哮喘联盟

   摘要
   目的：花粉季节前超短期过敏症疫苗接种（包含佐剂单磷酰脂A[MPL]）可有效治疗过敏性症状，然而，该措施在控制哮喘患者症状上的疗效尚不清楚。本试验旨在评价花粉季节前超短期免疫调节治疗是否有助于哮喘控制。
   方法：花粉季节之前，给予20名墙草属植物敏感的轻度、未治疗哮喘患者（M/F: 12/8; 年龄: 38 ± 14岁）4次皮下注射活性药物（Pollinex Quattro）。筛查后（第一次就诊），第2次就诊前即刻、最后一次（第5次）注射之后即刻以及花粉季节期（第6次），采用哮喘控制测试（ACT）评价哮喘控制。检测支气管和肺泡呼出气一氧化氮（NO）浓度。9名墙草属植物敏感的轻度哮喘患者（M/F: 3/6; 年龄: 40 ± 12岁）作为对照。
   结果：特异性免疫治疗（SIT）的哮喘患者（第2次：22 ± 3.2；第5次：23 ± 2.8；第6次：22 ± 3.6；ANOVA p = 0.47），ACT评分维持恒定，而对照组ACT评分在花粉季节下降（第2次：20 ± 2.5；第5次：21 ± 2.8；第6次：16 ± 5.7；ANOVA p = 0.01）。两组患者花粉暴露期间用力呼气NO（FENO）显著增加，而肺泡NO浓度在SIT治疗哮喘患者维持稳定（p = 0.11），且对照者为其2倍（p = 0.01）。
   结论：目前的研究结果显示，花粉季节前含MPL佐剂的疫苗接种能维持花粉季节哮喘控制。

（刘国梁 审校）
Ther Adv Respir Dis. 2013 Feb 21. [Epub ahead of print]
 

Clinical and anti-inflammatory effects of ultra-short preseasonal vaccine to Parietaria in asthma.
 
Scichilone N, Scalici V, Arrigo R, Bellia V.

Source
Dipartimento Biomedico di Medicina Interna e Specialistica (Di.Bi.M.I.S.), Sezione di Pneumologia, University of Palermo, Italy.

Abstract 
OBJECTIVE: The ultra-short course preseasonal allergy vaccine, containing the adjuvant monophosphoryl lipid A (MPL), is effective in treating allergic symptoms; however, the efficacy in controlling asthmatics symptoms has not been fully demonstrated. We aimed at evaluating whether the ultra-short preseasonal course of immunotherapy contributes to asthma control.
METHODS: Four subcutaneous injections of the active product (Pollinex Quattro) were administered, before the pollen season, to 20 Parietaria-sensitive mild, untreated asthmatics (M/F: 12/8; age: 38 ± 14 years). After the screening visit (visit 1), asthma control was assessed by the Asthma Control Test (ACT) immediately before the first (visit 2) and immediately after the last (visit 5) injections, as well as during the pollen season (visit 6). Bronchial and alveolar exhaled nitric oxide (NO) concentrations were also measured. Nine Parietaria-sensitive mild asthmatics (M/F: 3/6; age: 40 ± 12 years) served as untreated controls.
RESULTS: The ACT remained constant during allergen exposure in specific immunotherapy (SIT)-treated asthmatics (visit 2: 22 ± 3.2; visit 5: 23 ± 2.8; visit 6: 22 ± 3.6; analysis of variance [ANOVA], p = 0.47), whereas it dropped during pollen exposure in controls (visit 2: 20 ± 2.5; visit 5: 21 ± 2.8; visit 6: 16 ± 5.7; ANOVA, p = 0.01). The forced expiratory NO (FENO) values significantly increased during pollen exposure in both groups; however, the alveolar NO concentrations remained stable in SIT-treated asthmatics (p = 0.11), whereas they doubled in controls (p = 0.01).
CONCLUSIONS: The current findings show that the preseasonal vaccine adjuvated with MPL contributes to the maintenance of control of asthma during the pollen season.
 

Ther Adv Respir Dis. 2013 Feb 21. [Epub ahead of print]