Department of Allergy, Immunology and Respiratory Medicine, Alfred Hospital and Monash University, Melbourne, Victoria, Australia.
Expert Rev Vaccines. 2015;14(8):1073-87. doi: 10.1586/14760584.2015.1050385. Epub 2015 May 26.
Allergic diseases are prevalent worldwide. Allergen immunotherapy (AIT) is a current treatment for allergy, leading to modification of the natural course of disease. Mechanisms of efficacy include Treg through release of IL-10 and TGF-β and specific IgG4 blocking antibodies. Subcutaneous and sublingual routes are popular, but uptake is limited by inconvenience and safety concerns. Inclusion criteria limit application to a small proportion of allergic patients. New forms of immunotherapy are being investigated for more efficacious, convenient and safer options with promising advances in recent years. The rationale of reducing vaccine allergenicity to increase safety while improving immunogenicity led to investigation of T-cell epitope-based peptides and recombinant allergen derivatives. Additionally, different routes of administration and adjuvants and adjunct therapies are being explored. This review discusses the current status of AIT and recent advances to improve clinical efficacy, safety and long-term immune tolerance.
过敏性疾病在全球范围内普遍存在。变应原免疫疗法（AIT）是目前治疗过敏的一种方法，可改变疾病的自然进程。其疗效机制包括通过释放 IL-10 和 TGF-β以及特异性 IgG4 阻断抗体来调节 Treg。皮下和舌下途径很受欢迎，但由于不便和安全性问题，其应用受到限制。纳入标准将应用限制在一小部分过敏患者。近年来，新形式的免疫疗法正在研究中，以寻求更有效、更方便和更安全的选择，并取得了有希望的进展。为了提高免疫原性同时降低疫苗的变应原性以提高安全性，人们研究了基于 T 细胞表位的肽和重组变应原衍生物。此外，还在探索不同的给药途径、佐剂和辅助治疗。本文综述了 AIT 的现状和近期进展，以提高其临床疗效、安全性和长期免疫耐受性。
