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    basics basics Document Transcript

    • Basics Sekretion
    • Conjuktivitis Vernalis re. Obstruktion
    • Die Immunabwehr des Lungensystems
    • Urticaria Allergische Glottitis Allergische Glottitis
    • Angioedema
    • Allergic rhinitis and its impact on asthma ARIA Allergic rhinitis Allergic rhinitis is clinically defined as a symptomatic disorder of the nose induced by an IgE-mediated inflammation after allergen exposure of the membranes lining the nose. Allergic rhinitis is a major chronic respiratory disease due to its: •prevalence •impact on quality of life •impact on work/school performance and productivity •economic burden •links with asthma. • ARIA document, J Allergy Clin Immunol 2001; 108: S 147-336 ARIA Classification Intermittent Persistent . " 4 days per week . > 4 days per week . or " 4 weeks . and > 4 weeks Mild Moderate- normal sleep severe & no impairment of one or more items daily activities, sport, . abnormal sleep leisure . impairment of daily & normal work and activities, sport, leisure school . abnormal work and & no troublesome school symptoms . troublesome symptoms in untreated patients
    • Immunological mechanisms involved in allergic disease Sensitization Re-exposure Allergen Allergen Environment Submucosa Antigen presenting cell MHC class II Production of protein and antigen- Mast cell Clinical epitope specific IgE degranulation effects asthma, Th2-cell + B-cell Mediators hayfever, urticaria
    • Studiendesign Doppelblind, randomisiert, double-dummy, Parallelgruppen-Studie 7 T washout 7 T Behandlung tägliche Messungen Studienende, sobald Prick-Test > 90% der initialen Messung IL-5 im Nasensekret pg/ml 200 180 160 140 120 FEXO120 100 FEXO180 80 LORA10 60 40 20 0 prä Tag 1 Tag 2 Tag 3 Tryptase im Nasensekret mg/ml 100 90 80 70 60 FEXO120 50 FEXO180 40 LORA10 30 20 10 0 prä Tag 1 Tag 2 Tag 3
    • Allergic Rhinitis, Sinusitis, Nasal Polyposis and Asthma • What they have in common – Cytokines - the linking factor • Prevention as therapeutic strategy – We should treat more than symptoms • Future developments – new cytokine antagonists • State of the art devices – navigated sinus surgery, shavers, lasers surgery will still be needed!