Broide David H
Department of Medicine, University of California San Diego, La Jolla, California 92093, USA.
Annu Rev Med. 2009;60:279-91. doi: 10.1146/annurev.med.60.041807.123524.
This review focuses on sublingual immunotherapy (SLIT), toll-like receptor-9 (TLR-9) vaccines using cytosine phosphorothioate guanosine (CpG)-allergen conjugates, and anti-IL-5 as novel immunomodulating therapies in allergy. At present, all three approaches are investigational in the United States and require further study to determine their safety and effectiveness. SLIT provides a novel oral route of administering an allergen to induce tolerance to inhaled allergens. Studies of SLIT in allergic rhinitis demonstrate that it reduces symptoms and medication use and is associated with a low incidence of systemic allergic reactions. Initial phase II studies with TLR-9 vaccines conjugated to a ragweed allergen demonstrate that they reduce symptoms of allergic rhinitis during the ragweed season. Anti-IL-5 is effective as a corticosteroid-sparing agent in the hypereosinophilic syndrome. It has not shown benefit in moderate asthmatics with persistent symptoms but may reduce aspects of airway remodeling in asthma.
本综述聚焦于舌下免疫疗法（SLIT）、使用胞嘧啶磷硫酰鸟苷（CpG）-过敏原偶联物的Toll样受体9（TLR-9）疫苗以及抗白细胞介素-5作为变应性疾病中的新型免疫调节疗法。目前，这三种方法在美国均处于研究阶段，需要进一步研究以确定其安全性和有效性。SLIT提供了一种口服过敏原的新途径，以诱导对吸入性过敏原的耐受性。变应性鼻炎的SLIT研究表明，它可减轻症状、减少药物使用，且全身过敏反应发生率较低。与豚草过敏原偶联的TLR-9疫苗的初步II期研究表明，它们可减轻豚草季节变应性鼻炎的症状。抗白细胞介素-5在高嗜酸性粒细胞综合征中作为一种皮质类固醇节省剂有效。它在有持续症状的中度哮喘患者中未显示出益处，但可能减轻哮喘气道重塑的某些方面。
