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过敏与变应原特异性免疫疗法综述。

A review of allergy and allergen specific immunotherapy.

作者信息

Bidad Katayoon, Nicknam Mohammad Hossein, Farid Reza

机构信息

Department of Immunology, Tehran University of Medical Sciences, Tehran, Iran.

出版信息

Iran J Allergy Asthma Immunol. 2011 Mar;10(1):1-9.

Abstract

Since 20th century, when allergy was defined, an ongoing attempt for discovering the mechanisms underlying it and its treatment began. Defining allergens as well as cells such as regulatory T-cells and characterizing the antibodies involved in the pathogenesis (including blocking antibodies) have helped very much towards a better understanding of the immunologic process. However, allergen specific immunotherapy (SIT), as a specific curative treatment for allergy also dates back to the beginning of the previous century and has progressed considerably during these years. SIT similar to natural immunomodulation, directs the immune response towards tolerance. New strategies in this field, such as using recombinant allergens, T- and B-cell-epitope-containing peptides, and DNA vaccination have shown promising results. Sublingual immunotherapy, although not yet FDA-approved, as an alternative strategy in SIT has demonstrated efficacy as well as safety. Furthermore, allergen extracts, their standardization and their modification have also been the focus of much research. Undoubtedly, specific immunotherapy is proven to be an efficacious method to treat allergy, so its cost-effectiveness should be estimated in developing countries in order to include it in the country's health priorities. Informing physicians about the new anti-vaccination movement is also crucial.

摘要

自20世纪过敏被定义以来,人们就开始不断尝试探寻其背后的机制及治疗方法。确定过敏原以及诸如调节性T细胞等细胞,并对发病机制中涉及的抗体(包括阻断抗体)进行表征,这对更好地理解免疫过程有很大帮助。然而,过敏原特异性免疫疗法(SIT)作为一种针对过敏的特异性治疗方法,也可追溯到上世纪初,并且这些年来有了很大进展。与自然免疫调节类似,SIT将免疫反应导向耐受性。该领域的新策略,如使用重组过敏原、含T细胞和B细胞表位的肽以及DNA疫苗接种,已显示出有前景的结果。舌下免疫疗法虽然尚未获得美国食品药品监督管理局(FDA)的批准,但作为SIT的一种替代策略,已证明其有效性和安全性。此外,过敏原提取物、其标准化及其改性也一直是大量研究的重点。毫无疑问,特异性免疫疗法已被证明是治疗过敏的有效方法,因此在发展中国家应评估其成本效益,以便将其纳入国家卫生优先事项。让医生了解新的反疫苗运动也至关重要。

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