Yang Yao-Hsu, Chiang Bor-Luen
Department of Pediatrics, National Taiwan University Hospital, College of Medicine, National Taiwan University, Number 8 Chung-Shan South Road, Taipei, 10061, Taiwan,
Clin Rev Allergy Immunol. 2014 Jun;46(3):250-7. doi: 10.1007/s12016-013-8354-2.
Food allergies have increased in recent decades. However, they cannot be effectively treated by the current management, which is limited to the identification and avoidance of foods that induce allergies and to the use of medicines for symptoms relief. To meet the medical need of prevention and cure of food allergies, several therapeutic strategies are under investigation. Some newly developed biologics such as anti-IgE antibody and anti-interleukin (IL)-5 antibody directed against significant molecules in the allergic process have shown their potential for the treatment of food allergies. Allergen-specific immunotherapy is the therapy that induces immune tolerance and may reduce the need for conventional medication, severity of allergic symptoms and eliminate hypersensitivity. In this article, clinical studies of immunotherapy via subcutaneous, oral, sublingual, and epicutaneous routes are extensively reviewed for their safety and effectiveness on various food allergies. In addition, to reduce the risk of anaphylaxis and increase toleragenic immunity, many studies are focusing on the modification of traditional allergens used for immunotherapy. Moreover, a Chinese herbal formulation with potential anti-allergic effects is being evaluated for its efficacy in patients with peanut allergy. Although more studies are needed, accumulated data of current studies represent compelling evidence of curative effects of some strategies and give a hope that food allergies are likely to be successfully treated in the future.
近几十年来,食物过敏的情况有所增加。然而,目前的治疗方法无法有效治疗食物过敏,其局限于识别和避免诱发过敏的食物以及使用药物缓解症状。为满足预防和治疗食物过敏的医疗需求,几种治疗策略正在研究中。一些新开发的生物制剂,如针对过敏过程中重要分子的抗IgE抗体和抗白细胞介素(IL)-5抗体,已显示出治疗食物过敏的潜力。变应原特异性免疫疗法是一种诱导免疫耐受的疗法,可能会减少对传统药物的需求、减轻过敏症状的严重程度并消除超敏反应。在本文中,对皮下、口服、舌下和经皮途径免疫疗法针对各种食物过敏的安全性和有效性的临床研究进行了广泛综述。此外,为降低过敏反应风险并增强耐受性免疫,许多研究聚焦于对用于免疫疗法的传统变应原进行改造。而且,一种具有潜在抗过敏作用的中药配方正在评估其对花生过敏患者的疗效。尽管还需要更多研究,但当前研究的积累数据为一些策略的疗效提供了令人信服的证据,并带来了未来食物过敏可能得到成功治疗的希望。