Lymph Node Shots Tested for Grass Pollen Allergy
A Swiss-led study appears to point the way toward a faster, safer and less painful treatment for grass pollen allergy by using direct injections into the lymph node.
Compared with traditional under-the-skin shot regimens lasting several years and involving dozens of injections, the new method appears to offer patients the same degree of relief -- with fewer side effects -- with just three shots over two months.
"Because direct administration of the allergen into the lymph node markedly enhanced efficacy, the injected allergen dose could be reduced more than 1,000-fold, and this again significantly reduced the allergic side effects," said study co-author Dr. Thomas Kundig, medical director of the department of dermatology at University Hospital of Zurich.
Kundig and colleagues published their findings in this week's online edition of the Proceedings of the National Academy of Sciences.
The authors noted that allergic asthma affects upwards of 35 percent of those living in Westernized countries. To combat the problem, standard allergy shots -- injected in fatty tissue under the skin -- are considered the "gold standard" approach.
However, a typical shot regimen involves between 30 to 70 injections over three to five years, a time-consuming treatment that often provokes allergic reactions ranging from swelling at the shot site to systemic allergic reactions.
The result: "Less than 5 percent of allergy patients are treated with allergen-specific immunotherapy," Kundig said.
To test the potential of lymph node shots, the Swiss-American team focused on just under 100 patients between the ages of 18 and 65.
The volunteers were divided into two groups: those receiving a standard injection allergy treatment tracking a 54-injection schedule over a three-year period, and those receiving the lymph node therapy, which involved three injections over an eight-week period.
Kundig and his colleagues found that both approaches afforded similar benefits to the two groups of patients. However, those receiving the lymph node therapy experienced less pain and less frequent side effects than those undergoing conventional treatment.
After conducting nasal tests to assess allergy symptoms such as sneezing, nasal secretion, coughing, and shortness of breath, Kundig and his team concluded that their lymph node method proved to be both a shorter and safer treatment option compared with conventional shots. And they suggested that the relatively pain-free alternative could go a long way toward encouraging patients to stick with their anti-allergy treatment to the end.
"As the lymph node itself has no nerves, injection into a lymph node is painless," noted Kundig. "In fact, it was judged less painful than a blood draw. Overall, this treatment enhanced patient compliance, and the amelioration of hay fever symptoms was long lasting."
For his part, Dr. Clifford Bassett, a clinical instructor at New York University School of Medicine and attending physician in the allergy and immunology department of Long Island College Hospital in Brooklyn, N.Y., described the lymph node therapy as "quite novel" and "intriguing."
"I've never seen this type of approach before," noted Bassett, who is also the medical director of Allergy and Asthma Care of New York in New York City. "The allergens we're using now are certainly very potent and very effective. But we're obviously always looking at new ways to treat the epidemic of allergy. And there's a need for better treatment, and more cost-effective and safer treatment. So, this is a piece of information, although preliminary and focused only on grass pollen, that provides some insight into other ways to approach the problem."
～要約～
リンパ節へアレルゲンを直接注射することで、従来に比べて短期間で苦痛が少なく、かつ安全性も高い花粉症治療が実現できる可能性がスイスを中心とした研究によって示された。
研究著者の一人であるスイス、チューリッヒ大学病院のThomas Kundig博士は「リンパ節に直接アレルゲンを注入すると効果が著しく高まり、注入するアレルゲン用量を1，000分の1未満に減らすことができ、アレルギー性の副作用も軽減できる」と述べている。この知見は、米国科学アカデミー発行の「Proceedings of the National Academy of Sciences（PNAS）」オンライン版に11月10日掲載された（印刷版は11月18日号に掲載）。
著者らによると、西洋化した国々に暮らす人の35％以上がアレルギー性喘息であり、アレルギー注射（allergy shot、アレルゲン特異的免疫療法 [減感作療法] ）と呼ばれる皮下脂肪組織への注射が標準的な治療法である。しかし、この方法では一般に3～5年にわたり30～70回の注射を受ける必要があり、時間がかかる上に、注射部位の腫れから全身的反応まで、アレルギー反応が引き起こされることも多く、「この治療を受けるのはアレルギー患者の5％に満たない」とKundig氏はいう。
スイスおよび米国の研究チームは、リンパ節注射の有望性を試験するため、18～65歳の約100人を対象に研究を実施した。 被験者を2群に分け、一方には3年間にわたり54回の注射をする標準的な治療を行い、もう一方には8週間で3回のリンパ節注射を実施した。その結果、いずれの治療にも同等の効果がみられたが、リンパ節治療群は従来治療群に比べて痛みが少なく、副作用の頻度も低かった。
鼻の検査によりくしゃみ、鼻汁、咳（せき）および息切れなどのアレルギー症状を評価した結果、Kundig氏らは、リンパ節治療が従来の注射に比べて短期間かつ安全な治療法であると結論付けている。また、リンパ節自体には神経がないため、リンパ節注射は採血よりも痛みが少ないとされ、患者のコンプライアンス（医療従事者の指示・アドバイスに従って行動すること）にも向上がみられたという。共同研究者である米ニューヨーク大学医学部のClifford Bassett博士は、このリンパ節治療を極めて斬新かつ興味深いものだとしており、「予備段階の知見であり、草の花粉症だけを対象としているとはいえ、新しい治療法へつながる情報」と述べている。
まだ花粉症にはなってませんが…
周りを見渡している現状からすると、なりたくありません。
万能薬ってないと思うけど、効果のある治療法が確立されればと。
A Swiss-led study appears to point the way toward a faster, safer and less painful treatment for grass pollen allergy by using direct injections into the lymph node.
