Section of Allergy and Clinical Immunology, National Heart and Lung Institute, Faculty of Medicine, Imperial College London, London, UK.
Curr Opin Allergy Clin Immunol. 2011 Dec;11(6):586-93. doi: 10.1097/ACI.0b013e32834cb994.
The present review updates current findings on long-term clinical and immunological outcomes after cessation of allergen immunotherapy for allergic respiratory disease.
Recent studies have shown that allergen immunotherapy has sustained disease-modifying effects that persist for years after discontinuation. This is in contrast to the effects of antiallergic drugs that do not induce tolerance to offending allergens. Long-term effects of immunotherapy include a reduction in nasal symptoms, a decrease in the use of rescue medication and improvement in quality of life. These benefits are accompanied by immunological changes such as the induction of allergen-specific IgG antibodies with inhibitory activity for IgE-facilitated binding of allergen-IgE complexes to B cells. One study reported a reduction in the development of asthma in children with seasonal pollen-induced rhinitis.
Allergen immunotherapy induces clinical and immunological tolerance as defined by persistence of clinical benefit and associated long-term immunological parameters after discontinuation of treatment. These findings are largely confined to studies of subcutaneous and sublingual immunotherapy for seasonal pollinosis. Further studies are needed to address potential long-term clinical effects for other seasonal and perennial inhaled allergens in both children and adults, and to identify potential biomarkers of tolerance.
本综述更新了过敏原免疫治疗停止后过敏性呼吸道疾病的长期临床和免疫结局的最新发现。
最近的研究表明，过敏原免疫治疗具有持续的疾病改善作用，在停药后多年仍持续存在。这与抗过敏药物的作用形成对比，后者不能诱导对过敏原的耐受。免疫治疗的长期效果包括减轻鼻部症状、减少急救药物的使用以及改善生活质量。这些益处伴随着免疫学变化，如诱导具有抑制活性的过敏原特异性 IgG 抗体，该抗体可阻止过敏原-IgE 复合物与 B 细胞结合。一项研究报告称，季节性花粉引起的鼻炎儿童的哮喘发生率降低。
过敏原免疫治疗诱导临床和免疫耐受，定义为治疗停止后持续的临床获益和相关的长期免疫学参数。这些发现主要局限于季节性花粉症的皮下和舌下免疫治疗研究。需要进一步研究以确定其他季节性和常年吸入性过敏原在儿童和成人中的潜在长期临床效果，并确定潜在的耐受生物标志物。
