对牛奶过敏的儿童用微波加热牛奶进行两周持续口服免疫耐受治疗
2016/10/09
摘要
背景：有研究报道，口服免疫疗法（OIT）对牛奶过敏的儿童（CM）是有效的。这些研究报道口服免疫疗法的疗效都是以脱敏作用来表示的，但没有说明对牛奶过敏儿童的持续耐受。本研究的目的是评估用微波加热牛奶（MH-CM）持续两周无反应性（2-Weeks-SU）这一口服免疫疗法对的有效性和安全性。
方法：48名儿童参加了这项研究。31名儿童同意接受使用MH-CM的口服免疫疗法（OIT组），另外17名儿童谁也不想接受OIT治疗形成了非治疗组。在口服免疫治疗开始后1年，比较两组的脱敏率和两周持续耐受率。我们又随访测试了一年的脱敏率和两周持续耐受率，在OIT组随访的时间更长。
结果:在未治疗组，没有一个对牛奶过敏的孩子能通过开放的食物激发。在口服免疫疗法组的31个孩子中，从开始免疫口服疗法一年内，14个孩子（P = 0.002）实现了脱敏，8个孩子（P = 0.036）获得了两周持续口服无反应性。口服免疫疗法开始两年后，口服免疫组的脱敏率和两周持续口服无反应性均比开始一年后显著增加(P = 0.025和P = 0.008)。
结论：对牛奶过敏的儿童用微波加热牛奶进行口服免疫治疗诱导牛奶过敏儿童的两周持续无反应性是有效且安全的。试验注册批准编号：324, 2009年2月3日注册
关键词：牛奶特异性IgE；食物过敏；微波加热牛奶；口服免疫治疗；持续性无反应
（杨冬 审校）
AllergyAsthmaClinImmunol. 2016 Aug 26;12(1):44.doi:10.1186/s13223-016-0150-0. eCollection 2016.
Two-weeks-sustained unresponsiveness by oral immunotherapy using microwave heated cow's milk for children with cow's milk allergy.
Takahashi M1, Taniuchi S1, Soejima K1, Hatano Y1, Yamanouchi S1, Kaneko K1.
Author information
Abstract
BACKGROUND:Several studies have reported that oral immunotherapy (OIT) is effective for children with cow's milk (CM) allergy. These studies reported the efficacy of OIT in terms of desensitization, but did not describe sustained unresponsiveness to CM. The aim of this study was to evaluate the efficacy of the OIT protocol using microwave heated cow's milk (MH-CM) in terms of 2-weeks-sustained unresponsiveness (2-weeks-SU) and safety.
METHODS:Forty-eight children were enrolled in this study. Thirty-one children agreed to receive rush OIT using MH-CM (the OIT group) and another 17 children who did not want to receive rush OIT formed the untreated group. Rates of desensitization and 2-weeks-sustained unresponsiveness were compared between the two groups at 1 year after the start of OIT. We followed up these rates and safety data for another year and for longer in the OIT group.
RESULTS:No children in the untreated group did not pass an open food challenge to CM. Of the 31 children in the OIT group, 14 (P = 0.002) achieved desensitization, and 8 (P = 0.036) achieved 2-weeks-SU to CM at 1 year from the start of OIT. Two years after the start of OIT, both the rate of desensitization and the rate of 2-weeks-SU in the OIT group significantly increased compared with the rates at 1 year (P = 0.025 and P = 0.008 respectively).
CONCLUSIONS:The rush OIT protocol using MH-CM was effective at inducing 2-weeks-SU s to CM and had a good safety profile in children with CM allergy. Trial registration Approval number: 324, Registered 3 February 2009.
KEYWORDS:Cow’s milk specific IgE; Food allergy; Microwave heated cow’s milk; Oral immunotherapy; Sustained unresponsiveness
AllergyAsthmaClinImmunol. 2016 Aug 26;12(1):44.doi:10.1186/s13223-016-0150-0. eCollection 2016.
