u010dov v\u010delieho jedu","potentialAction":[{"@type":"SearchAction","target":{"@type":"EntryPoint","urlTemplate":"http:\/\/apitoxin.sk\/?s={search_term_string}"},"query-input":"required name=search_term_string"}],"inLanguage":"sk-SK"},{"@type":"Person","@id":"http:\/\/apitoxin.sk\/#\/schema\/person\/3432b72e01828705a1bdf176a0c88c35","name":"admin","image":{"@type":"ImageObject","inLanguage":"sk-SK","@id":"http:\/\/apitoxin.sk\/#\/schema\/person\/image\/","url":"http:\/\/0.gravatar.com\/avatar\/06dd689f8b2c0a42278f99d7607e0cb1?s=96&d=mm&r=g","contentUrl":"http:\/\/0.gravatar.com\/avatar\/06dd689f8b2c0a42278f99d7607e0cb1?s=96&d=mm&r=g","caption":"admin"},"sameAs":["http:\/\/apitoxin.sk"],"url":"http:\/\/d.r5.wbsprt.com\/apitoxin.sk\/author\/trix\/"}]}},"_links":{"self":[{"href":"http:\/\/d.r5.wbsprt.com\/apitoxin.sk\/wp-json\/wp\/v2\/posts\/83"}],"collection":[{"href":"http:\/\/d.r5.wbsprt.com\/apitoxin.sk\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"http:\/\/d.r5.wbsprt.com\/apitoxin.sk\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"http:\/\/d.r5.wbsprt.com\/apitoxin.sk\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"http:\/\/d.r5.wbsprt.com\/apitoxin.sk\/wp-json\/wp\/v2\/comments?post=83"}],"version-history":[{"count":4,"href":"http:\/\/d.r5.wbsprt.com\/apitoxin.sk\/wp-json\/wp\/v2\/posts\/83\/revisions"}],"predecessor-version":[{"id":89,"href":"http:\/\/d.r5.wbsprt.com\/apitoxin.sk\/wp-json\/wp\/v2\/posts\/83\/revisions\/89"}],"wp:featuredmedia":[{"embeddable":true,"href":"http:\/\/d.r5.wbsprt.com\/apitoxin.sk\/wp-json\/wp\/v2\/media\/90"}],"wp:attachment":[{"href":"http:\/\/d.r5.wbsprt.com\/apitoxin.sk\/wp-json\/wp\/v2\/media?parent=83"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"http:\/\/d.r5.wbsprt.com\/apitoxin.sk\/wp-json\/wp\/v2\/categories?post=83"},{"taxonomy":"post_tag","embeddable":true,"href":"http:\/\/d.r5.wbsprt.com\/apitoxin.sk\/wp-json\/wp\/v2\/tags?post=83"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}