Niebuhr M, Kapp A, Werfel T
Klinik und Poliklinik für Dermatologie und Allergologie der Medizinischen Hochschule Hannover, Ricklinger Strasse 5, 30449 Hannover, Deutschland.
Hautarzt. 2008 Jul;59(7):544-50. doi: 10.1007/s00105-008-1490-6.
Atopic dermatitis (AD) is one of the most frequent chronic inflammatory skin diseases with an increasing prevalence. About 80% of adult AD patients are sensitized against seasonal or perennial aeroallergens and/or food allergens which may play a pivotal role in triggering or maintaining eczema. In addition to local and systemic therapy adjusted to the stage of the disease, the search for relevant trigger factors and then their avoidance plays a crucial role in managing AD. While the effectiveness of SIT is best established in allergic rhinitis, bronchial asthma and insect venom allergy, its use in AD is still controversial. Double-blind, placebo-controlled clinical studies are now available showing good efficacy of SIT in patients with AD. For food allergies there are clues from case reports and small clinical studies suggesting effectiveness of SIT both for food allergies and associated aeroallergens. Double-blind, placebo-controlled studies involving larger numbers of patients are needed to establish the clinical effectiveness and immunologic mechanisms of SIT in food allergies.
特应性皮炎(AD)是最常见的慢性炎症性皮肤病之一,其患病率呈上升趋势。约80%的成年AD患者对季节性或常年性气传变应原和/或食物变应原致敏,这些变应原可能在引发或维持湿疹方面起关键作用。除了根据疾病阶段调整的局部和全身治疗外,寻找相关触发因素并加以避免在AD的管理中起着至关重要的作用。虽然特异性免疫治疗(SIT)在过敏性鼻炎、支气管哮喘和昆虫毒液过敏中的有效性已得到充分证实,但其在AD中的应用仍存在争议。目前已有双盲、安慰剂对照的临床研究表明SIT对AD患者有良好疗效。对于食物过敏,病例报告和小型临床研究提示SIT对食物过敏及相关气传变应原均有效。需要开展涉及更多患者的双盲、安慰剂对照研究,以确定SIT在食物过敏中的临床有效性和免疫机制。