免疫治疗在变应性鼻炎免疫调节机制中的作用研究
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摘要
<正>变应原特异性免疫治疗(ASIT)是唯一通过免疫调节机制诱导产生变应原免疫耐受的治疗方法[1-2],在治疗完成后依然能够保持较长时间的疗效[3],已经成为变应性鼻炎(AR)的重要治疗方法[3,4-6],而且在IgE介导的Ⅰ型变态反应疾病治疗中起到了十分重要的作用。皮下免疫治疗(SCIT)和舌下免疫治疗(SLIT)是ASIT两种常规的治疗方法[7]。有文献报道,
Immunotherapy,among all the treatments of allergic rhinitis,is the only one which aims directly at etiological factor.Even though,subcutaneous immunotherapy is a widely used and effective therapeutic method in clinical practice,there is no definite answer in the current research about how it regulates the immune mechanism of allergic rhinitis,that is,how to predict the curative effect according to its objective indicators.In order to have an insight into its clinical role in the immune mechanism of allergic rhinitis,this article will have an overview about it,on the basis of the pertinent medical literature.
Immunotherapy,among all the treatments of allergic rhinitis,is the only one which aims directly at etiological factor.Even though,subcutaneous immunotherapy is a widely used and effective therapeutic method in clinical practice,there is no definite answer in the current research about how it regulates the immune mechanism of allergic rhinitis,that is,how to predict the curative effect according to its objective indicators.In order to have an insight into its clinical role in the immune mechanism of allergic rhinitis,this article will have an overview about it,on the basis of the pertinent medical literature.
引文
[1]SHAMJI M H,DURHAM S R.Mechanisms of immunotherapy to aeroallergens[J].Clin Exp Allergy,2011,41:1235-1246.
[2]COX L,NELSON H,LOCKEY R,et al.Allergen immunotherapy:a practice parameter third update[J].J Allergy Clin Immunol,2011,127(1 Suppl):S1-55.
[3]JUTEL M,KOSOWSKA A,SMOLINSKA S.Allergen Immunotherapy:Past,Present,and Future[J].Allergy Asthma Immunol Res,2016,8:191-197.
[4]JUTEL M,AGACHE I,BONINI S,et al.International Consensus on Allergen Immunotherapy II:Mechanisms,standardization,and pharmacoeconomics[J].J Allergy Clin Immunol,2016,137:358-368.
[5]JUTEL M,AGACHE I,BONINI S,et al.International consensus on allergy immunotherapy[J].J Allergy Clin Immunol,2015,136:556-568.
[6]程雷.特异性免疫治疗是变应性鼻炎的一线疗法[J].山东大学耳鼻喉眼学报,2016,30(4):1-2.
[7]DI BONA D,PLAIA A,LETO-BARONE M S,et al.Efficacy of subcutaneous and sublingual immunotherapy with grass allergens for seasonal allergic rhinitis:a meta-analysis-based comparison[J].J Allergy Clin Immunol,2012,130:1097-1107.e2.
[8]BAO Y,CHEN J,CHENG L,et al.Chinese Guideline on allergen immunotherapy for allergic rhinitis[J].J Thorac Dis,2017,9:4607-4650.
[9]TSABOURI S,MAVROUDI A,FEKETEA G,et al.Subcutaneous and Sublingual Immunotherapy in Allergic Asthma in Children[J].Front Pediatr,2017,5:82.
[10]KIM J M,LIN S Y,SUAREZCUERVO C,et al.Allergen-Specific Immunotherapy for Pediatric Asthma and Rhinoconjunctivitis:A Systematic Review[J].Pediatrics,2013,131:1155-1167.
[11]KLIMEK L,UHLIG J,MSGES R,et al.A high polymerized grass pollen extract is efficacious and safe in a randomized double-blind,placebo-controlled study using a novel up-dosing cluster-protocol[J].Allergy,2014,69:1629-1638.
[12]FREW A J.Hundred years of allergen immunotherapy[J].Clin Exp Allergy,2011,41:1221-1225.
[13]JACOBSEN L,NIGGEMANN B,DREBORG S,et al.Specific immunotherapy has long-term preventive effect of seasonal and perennial asthma:10-year follow-up on the PAT study[J].Allergy,2007,62:943-948.
[14]MATRICARDI P M,KUNA P,PANETTA V,et al.Subcutaneous immunotherapy and pharmacotherapy in seasonal allergic rhinitis:acomparison based on meta-analyses[J].J Allergy Clin Immunol,2011,128:791-799.
