REACTION OF NASAL POLYPS IN ALLERGEN-SPECIFIC IMMUNOTHERAPY WITH FUNGAL ALLERGENS IN PATIENTS WITH NASAL POLYPS ON THE BACKGROUND OF FUNGAL SENSITIZATION

Fungal flora is one of the causes of in-flammation, including nasal polyposis. Therefore, re-searches aimed at reducing the impact of fungal sensitiza-tion (FS) on the course of chronic rhinosinusitis with nasal polyps (CRSwNP) are relevant.The research included 90 patients with chronic rhinosinusitis with nasal polyps combined with fungal sen-sitization. The patients were divided into two groups —the first clinical group (G1) and the second clinical group (G2). Group G1 received allergen-specific immunother-apy (ASIT) according to the scheme. Group G2 received basic treatment according to the protocol No 181 of 24.03.2009 (“Protocol for providing medical care to pa-tients with chronic sinusitis”). Indications for allergen-spe-cific therapy were hyperreactivity to fungi (positive al-lergy history of FS), the presence of specific IgE antibod-ies to fungal allergens, positive skin tests with fungal al-lergens, and high levels of total IgE. The research aimed to evaluate the effect of allergen-specific therapy on nasal polyps in patients with CRSwNP on the background of fungal sensitization. The specific oral treatment was car-ried out in two phases: the first —cumulative or initial, and the second —maintaining, in which the maximum tol-erated dose was reached by gradually increasing the aller-gen concentration. The first phase duration was about 2.5–3 months. In the second phase, which lasted up to 6 months, the patient received the maximum allowable dose of the allergen to achieve a state of persistent hyposensiti-zation. The therapeutic allergen was administered in the morning, 30 minutes before meals. The right amount of 202(22)квітень-червень,2022ISSN2521-1455 (Print)ISSN2523-4250 (Online) «Art of Medicine»drops were dosed per teaspoon from the bottle with the al-lergen. Treatment was initiated during the period of clin-ical remission. ASIT was performed with basic anti-in-flammatory treatment. The treatment efficiency was eval-uated after 3, 6, and 12 months of treatment.Evaluation of the clinical efficiency of allergen-specific immunotherapy was made on the 4-point scale, where excellent results (4points) —complete remission of the disease during the follow-up period (6-12 months); good results (3 points) —exacerbation of the disease 1-2 times per year, in mild form and removed by expectant treatment; fair results (2 points) —the number of exacer-bations did not decrease, poor results (1 point) treatment is stopped due to lack of effect or the patient's symptoms con-stantly worsen after the introduction of an allergen. The size and distribution of nasal polyps were assessed by the results of nasal endoscopy using the IV-grade scale: I de-gree -polyps are not visible on endoscopic examination but present on CT scan; II degree -polyps visible in the middle nasal passages; III degree -polyps visible outside the middle nasal passages; IV -degree –nasal polyps ob-turate the nasal cavity.Improvement of nasal endoscopy picture (the number of G1 patients diagnosed with stage III of nasal polyps after 12 months decreased by 11.1%), reducing the volume of basic therapy. Satisfactory treatment results were determined in 13.8% of patients, in whom the num-ber of exacerbations did not decrease, but the general well-being became much better than before specific immuno-therapy, which indicates a stable effect after the treatment.