Asher Ilan, Mahlab-Guri Keren, Sthoeger Zev
Clinical immunology, Allergy and AIDS Center, Kaplan Medical Center Rehovot, Israel affiliated to the Hebrew University-Hadassah Medical School, Jerusalem, Israel.
Harefuah. 2013 Sep;152(9):529-33, 564, 563.
The prevalence of allergic diseases has increased dramatically in the western world. In the last 2 decades, the frequency of asthma and allergic rhinitis has doubled. Allergen specific immunotherapy [SIT] has been used successfully for more than 100 years for the treatment of allergic disorders. Allergen SIT provides not only symptomatic relief, but it is potentially curative. The immunologic mechanisms of allergen SIT include all parts of the immune system. Regulatory T cells (TR1, Treg), have a major pivotal role in the success of immunotherapy. Along with the regulatory T cells, elevated suppressor cytokines (IL-10), suppression of TH2 cells, increasing titer of specific IgG4 and gradual decline in the number and function of basophils and mast cells also contribute to the success of the treatment (SIT). The above immune mechanisms are connected and related to each other acting at different times with the treatment with SIT. In this review we focused on the current knowledge and understanding of the different immune mechanisms which are involved in the success of SIT.
在西方世界,过敏性疾病的患病率急剧上升。在过去20年中,哮喘和过敏性鼻炎的发病率翻了一番。变应原特异性免疫疗法(SIT)已成功用于治疗过敏性疾病100多年。变应原SIT不仅能缓解症状,还具有潜在的治愈作用。变应原SIT的免疫机制包括免疫系统的各个部分。调节性T细胞(TR1、Treg)在免疫疗法的成功中起主要关键作用。除了调节性T细胞外,抑制性细胞因子(IL-10)升高、TH2细胞受到抑制、特异性IgG4滴度增加以及嗜碱性粒细胞和肥大细胞数量和功能逐渐下降也有助于治疗(SIT)取得成功。上述免疫机制相互联系、相互关联,在SIT治疗的不同时间发挥作用。在本综述中,我们重点关注了目前对参与SIT成功的不同免疫机制的认识和理解。