Department of Pediatrics, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC 27599-7220, USA.
J Allergy Clin Immunol. 2013 May;131(5):1288-96.e3. doi: 10.1016/j.jaci.2013.01.049. Epub 2013 Mar 14.
Allergy immunotherapy (AIT) is an effective treatment for allergic asthma and rhinitis, as well as venom-induced anaphylaxis. In addition to reducing symptoms, AIT can change the course of allergic disease and induce allergen-specific immune tolerance. In current clinical practice immunotherapy is delivered either subcutaneously or sublingually; some allergens, such as grass pollen, can be delivered through either route, whereas others, such as venoms, are only delivered subcutaneously. Both subcutaneous and sublingual immunotherapy appear to have a duration of efficacy of up to 12 years, and both can prevent the development of asthma and new allergen sensitivities. In spite of the advances with AIT, safer and more effective AIT strategies are needed, especially for patients with asthma, atopic dermatitis, or food allergy. Novel approaches to improve AIT include use of adjuvants or recombinant allergens and alternate routes of administration. As part of the PRACTALL initiatives, the European Academy of Allergy and Clinical Immunology and the American Academy of Allergy, Asthma & Immunology nominated an expert team to develop a comprehensive consensus report on the mechanisms of AIT and its use in clinical practice, as well as unmet needs and ongoing developments in AIT. This resulting report is endorsed by both academies.
变应原免疫治疗（AIT）是治疗过敏性哮喘和鼻炎以及毒液引起的过敏反应的有效方法。除了减轻症状外，AIT 还可以改变过敏性疾病的进程，并诱导过敏原特异性免疫耐受。在当前的临床实践中，免疫治疗通过皮下或舌下途径给药；有些过敏原，如草花粉，可通过这两种途径给药，而其他过敏原，如毒液，只能通过皮下途径给药。皮下和舌下免疫治疗似乎都具有长达 12 年的疗效，并且都可以预防哮喘和新的过敏原敏感性的发生。尽管 AIT 取得了进展，但仍需要更安全、更有效的 AIT 策略，特别是对于哮喘、特应性皮炎或食物过敏的患者。改善 AIT 的新方法包括使用佐剂或重组过敏原和替代给药途径。作为 PRACTALL 倡议的一部分，欧洲过敏与临床免疫学学会和美国过敏、哮喘和免疫学学会提名了一个专家小组，制定了一份关于 AIT 机制及其在临床实践中的应用、以及 AIT 未满足的需求和正在进行的发展的全面共识报告。该报告得到了两个学会的认可。
