过敏原免疫治疗指南更新：美国过敏、哮喘&免疫学研究院／欧洲过敏和临床免疫学学院／PRACTALL共识报道
2013/05/04
摘要
过敏原免疫治疗（AIT）对于过敏性哮喘和鼻炎以及毒液诱导过敏反应是一种有效的治疗手段。除了缓解症状之外，AIT还能改变过敏性疾病的进程，同时诱导过敏原特异性免疫耐受。在当前临床实践中，免疫治疗的给药方式包括皮下或舌下给药；有些过敏原比如花粉，采用上述两种给药方式均可；而其他过敏原比如毒液，只能皮下给药。皮下给药和舌下给药的有效期均可长达12年，且均能防止哮喘疾病进展和新过敏原致敏。尽管AIT在不断进步，但是对于那些患有哮喘、特应性皮炎或食物过敏患者，仍需要更安全、更有效的AIT方法。AIT新方法包括使用佐剂或重组过敏原以及改变给药途径。作为PRACTALL创议成员，欧洲过敏和临床免疫学学院以及美国过敏、哮喘&免疫学研究院均提名一支专家小组就AIT机制、其在临床实践中的使用以及AIT未满足的需要和发展中的新动态达成综合性的共识报告。该结果报告得到两大学院的支持和肯定。
（刘国梁 审校）
2013 Mar 13. pii: S0091-6749(13)00259-5. doi: 10.1016/j.jaci.2013.01.049. [Epub ahead of print]
Update on allergy immunotherapy: American Academy of Allergy, Asthma & Immunology/European Academy of Allergy and Clinical Immunology/PRACTALL consensus report.
Burks AW, Calderon MA, Casale T, Cox L, Demoly P, Jutel M, Nelson H, Akdis CA.
Source
Department of Pediatrics, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC. Electronic address: wburks@email.unc.edu.
Abstract
Allergy immunotherapy (AIT) is an effective treatment for allergic asthma and rhinitis, as well as venom-induced anaphylaxis. In addition to reducing symptoms, AIT can change the course of allergic disease and induce allergen-specific immune tolerance. In current clinical practice immunotherapy is delivered either subcutaneously or sublingually; some allergens, such as grass pollen, can be delivered through either route, whereas others, such as venoms, are only delivered subcutaneously. Both subcutaneous and sublingual immunotherapy appear to have a duration of efficacy of up to 12 years, and both can prevent the development of asthma and new allergen sensitivities. In spite of the advances with AIT, safer and more effective AIT strategies are needed, especially for patients with asthma, atopic dermatitis, or food allergy. Novel approaches to improve AIT include use of adjuvants or recombinant allergens and alternate routes of administration. As part of the PRACTALL initiatives, the European Academy of Allergy and Clinical Immunology and the American Academy of Allergy, Asthma & Immunology nominated an expert team to develop a comprehensive consensus report on the mechanisms of AIT and its use in clinical practice, as well as unmet needs and ongoing developments in AIT. This resulting report is endorsed by both academies.
J Allergy Clin Immunol. 2013 Mar 13. pii: S0091-6749(13)00259-5. doi: 10.1016/j.jaci.2013.01.049. [Epub ahead of print]
