[EVALUATION OF THE EFFECTIVENESS OF SUBCUTANEOUS IMMUNOTHERAPY USING BIRCH POLLEN EXTRACT FOR POLLEN-FOOD ALLERGY SYNDROME].

BACKGROUNDS: Recently, patients with oral allergy syndrome (OAS) to fruits or vegetables caused by pollenfood allergy syndrome (PFAS) have increased nationwide. We examined effectiveness of SCIT using birch pollen extract for PFAS. METHODS: A total of 19 patients (9 male and 10 female) underwent SCIT with birch pollen extract from August 2011 to August 2016. Rush schedule was used for the initial updosing for SCIT in a hospital setting. In maintenance phase, SCIT was administered every 4-8 weeks on an outpatient basis. According to the situation of sensitization, patients underwent SCIT with other extracts at the same time. Oral food challenge (OFC) with fruits and vegetables was performed at baseline and after rush phase. We also investigated about OAS symptoms in maintenance phase. RESULTS: SCIT was remarkably effective in five patients for OAS symptoms just after rush phase, and effective in nine patients. And it was not effective in two patients, and not determined in three patients, but it was confirmed to be effective in four out of these five patients in maintenance phase. There were relapse of OAS symptoms in three patients, then SCIT was remarkably effective or effective in 15 patients (79%) in maintenance phase. No patients dropped off the SCIT protocol. CONCLUSIONS: Generally, PFAS can't be expected to remit naturally. SCIT with birch pollen extract effectively reduces OAS symptoms, and it can be expected as a radical therapy for PFAS.

[A case of oral allergy syndrome whose symptoms were dramatically improved after rush subcutaneous injection immunotherapy with pollen extracts of birch].

We report a case of oral allergy syndrome, whose symptoms were dramatically improved after rush subcutaneous injection immunotherapy (SCIT) with pollen extracts of birch, ragweed and Japanese cedar. She was diagnosed as allergic rhinitis at 2 years old, and experienced oral allergy syndrome at 5 years old after eating cucumber. Then she had become allergic to wide range of fruits and vegetables. She was introduced to our department for the possible treatment for allergic rhinitis, and underwent rush SCIT at 15 years old. The symptom of single blind oral challenge test of apple up to 30 g, which had been positive before SCIT, turned to negative after the treatment. The threshold of apple measured by open oral challenge test increased from 3 g to more than 50 g. The symptoms to most fruits and vegetables were improved or disappeared. This suggests the possibility that SCIT of birch pollen can be a promising candidate as a radical treatment for pollen-food allergy syndrome.