Hamelmann Eckard, Rolinck-Werninghaus Claudia, Wahn Ulrich, Kopp Matthias Volkmar
Klinik für Kinder- und Jugendmedizin, Ruhr Universität Bochum.
Arb Paul Ehrlich Inst Bundesinstitut Impfstoffe Biomed Arzneim Langen Hess. 2009;96:303-13; discussion 313-5.
Novel therapies that interfere specifically with immunological mechanisms underlying allergen-induced pathology are currently in clinical evaluation. Among these is anti-IgE, which directly targets IgE serum antibodies, thus inhibiting the central mechanism of immediate type hypersensitivity reactions. Application of anti-IgE antibodies effectively reduces IgE serum levels regardless of allergen specificity. It has been successfully tested in patients with allergic rhinitis, asthma and food allergy, showing significant efficacy in reducing symptom scores and use of rescue medications. Anti-IgE therapy is limited by high costs and the requirements for permanent or every-season treatment. The advantage of specific immune therapy (SIT) is the potential to alter the course of the disease, which has been demonstrated in patients with allergic rhinitis, insect venom allergy and, to a lesser degree, with asthma. The broader application of SIT is restricted by sometimes life-threatening side-effects. Here, we summarize the results of clinical trials investigating the effects of combination therapy with anti-IgE and SIT in patients with rhinitis and asthma. These studies show that combination of anti-IgE plus SIT may be beneficial for the treatment of allergic diseases by improving efficacy and limiting side effects.
目前，专门针对变应原诱导的病理过程中免疫机制的新型疗法正在进行临床评估。其中包括抗IgE，它直接作用于IgE血清抗体，从而抑制速发型超敏反应的核心机制。无论变应原特异性如何，抗IgE抗体的应用都能有效降低IgE血清水平。它已在过敏性鼻炎、哮喘和食物过敏患者中成功进行了测试，在降低症状评分和急救药物使用方面显示出显著疗效。抗IgE疗法受到高成本以及长期或季节性治疗需求的限制。特异性免疫疗法（SIT）的优势在于有可能改变疾病进程，这已在过敏性鼻炎、昆虫毒液过敏患者中得到证实，在哮喘患者中也有一定程度的体现。SIT的广泛应用受到有时会危及生命的副作用的限制。在此，我们总结了关于抗IgE与SIT联合治疗对鼻炎和哮喘患者影响的临床试验结果。这些研究表明，抗IgE加SIT联合治疗可能通过提高疗效和限制副作用而有益于过敏性疾病的治疗。
