Department of Respiratory Medicine, Brighton & Sussex Medical School, Brighton, United Kingdom.
J Allergy Clin Immunol. 2010 Feb;125(2 Suppl 2):S306-13. doi: 10.1016/j.jaci.2009.10.064.
Specific immunotherapy (SIT) involves the administration of allergen extracts to achieve clinical tolerance of those allergens that cause symptoms in patients with allergic conditions. Immunotherapy is effective in patients with mild forms of allergic disease and also in those who do not respond well to standard drug therapy. Most SIT is given by means of injection, but there is increasing interest in performing SIT through the sublingual route. SIT remains the treatment of choice for patients with systemic allergic reactions to wasp and bee stings and should be considered as an option in patients with allergic rhinitis, asthma, or both. SIT can modify the course of allergic disease by reducing the risk of new allergic sensitizations and inhibiting the development of clinical asthma in children treated for allergic rhinitis. The precise mechanisms responsible for the beneficial effects of SIT remain a matter of research and debate. An effect on regulatory T cells seems most probable and is associated with switching of allergen-specific B cells toward IgG4 production. Few direct comparisons of SIT and drug therapy have been made. Existing data suggest that the effects of SIT take longer to develop, but once established, SIT achieves long-lasting relief of allergic symptoms, whereas the benefits of drugs only last as long as they are continued.
特异性免疫治疗（SIT）涉及给予过敏原提取物，以实现对引起过敏患者症状的过敏原的临床耐受。免疫治疗对轻度过敏疾病患者有效，对那些对标准药物治疗反应不佳的患者也有效。大多数 SIT 通过注射给药，但通过舌下途径进行 SIT 的兴趣日益增加。SIT 仍然是对黄蜂和蜜蜂蜇伤有全身性过敏反应患者的治疗选择，并且应该被视为对过敏性鼻炎、哮喘或两者都有患者的一种选择。SIT 通过降低新的过敏致敏风险和抑制接受过敏性鼻炎治疗的儿童的临床哮喘发展，从而改变过敏疾病的进程。SIT 有益效果的确切机制仍然是研究和争论的主题。对调节性 T 细胞的影响似乎最有可能，并且与过敏原特异性 B 细胞向 IgG4 产生的转换有关。很少对 SIT 和药物治疗进行直接比较。现有数据表明，SIT 的效果需要更长的时间才能显现，但一旦建立，SIT 就能长期缓解过敏症状，而药物的益处仅在持续使用时才会持续。