[15]SHAMJI M H,DURHAM S R.Mechanisms of allergen immunotherapy for inhaled allergens and predictive biomarkers[J].J Allergy Clin Immunol,2017,140:1485-1498.
[16]KUCUKSEZER U C,OZDEMIR C,AKDIS M,et al.Mechanisms of immune tolerance to allergens in children[J].Korean J Pediatr,2013,56:505-513.
[17]SOYER O U,AKDIS M,AKDIS C A.Mechanisms of subcutaneous allergen immunotherapy[J].Immunol Allergy Clin North Am,2011,31:175-190.
[18]SHAMJI M H,KAPPEN J H,AKDIS M,et al.Biomarkers for monitoring clinical efficacy of allergen immunotherapy for allergic rhinoconjunctivitis and allergic asthma:an EAACI Position Paper[J].Allergy,2017,72:1156-1173.
[19]BERINGS M,KARAASLAN C,Altunbulakli C,et al.Advances and highlights in allergen immunotherapy:On the way to sustained clinical and immunologic tolerance[J].J Allergy Clin Immunol,2017,140:1250-1267.
[20]ZHANG L,WANG C,HAN D,et al.Comparative study of cluster and conventional immunotherapy schedules with dermatophagoides pteronyssinus in the treatment of persistent allergic rhinitis[J].Int Arch Allergy Immunol,2009,148:161-169.
[21]雍磊,程相铎,郑晓丹,等.集群免疫治疗对支气管哮喘患者血清IL-4和INF-γ的影响[J].临床军医杂志,2011,39(6):1114-1116.
[22]程相铎,雍磊,梅海豫,等.集群免疫治疗对轻中度哮喘患者嗜酸粒细胞阳离子蛋白的影响[J].中国医药导报,2011,8(30):51-52.
[23]邱前辉,卢川,陈建军,等.变应性鼻炎冲击免疫治疗的安全性研究[J].临床耳鼻咽喉头颈外科杂志,2014,28(11):776-779.
[24]谢薇,张汉钟,陈剑,等.冲击免疫治疗变应性鼻炎的有效性与安全性研究[J].中华耳鼻咽喉头颈外科杂志,2015,50(8):641-645.
[25]KIM H B,JIN H S,LEE S Y,et al.The effect of rush immunotherapy with house dust mite in the production of IL-5and IFN-gamma from the peripheral blood T cells of asthmatic children[J].J Korean Med Sci,2009,24:392-397.
[26]DAVIS L S,SUMIT B,RIDZ B S,et al.Early gene expression changes with rush immunotherapy[J].Clin Mol Allergy,2011,9:12.
[27]邱前辉.变应性鼻炎免疫治疗的现状和未来[J].临床耳鼻咽喉头颈外科杂志,2017,31(1):9-12.
[28]张策,沙骥超,朱冬冬.变应性鼻炎基于免疫学机制的药物治疗研究进展[J].临床耳鼻咽喉头颈外科杂志,2016,30(13):1086-1089.
[29]鲁爱武,汪志伟,邓少芳,等.特异性免疫治疗的相关细胞因子的动态变化及其临床意义[J].临床耳鼻咽喉头颈外科杂志,2016,30(12):955-959.
[2]COX L,NELSON H,LOCKEY R,et al.Allergen immunotherapy:a practice parameter third update[J].J Allergy Clin Immunol,2011,127(1 Suppl):S1-55.
[3]JUTEL M,KOSOWSKA A,SMOLINSKA S.Allergen Immunotherapy:Past,Present,and Future[J].Allergy Asthma Immunol Res,2016,8:191-197.
[4]JUTEL M,AGACHE I,BONINI S,et al.International Consensus on Allergen Immunotherapy II:Mechanisms,standardization,and pharmacoeconomics[J].J Allergy Clin Immunol,2016,137:358-368.
[5]JUTEL M,AGACHE I,BONINI S,et al.International consensus on allergy immunotherapy[J].J Allergy Clin Immunol,2015,136:556-568.
[6]程雷.特异性免疫治疗是变应性鼻炎的一线疗法[J].山东大学耳鼻喉眼学报,2016,30(4):1-2.
[7]DI BONA D,PLAIA A,LETO-BARONE M S,et al.Efficacy of subcutaneous and sublingual immunotherapy with grass allergens for seasonal allergic rhinitis:a meta-analysis-based comparison[J].J Allergy Clin Immunol,2012,130:1097-1107.e2.
[8]BAO Y,CHEN J,CHENG L,et al.Chinese Guideline on allergen immunotherapy for allergic rhinitis[J].J Thorac Dis,2017,9:4607-4650.
