哮喘联盟

   摘要
   皮下注射免疫疗法（SCIT）被证明对过敏性鼻炎及哮喘有显著临床疗效。其不仅在治疗的过程中使疾病症状得到改善，而且在药物注射起效并停药后的很多年内，由于其对注射过敏原的修饰改变了机体免疫应答格局，因此病情会持续好转。SCIT的一个副作用是可能会发生注射反应。为降低这一风险，在增加注射剂量时需注意延长时间；出于安全考虑，进行注射的医疗设施必须具备应对各种可能发生的全身反应的能力。另外，为取得长久获益，需要长期高剂量注射。由于不便捷、费用昂贵、安全顾虑及排斥注射这种给药方式等综合原因，SCIT虽能使很多患者获益，但只在一小部分患者中使用。因此，研究者们正在探索如何通过多种途径，或改变给药方式，或修饰过敏原以减少机体对IgE的免疫反应，同时保留其引起有益免疫应答变化的能力，以解决该疗法的安全问题及不便之处。
 

（刘国梁 审校）
Allergy Asthma Proc. 2014 Jul;35(4):271-7. doi: 10.2500/aap.2014.35.3778.

 

New forms of allergy immunotherapy for rhinitis and asthma.
 

Nelson HS.
 

ABSTRACT
Subcutaneous immunotherapy (SCIT) has been proven to be clinically effective in the treatment of allergic rhinitis and asthma. Not only does it reduce symptoms during the course of treatment, but because of modification in the immune response to the administered allergen, there is persistence of improvement for years after discontinuation of a successful course of therapy. A drawback of SCIT is the potential for reactions to the injections. To reduce this risk, a prolonged course of build-up in dose is required and for reasons of safety injections must be administered in a facility prepared to treat the possible systemic reactions. Furthermore, to achieve the persisting benefit, a prolonged administration of the highest dose is required. The perception is that the inconvenience, expense, safety concerns, and dislike for injections all combine to cause SCIT to be used in only a small percentage of patients who would benefit from the treatment. Therefore, a number of new approaches are being investigated that overcome the problems of safety and inconvenience, either by alternative methods of administering the currently available extracts or by modifying the allergens to reduce reactivity with IgE while preserving the potential to induce favorable immunologic changes.
 

Allergy Asthma Proc. 2014 Jul;35(4):271-7. doi: 10.2500/aap.2014.35.3778