Sampath Vanitha, Tupa Dana, Graham Michelle Toft, Chatila Talal A, Spergel Jonathan M, Nadeau Kari C
Division of Pulmonary and Critical Care Medicine, Department of Medicine, Stanford University, Stanford, California; Sean N. Parker Center for Allergy and Asthma Research, Stanford University School of Medicine, Stanford, California.
Division of Immunology, Boston Children's Hospital, Boston, Massachusetts; Department of Pediatrics, Harvard Medical School, Boston, Massachusetts.
Ann Allergy Asthma Immunol. 2017 Jan;118(1):21-27. doi: 10.1016/j.anai.2016.10.017.
To review our current understanding of immunotherapy, the immune mechanisms underlying food allergy, and the methodological advances that are furthering our understanding of the role of immune cells and other molecules in mediating food allergies.
Literature searches were performed using the following combination of terms: allergy, immunotherapy, food, and mechanisms. Data from randomized clinical studies using state-of-the-art mechanistic tools were prioritized.
Articles were selected based on their relevance to food allergy.
Current standard of care for food allergies is avoidance of allergenic foods and the use of epinephrine in case of severe reaction during unintentional ingestion. During the last few decades, great strides have been made in understanding the cellular and molecular mechanisms underlying food allergy, and this information is spearheading the development of exciting new treatments.
Immunotherapy protocols are effective in desensitizing individuals to specific allergens; however, recurrence of allergic sensitization is common after discontinuation of therapy. Interestingly, in a subset of individuals, immunotherapy is protective against allergens even after discontinuation of immunotherapy. Whether this protection is permanent is currently unknown because of inadequate long-term follow-up data. Research on understanding the underlying mechanisms may assist in modifying protocols to improve outcome and enable sustained unresponsiveness, rather than a temporary relief against food allergies. The cellular changes brought about by immunotherapy are still a black box, but major strides in our understanding are being made at an exciting pace.
回顾我们目前对免疫疗法、食物过敏潜在免疫机制的理解，以及有助于我们进一步了解免疫细胞和其他分子在介导食物过敏中作用的方法学进展。
使用以下术语组合进行文献检索：过敏、免疫疗法、食物和机制。优先选用使用先进机制工具的随机临床研究数据。
根据文章与食物过敏的相关性进行选择。
目前食物过敏的标准治疗方法是避免食用致敏食物，并在无意中摄入导致严重反应时使用肾上腺素。在过去几十年里，我们在理解食物过敏的细胞和分子机制方面取得了巨大进展，这些信息正引领着令人兴奋的新治疗方法的发展。
免疫疗法方案在使个体对特定过敏原脱敏方面是有效的；然而，治疗中断后过敏致敏复发很常见。有趣的是，在一部分个体中，即使在免疫疗法中断后，免疫疗法对过敏原仍有保护作用。由于长期随访数据不足，目前尚不清楚这种保护是否是永久性的。对潜在机制的研究可能有助于改进方案以改善结果，并实现持续无反应，而不是暂时缓解食物过敏。免疫疗法引起的细胞变化仍是一个未知领域，但我们正以惊人的速度在理解方面取得重大进展。
