桃过敏舌下免疫治疗：监测分子致敏和对苹果果实和悬铃木花粉的反应性。

Sublingual immunotherapy in peach allergy: monitoring molecular sensitizations and reactivity to apple fruit and Platanus pollen.

机构信息

Servicio de Alergia, Hospital Virgen del Camino, Pamplona, Spain.

出版信息

J Investig Allergol Clin Immunol. 2010;20(6):514-20.

Abstract

BACKGROUND

Peach allergy is prevalent, persistent, and potentially severe and as such is a target for immunotherapy. Our aims were to evaluate the profile of sensitization to Rosaceae allergens and the effects of sublingual peach immunotherapy on immunoglobulin (Ig) E levels to these allergens, to monitor for neosensitizations, and to check if this treatment modified other Rosaceae fruit and pollen-related sensitizations.

METHODS

A double-blind placebo-controlled trial was conducted on 56 peach-allergic patients who received, sublingually, a standardized peach extract quantified in mass units of Pru p 3, or placebo for 6 months. IgE to recombinant (r) Mal d 1, rMal d 4, rPru p 3, and natural (n) Art v 3 and skin prick test (SPT) reactivity to Platanus pollen and apple extracts evaluated before treatment (T0), after 1 month (T1) and after and 6 months (T6) were recorded.

RESULTS

In total, 18.5% of patients recognized rMal d 1, 83.3%, rPru p 3, 24.1%, rMal d 4, and 25.9% nArt v 3. IgE to Pru p 3 rose from T0 to T1 in both the active group (P = .003) and the placebo group (P = .022), and remained elevated at T6 in the active group (P = .001). IgE to other purified allergens did not change significantly and no relevant neosensitizations were detected. SPT reactions to peach decreased from T0 to T6 in the active group (P < 0.05). Reactivity to peach (T1 and T6) and apple (T6) was lower in the active group than in the control group.

CONCLUSIONS

The main allergen was Pru p 3. Changes in rPru p 3 IgE levels and in peach and apple extract SPT were induced by sublingual immunotherapy.

摘要

背景

桃过敏较为常见，且持续时间长，潜在风险大，因此成为免疫治疗的目标。我们的目的是评估蔷薇科过敏原致敏情况，以及舌下含服桃免疫治疗对这些过敏原的免疫球蛋白（Ig）E 水平的影响，监测新的致敏情况，并检查这种治疗是否改变了其他蔷薇科水果和花粉相关的致敏情况。

方法

对 56 名桃过敏患者进行了一项双盲安慰剂对照试验，这些患者接受了标准化的桃提取物（以质量单位 Pru p 3 进行定量）或安慰剂，通过舌下途径给药，共 6 个月。在治疗前（T0）、治疗后 1 个月（T1）和 6 个月（T6）时，记录患者对重组（r）Mal d 1、rMal d 4、rPru p 3、天然（n）Art v 3 的 IgE 以及对 Platanus 花粉和苹果提取物的皮肤点刺试验（SPT）反应。

结果

共有 18.5%的患者识别出 rMal d 1，83.3%的患者识别出 rPru p 3，24.1%的患者识别出 rMal d 4，25.9%的患者识别出 nArt v 3。无论是在治疗组还是安慰剂组，患者的 Pru p 3 IgE 水平都从 T0 升高到 T1（P =.003），且在治疗组中仍保持升高至 T6（P =.001）。其他纯化过敏原的 IgE 水平没有明显变化，也没有发现相关的新致敏情况。SPT 对桃的反应从 T0 到 T6 在治疗组中降低（P < 0.05）。治疗组对桃（T1 和 T6）和苹果（T6）的反应均低于对照组。