スギ花粉エキスを用いた免疫治療へのヒノキ花粉感作の影響  [in Japanese] THE LESS EFFECT OF THE IMMUNOTHERAPY FOR CYPRESS POLLINOSIS BY USING JAPANESE CEDAR POLLEN EXTRACT  [in Japanese]

【背景】スギ花粉とヒノキ花粉が共通抗原を持つことは良く知られているが,スギ花粉症患者でのヒノキ花粉症合併の有無とその意義については明らかになっていない.【方法】スギ花粉とヒノキ花粉との飛散の重複がほとんど認められなかった2006年にスギ花粉症患者を対象にスギ花粉エキスを用いた舌下免疫治療のランダム化比較試験から,ヒノキ花粉飛散期の臨床症状の検討を行った.また,スギ花粉症患者のヒノキ抗体の季節変動についても検討を行った.【結果】スギ花粉エキスを用いた免疫治療はヒノキ花粉症に対する効果は明らかではなかった.また,ヒノキ花粉抗体は測定時期により影響を受けていた.【結論】ヒノキ花粉飛散がみられる時期の治療の評価はヒノキ花粉症の合併の有無で異なり,スギ花粉症患者を区別して検討していくことが必要である.また,スギ花粉エキスを用いた舌下免疫治療はヒノキ花粉症に対して効果は少ない.今後,ヒノキ花粉症に対する詳細な検討が望まれる.

Background: Japanese cedar and cypress pollen share a common antigen. The cedar pollen season is followed by the cypress pollen season. However, both the clinical significance and involvement of cypress pollinosis in the treatment of the cedar pollinosis have not yet been clarified. Methods: The clinical efficacy of sublingual immunotherapy with cedar pollen extract for cedar pollinosis was evaluated during the cypress pollen dispersal season in Japan. In addition, the change in cypress pollen specific IgE antibodies of the patients with cedar pollinosis was examined before and after the pollen season. Results: Sublingual immunotherapy with cedar pollen extract did not improve the clinical symptoms of the cedar pollinosis patients combined with cypress pollinosis in the cypress pollen season. The cypress pollen specific IgE antibodies were found to demonstrate significant seasonal changes. Conclusion: The presence of cypress pollinosis should therefore be taken into consideration when planning the optimal treatment for cedar pollinosis. Sublingual immunotherapy with cedar pollen extract may not be effective for cypress pollinosis.