[9]TSABOURI S,MAVROUDI A,FEKETEA G,et al.Subcutaneous and Sublingual Immunotherapy in Allergic Asthma in Children[J].Front Pediatr,2017,5:82.
[10]KIM J M,LIN S Y,SUAREZCUERVO C,et al.Allergen-Specific Immunotherapy for Pediatric Asthma and Rhinoconjunctivitis:A Systematic Review[J].Pediatrics,2013,131:1155-1167.
[11]KLIMEK L,UHLIG J,MSGES R,et al.A high polymerized grass pollen extract is efficacious and safe in a randomized double-blind,placebo-controlled study using a novel up-dosing cluster-protocol[J].Allergy,2014,69:1629-1638.
[12]FREW A J.Hundred years of allergen immunotherapy[J].Clin Exp Allergy,2011,41:1221-1225.
[13]JACOBSEN L,NIGGEMANN B,DREBORG S,et al.Specific immunotherapy has long-term preventive effect of seasonal and perennial asthma:10-year follow-up on the PAT study[J].Allergy,2007,62:943-948.
[14]MATRICARDI P M,KUNA P,PANETTA V,et al.Subcutaneous immunotherapy and pharmacotherapy in seasonal allergic rhinitis:acomparison based on meta-analyses[J].J Allergy Clin Immunol,2011,128:791-799.
[15]SHAMJI M H,DURHAM S R.Mechanisms of allergen immunotherapy for inhaled allergens and predictive biomarkers[J].J Allergy Clin Immunol,2017,140:1485-1498.
[16]KUCUKSEZER U C,OZDEMIR C,AKDIS M,et al.Mechanisms of immune tolerance to allergens in children[J].Korean J Pediatr,2013,56:505-513.
[17]SOYER O U,AKDIS M,AKDIS C A.Mechanisms of subcutaneous allergen immunotherapy[J].Immunol Allergy Clin North Am,2011,31:175-190.
[18]SHAMJI M H,KAPPEN J H,AKDIS M,et al.Biomarkers for monitoring clinical efficacy of allergen immunotherapy for allergic rhinoconjunctivitis and allergic asthma:an EAACI Position Paper[J].Allergy,2017,72:1156-1173.
[19]BERINGS M,KARAASLAN C,Altunbulakli C,et al.Advances and highlights in allergen immunotherapy:On the way to sustained clinical and immunologic tolerance[J].J Allergy Clin Immunol,2017,140:1250-1267.
[20]ZHANG L,WANG C,HAN D,et al.Comparative study of cluster and conventional immunotherapy schedules with dermatophagoides pteronyssinus in the treatment of persistent allergic rhinitis[J].Int Arch Allergy Immunol,2009,148:161-169.
[21]雍磊,程相铎,郑晓丹,等.集群免疫治疗对支气管哮喘患者血清IL-4和INF-γ的影响[J].临床军医杂志,2011,39(6):1114-1116.
[22]程相铎,雍磊,梅海豫,等.集群免疫治疗对轻中度哮喘患者嗜酸粒细胞阳离子蛋白的影响[J].中国医药导报,2011,8(30):51-52.
[23]邱前辉,卢川,陈建军,等.变应性鼻炎冲击免疫治疗的安全性研究[J].临床耳鼻咽喉头颈外科杂志,2014,28(11):776-779.
[24]谢薇,张汉钟,陈剑,等.冲击免疫治疗变应性鼻炎的有效性与安全性研究[J].中华耳鼻咽喉头颈外科杂志,2015,50(8):641-645.
[25]KIM H B,JIN H S,LEE S Y,et al.The effect of rush immunotherapy with house dust mite in the production of IL-5and IFN-gamma from the peripheral blood T cells of asthmatic children[J].J Korean Med Sci,2009,24:392-397.
[26]DAVIS L S,SUMIT B,RIDZ B S,et al.Early gene expression changes with rush immunotherapy[J].Clin Mol Allergy,2011,9:12.
[27]邱前辉.变应性鼻炎免疫治疗的现状和未来[J].临床耳鼻咽喉头颈外科杂志,2017,31(1):9-12.
[28]张策,沙骥超,朱冬冬.变应性鼻炎基于免疫学机制的药物治疗研究进展[J].临床耳鼻咽喉头颈外科杂志,2016,30(13):1086-1089.
[29]鲁爱武,汪志伟,邓少芳,等.特异性免疫治疗的相关细胞因子的动态变化及其临床意义[J].临床耳鼻咽喉头颈外科杂志,2016,30(12):955-959.