Research Centre for Prevention and Health, Glostrup University Hospital, Glostrup, Denmark.
J Allergy Clin Immunol. 2012 Feb;129(2):413-9. doi: 10.1016/j.jaci.2011.09.007. Epub 2011 Oct 17.
Subcutaneous allergen-specific immunotherapy (SCIT) is a well-documented treatment of IgE-mediated allergic disease. Little is known about potential effects of SCIT on the risk of other chronic immune-related diseases. Over the years, a few casuistic reports have caused concern that SCIT might act as a trigger of autoimmune disease.
We aimed to investigate the association of SCIT with the incidence of autoimmune disease and ischemic heart disease (IHD), as well as all-cause mortality.
All Danish citizens without other known diseases were linked and followed through central registries on medications and hospital admissions. Persons receiving SCIT and persons receiving conventional allergy treatment (CAT; nasal steroids or oral antihistamines) were compared with regard to mortality and development of autoimmune diseases, acute myocardial infarction (AMI), and IHD. Cox regression (survival analysis) with age as the underlying time scale was used to estimate relative risks (hazard ratios [HRs] with 95% CIs) associated with SCIT compared with CAT adjusted for age, sex, vocational status, and income.
During the 10-year study period (1997-2006), a total of 18,841 and 428,484 persons were followed in the SCIT and CAT groups, respectively. Receiving SCIT was associated with lower mortality (HR, 0.71; 95% CI, 0.62-0.81) and lower incidence of AMI (HR, 0.70; 95% CI, 0.52-0.93), IHD (HR, 0.88; 95% CI, 0.73-1.05), and autoimmune disease (HR, 0.86; 95% CI, 0.74-0.99).
In this registry-based observational study, receiving SCIT compared with CAT was associated with lower risk of autoimmune disease and AMI, as well as decreased all-cause mortality.
皮下变应原特异性免疫疗法（SCIT）是一种已被充分证实的 IgE 介导的过敏性疾病治疗方法。然而，对于 SCIT 是否会对其他慢性免疫相关疾病的风险产生潜在影响，我们知之甚少。多年来，一些个案报告引起了人们的关注，即 SCIT 可能会引发自身免疫性疾病。
我们旨在研究 SCIT 与自身免疫性疾病和缺血性心脏病（IHD）的发病风险以及全因死亡率之间的关联。
所有丹麦无其他已知疾病的公民均通过中央登记册与药物和住院治疗相关联，并进行随访。比较接受 SCIT 和接受常规过敏治疗（CAT；鼻内类固醇或口服抗组胺药）的患者的死亡率以及自身免疫性疾病、急性心肌梗死（AMI）和 IHD 的发病情况。采用 Cox 回归（生存分析），以年龄作为基础时间尺度，估计与 CAT 相比，SCIT 相关的相对风险（风险比[HR]及其 95%置信区间[CI]），并调整年龄、性别、职业状况和收入。
在 10 年的研究期间（1997-2006 年），SCIT 和 CAT 组分别有 18841 人和 428484 人被随访。与接受 CAT 相比，接受 SCIT 与死亡率降低（HR，0.71；95%CI，0.62-0.81）、AMI（HR，0.70；95%CI，0.52-0.93）、IHD（HR，0.88；95%CI，0.73-1.05）和自身免疫性疾病（HR，0.86；95%CI，0.74-0.99）的发病率降低相关。
在这项基于登记的观察性研究中，与接受 CAT 相比，接受 SCIT 与自身免疫性疾病和 AMI 的风险降低以及全因死亡率降低相关。
