Demoly Pascal, Michel François-Bernard
Unité d'Exploration des Allergies, Maladies Respiratoires, Hôpital Arnaud de Villeneuve, CHU de Montpellier et Inserm U657, 34295 Montpellier Cedex 5, France.
Bull Acad Natl Med. 2009 May;193(5):1127-44; discussion 1144-5.
Allergen-specific immunotherapy or desensitization represents an etiological treatment option for patients with allergic respiratory diseases. First introduced in 1911, it was widely disparaged until its mechanism of action was better understood and its efficacy on both allergic rhinoconjunctivitis and allergic asthma was demonstrated in double-blind placebo-controlled studies. Its indications are now widely agreed and practical rules have been established. Several factors have contributed to its increasing use in patients with respiratory allergies, including better-quality allergen extracts, better understanding of the mechanism of action, the introduction of oral tablet forms, and rationalization of prescriptions. Specific immunotherapy can benefit patients with severe allergic respiratory diseases in whom pharmacological treatment is ineffective or poorly accepted. Further well-designed and strictly conducted randomized trials in adults and children with allergic rhinitis and asthma are needed, using patient-important endpoints. More information is also needed on patient selection, the treatment duration, and dosing schedules.
变应原特异性免疫疗法或脱敏疗法是过敏性呼吸道疾病患者的一种病因治疗选择。该疗法于1911年首次引入，在其作用机制得到更好理解且双盲安慰剂对照研究证明其对过敏性鼻结膜炎和过敏性哮喘均有效之前，一直备受诋毁。目前其适应证已得到广泛认可，且已制定了实用规则。有几个因素促使其在呼吸道过敏患者中得到越来越多的应用，包括质量更好的变应原提取物、对作用机制的更好理解、口服片剂形式的引入以及处方的合理化。特异性免疫疗法可使药物治疗无效或难以接受的重度过敏性呼吸道疾病患者受益。需要在患有过敏性鼻炎和哮喘的成人及儿童中开展更多设计良好且严格实施的随机试验，采用对患者重要的终点指标。还需要更多关于患者选择、治疗持续时间和给药方案的信息。