Compared with traditional under-the-skin shot regimens lasting several years and involving dozens of injections, the new method appears to offer patients the same degree of relief -- with fewer side effects -- with just three shots over two months.
"Because direct administration of the allergen into the lymph node markedly enhanced efficacy, the injected allergen dose could be reduced more than 1,000-fold, and this again significantly reduced the allergic side effects," said study co-author Dr. Thomas Kundig, medical director of the department of dermatology at University Hospital of Zurich.
Kundig and colleagues published their findings in this week's online edition of the Proceedings of the National Academy of Sciences.
The authors noted that allergic asthma affects upwards of 35 percent of those living in Westernized countries. To combat the problem, standard allergy shots -- injected in fatty tissue under the skin -- are considered the "gold standard" approach.
However, a typical shot regimen involves between 30 to 70 injections over three to five years, a time-consuming treatment that often provokes allergic reactions ranging from swelling at the shot site to systemic allergic reactions.
The result: "Less than 5 percent of allergy patients are treated with allergen-specific immunotherapy," Kundig said.
To test the potential of lymph node shots, the Swiss-American team focused on just under 100 patients between the ages of 18 and 65.
The volunteers were divided into two groups: those receiving a standard injection allergy treatment tracking a 54-injection schedule over a three-year period, and those receiving the lymph node therapy, which involved three injections over an eight-week period.
Kundig and his colleagues found that both approaches afforded similar benefits to the two groups of patients. However, those receiving the lymph node therapy experienced less pain and less frequent side effects than those undergoing conventional treatment.
After conducting nasal tests to assess allergy symptoms such as sneezing, nasal secretion, coughing, and shortness of breath, Kundig and his team concluded that their lymph node method proved to be both a shorter and safer treatment option compared with conventional shots. And they suggested that the relatively pain-free alternative could go a long way toward encouraging patients to stick with their anti-allergy treatment to the end.
"As the lymph node itself has no nerves, injection into a lymph node is painless," noted Kundig. "In fact, it was judged less painful than a blood draw. Overall, this treatment enhanced patient compliance, and the amelioration of hay fever symptoms was long lasting."
For his part, Dr. Clifford Bassett, a clinical instructor at New York University School of Medicine and attending physician in the allergy and immunology department of Long Island College Hospital in Brooklyn, N.Y., described the lymph node therapy as "quite novel" and "intriguing."
"I've never seen this type of approach before," noted Bassett, who is also the medical director of Allergy and Asthma Care of New York in New York City. "The allergens we're using now are certainly very potent and very effective. But we're obviously always looking at new ways to treat the epidemic of allergy. And there's a need for better treatment, and more cost-effective and safer treatment. So, this is a piece of information, although preliminary and focused only on grass pollen, that provides some insight into other ways to approach the problem."
～要約～
リンパ節へアレルゲンを直接注射することで、従来に比べて短期間で苦痛が少なく、かつ安全性も高い花粉症治療が実現できる可能性がスイスを中心とした研究によって示された。
研究著者の一人であるスイス、チューリッヒ大学病院のThomas Kundig博士は「リンパ節に直接アレルゲンを注入すると効果が著しく高まり、注入するアレルゲン用量を1，000分の1未満に減らすことができ、アレルギー性の副作用も軽減できる」と述べている。この知見は、米国科学アカデミー発行の「Proceedings of the National Academy of Sciences（PNAS）」オンライン版に11月10日掲載された（印刷版は11月18日号に掲載）。
著者らによると、西洋化した国々に暮らす人の35％以上がアレルギー性喘息であり、アレルギー注射（allergy shot、アレルゲン特異的免疫療法 [減感作療法] ）と呼ばれる皮下脂肪組織への注射が標準的な治療法である。しかし、この方法では一般に3～5年にわたり30～70回の注射を受ける必要があり、時間がかかる上に、注射部位の腫れから全身的反応まで、アレルギー反応が引き起こされることも多く、「この治療を受けるのはアレルギー患者の5％に満たない」とKundig氏はいう。
スイスおよび米国の研究チームは、リンパ節注射の有望性を試験するため、18～65歳の約100人を対象に研究を実施した。 被験者を2群に分け、一方には3年間にわたり54回の注射をする標準的な治療を行い、もう一方には8週間で3回のリンパ節注射を実施した。その結果、いずれの治療にも同等の効果がみられたが、リンパ節治療群は従来治療群に比べて痛みが少なく、副作用の頻度も低かった。
鼻の検査によりくしゃみ、鼻汁、咳（せき）および息切れなどのアレルギー症状を評価した結果、Kundig氏らは、リンパ節治療が従来の注射に比べて短期間かつ安全な治療法であると結論付けている。また、リンパ節自体には神経がないため、リンパ節注射は採血よりも痛みが少ないとされ、患者のコンプライアンス（医療従事者の指示・アドバイスに従って行動すること）にも向上がみられたという。共同研究者である米ニューヨーク大学医学部のClifford Bassett博士は、このリンパ節治療を極めて斬新かつ興味深いものだとしており、「予備段階の知見であり、草の花粉症だけを対象としているとはいえ、新しい治療法へつながる情報」と述べている。
まだ花粉症にはなってませんが…
周りを見渡している現状からすると、なりたくありません。
万能薬ってないと思うけど、効果のある治療法が確立されればと。
