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职业性过敏的特异性免疫疗法和生物治疗

Specific immunotherapy and biological treatments for occupational allergy.

作者信息

Moscato Gianna, Pala Gianni, Sastre Joaquin

机构信息

aDepartment of Public Health, Experimental and Forensic Medicine, University of Pavia, Pavia bOccupational Physician's Division, Local Health Authority of Sassari, Sassari, Italy cAllergy Department Fundación Jiménez Díaz and CIBER de Enfermedades Respiratorias (CIBERES, Institute Carlos III, Ministry of Economy and Competetiveness), Madrid, Spain.

出版信息

Curr Opin Allergy Clin Immunol. 2014 Dec;14(6):576-81. doi: 10.1097/ACI.0000000000000105.

Abstract

PURPOSE OF REVIEW

Occupational allergy represents a substantial health, social, and financial burden for the society. Its management is a complex task that, in selected cases, may also include allergen-specific immunotherapy. The purpose of this article is to review clinical data on allergen immunotherapy and biological treatments applied to occupational allergy in 2013.

RECENT FINDINGS

Immunotherapy in occupational allergic diseases has been scarcely used, and only for a few sensitizers, such as latex, flour, and Hymenoptera venom, partly due to the lack of standardized extracts. The recent use of the molecular diagnosis can improve the indication and selection of suitable allergens for preparing new standardized and powerful extracts for immunotherapy. Some recent reports suggest a beneficial role of treatment with omalizumab in workers with occupational asthma who continue to be exposed to the causal agent.

SUMMARY

Although scarce, available data suggest that immunotherapy and biological treatments may allow allergic workers to continue their work activity, but further studies are needed to standardize extracts and to evaluate the cost-effectiveness of these treatments, when exposure at the workplace cannot be avoided.

摘要

综述目的

职业性过敏给社会带来了巨大的健康、社会和经济负担。其管理是一项复杂的任务,在某些特定情况下,可能还包括变应原特异性免疫疗法。本文旨在综述2013年应用于职业性过敏的变应原免疫疗法和生物治疗的临床数据。

最新发现

职业性过敏性疾病的免疫疗法很少使用,仅用于少数致敏原,如乳胶、面粉和膜翅目毒液,部分原因是缺乏标准化提取物。分子诊断的近期应用可改善变应原的选择和适应证,从而制备用于免疫疗法的新型标准化强效提取物。近期一些报告表明,奥马珠单抗治疗对继续接触致病原的职业性哮喘患者有益。

总结

尽管现有数据较少,但表明免疫疗法和生物治疗可能使过敏工人能够继续工作,但当无法避免工作场所接触时,还需要进一步研究来标准化提取物并评估这些治疗的成本效益。

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