Clinical Trials Center, Center for Clinical Research, University and University Hospital of Zurich, Switzerland.
Curr Opin Allergy Clin Immunol. 2009 Dec;9(6):537-43. doi: 10.1097/ACI.0b013e3283310ff7.
IgE-mediated allergy can be treated by subcutaneous allergen-specific immunotherapy (SCIT). However, the percentage of allergic patients undergoing SCIT is low, mainly due to the long duration of the therapy and the risk of severe systemic allergic reactions associated with the allergen administration. Typically, SCIT requires dozens of subcutaneous allergen injections that stretch over 3-5 years. Over the last decade, sublingual immunotherapy has been established as an alternative to SCIT, but treatment duration and dosing frequencies could not be reduced. Recently, immunotherapy by direct administration of the allergen into lymph nodes [intralymphatic immunotherapy (ILIT)] has proven a promising alternative and this method is the focus of the present review.
Several studies on animals and on humans have shown that direct injection into lymph nodes enhanced immune responses to protein, peptide, and naked DNA vaccines. Moreover, ILIT strongly improved allergen immunotherapy, so that the number of allergen administrations as well as the allergen dose could be reduced. As ILIT was also well tolerated, practically painless, and easy to perform, patient compliance was improved as compared with SCIT.
Direct ILIT into a subcutaneous lymph node markedly enhances protective immune responses, so that both the dose and the number of allergen injections can be reduced, making ILIT safer and faster than other forms of immunotherapy, and most importantly, this enhances patient convenience and compliance.
IgE 介导的过敏可以通过皮下过敏原特异性免疫疗法（SCIT）进行治疗。然而，接受 SCIT 的过敏患者比例较低，主要是由于治疗时间长，以及与过敏原给药相关的严重全身性过敏反应的风险。通常，SCIT 需要数十次皮下过敏原注射，持续 3-5 年。在过去的十年中，舌下免疫疗法已被确立为 SCIT 的替代疗法，但治疗持续时间和给药频率无法降低。最近，通过直接将过敏原注入淋巴结进行免疫疗法[淋巴结内免疫疗法（ILIT）]已被证明是一种很有前途的替代方法，本综述重点介绍了这种方法。
几项关于动物和人类的研究表明，直接注射到淋巴结中增强了对蛋白质、肽和裸露 DNA 疫苗的免疫反应。此外，ILIT 大大改善了过敏原免疫疗法，从而减少了过敏原的给药次数和剂量。由于 ILIT 也具有良好的耐受性、几乎无痛且易于操作，与 SCIT 相比，患者的依从性得到了提高。
直接将 ILIT 注入皮下淋巴结可显著增强保护性免疫反应，从而减少过敏原注射的剂量和次数，使 ILIT 比其他形式的免疫疗法更安全、更快，最重要的是，这提高了患者的便利性和依从性。
