Department of Pediatrics, Allergy Unit, University of Messina, Italy.
Ann Allergy Asthma Immunol. 2011 Nov;107(5):395-400. doi: 10.1016/j.anai.2011.04.011. Epub 2011 Jun 8.
The goal was to assess the effectiveness of specific immunotherapy (SIT) in reduction of symptoms and medication score in patients with immunoglobulin E (IgE) mediated extrinsic form of atopic dermatitis (AD); and to assess the effectiveness of oral immunotherapy (OIT) as "active" treatment to achieving tolerance for food(s) in patients with IgE mediated food allergy.
Computerized bibliographic searches of MEDLINE (1998-2010) were supplemented by hand searches of reference lists. Studies were included if they were double-blind randomized controlled trials comparing subcutaneous immunotherapy (SCIT) or sublingual immunotherapy (SLIT) or OIT with placebo. However uncontrolled studies and case reports were also included.
Thirty-two studies were analyzed. Because of the high heterogeneity of the AD studied only results of 2 placebo controlled studies 1-SCIT and 1-SLIT respectively were comparable. Among OIT studies: 4 carried out with control groups were analyzed.
From 36% to 92% of patients treated with OIT reached tolerance to cow's milk or egg; a rate of 8% to 53% reached partial tolerance. The patients had either clinical history of severe systemic reactions to foods: anaphylaxis, or mild to moderate reactions. Regarding SIT for AD: 72% of patients treated with house dust mite SCIT and 54% treated with SLIT had a significant improvement of SCORAD-Index.
This review found that OIT with cow's milk or egg is effective in achieving full tolerance or partial tolerance in the majority of patients with IgE mediated food allergy. SIT may represent an additional therapeutic tool for the treatment of extrinsic AD in properly selected patients.
评估特异性免疫治疗（SIT）在降低免疫球蛋白 E（IgE）介导的特应性皮炎（AD）患者症状和药物评分方面的有效性；并评估口服免疫治疗（OIT）作为实现 IgE 介导的食物过敏患者对食物（s）耐受的“有效”治疗的有效性。
计算机检索 MEDLINE（1998-2010 年）并辅以手工检索参考文献。如果研究为比较皮下免疫治疗（SCIT）或舌下免疫治疗（SLIT）或 OIT 与安慰剂的双盲随机对照试验，则纳入研究。但也纳入了未对照研究和病例报告。
分析了 32 项研究。由于所研究的 AD 存在高度异质性，仅比较了 2 项安慰剂对照研究（1-SCIT 和 1-SLIT）的结果是可比的。在 OIT 研究中：分析了 4 项有对照组的研究。
接受 OIT 治疗的患者中有 36%至 92%达到对牛奶或鸡蛋的耐受；有 8%至 53%的患者达到部分耐受。这些患者要么有食物严重全身性反应（过敏反应）的临床病史，要么有轻度至中度反应。关于 AD 的 SIT：接受屋尘螨 SCIT 治疗的 72%和接受 SLIT 治疗的 54%的患者 SCORAD 指数有显著改善。
本综述发现，OIT 治疗牛奶或鸡蛋在大多数 IgE 介导的食物过敏患者中有效实现完全或部分耐受。SIT 可能代表了治疗特应性 AD 的另一种治疗工具，适用于适当选择的患者。
