Schendzielorz P, Klimek L
HNO-Universitätsklinik Würzburg, Würzburg, Deutschland.
HNO. 2013 Oct;61(10):834-42. doi: 10.1007/s00106-013-2730-3.
Currently, preparations containing native allergens or allergoids are used predominantly in allergen-specific immunotherapy (SIT) of inhaled allergies. The safety and efficacy of these preparations has been demonstrated. However, their reproducible production and standardisation requires substantial effort. Besides this, improved efficacy is often associated with higher doses and an increase in adverse events. The production of recombinant allergens could make SIT preparations more precisely definable, purer, more reproducible, safer and more efficacious. Furthermore, a more specific and individually tailored therapy would be conceivable. These effects could be further amplified by modification to hypoallergenic variants and peptides, or by the addition of adjuvants. Results of clinical trials with recombinant grass, birch and ragweed pollen, as well as with cat hair allergens have already been published. Particularly broad clinical experience exists for recombinant birch and grass pollen preparations, and results are promising for commercial application. Taken as a whole, this new technology can both improve the therapy of allergic diseases and deepen the understanding of the molecular mechanisms of SIT.
目前，含有天然变应原或类变应原的制剂主要用于吸入性过敏的变应原特异性免疫疗法（SIT）。这些制剂的安全性和有效性已得到证实。然而，其可重复生产和标准化需要付出巨大努力。除此之外，疗效的提高往往伴随着更高的剂量和不良事件的增加。重组变应原的生产可以使SIT制剂更精确、更纯净、更可重复、更安全且更有效。此外，还可以设想一种更具特异性和个性化定制的疗法。通过修饰为低变应原性变体和肽，或添加佐剂，这些效果可能会进一步增强。重组草、桦树和豚草花粉以及猫毛变应原的临床试验结果已经发表。重组桦树和草花粉制剂拥有特别广泛的临床经验，其结果有望用于商业应用。总体而言，这项新技术既能改善过敏性疾病的治疗，又能加深对SIT分子机制的理解。
