Tsabouri Sophia, Mavroudi Antigoni, Feketea Gavriela, Guibas George V
Child Health Department, University of Ioannina School of Medicine, Ioannina, Greece.
Allergy Unit of the 3rd Pediatric Department, Aristotle University of Thessaloniki, Thessaloniki, Greece.
Front Pediatr. 2017 Apr 21;5:82. doi: 10.3389/fped.2017.00082. eCollection 2017.
This review presents up-to-date understanding of immunotherapy in the treatment of children with allergic asthma. The principal types of allergen immunotherapy (AIT) are subcutaneous immunotherapy (SCIT) and sublingual immunotherapy (SLIT). Both of them are indicated for patients with allergic rhinitis and/or asthma, who have evidence of clinically relevant allergen-specific IgE, and significant symptoms despite reasonable avoidance measures and/or maximal medical therapy. Studies have shown a significant decrease in asthma symptom scores and in the use of rescue medication, and a preventive effect on asthma onset. Although the safety profile of SLIT appears to be better than SCIT, the results of some studies and meta-analyses suggest that the efficacy of SCIT is better and that SCIT has an earlier onset than SLIT in children with allergic asthma. Severe, not controlled asthma, and medical error were the most frequent causes of SCIT-induced adverse events.
本综述介绍了目前对免疫疗法治疗儿童过敏性哮喘的认识。变应原免疫疗法(AIT)的主要类型是皮下免疫疗法(SCIT)和舌下免疫疗法(SLIT)。两者均适用于患有过敏性鼻炎和/或哮喘、有临床相关变应原特异性IgE证据且尽管采取了合理的回避措施和/或最大程度的药物治疗仍有明显症状的患者。研究表明,哮喘症状评分和急救药物的使用显著减少,且对哮喘发作有预防作用。尽管SLIT的安全性似乎优于SCIT,但一些研究和荟萃分析的结果表明,SCIT的疗效更好,且在儿童过敏性哮喘中,SCIT比SLIT起效更早。严重、未得到控制的哮喘和医疗失误是SCIT引起不良事件的最常见原因。