a Department of Medicine , Division of Allergy/Immunology, University of California , San Diego , CA , USA.
b Kaiser Permanente , San Diego , CA , USA.
Hum Vaccin Immunother. 2017 Oct 3;13(10):2434-2442. doi: 10.1080/21645515.2017.1359363.
The prevalence of IgE mediated food allergy is an increasing public health concern. The current standard of treatment is strict avoidance of the offending food(s). There are no FDA approved treatments for food allergy. This review will provide an overview of strategies currently under investigation for the treatment of food allergy. The main focus of research has been directed at various forms of immunotherapy, including oral, sublingual and epicutaneous delivery routes. While oral immunotherapy (OIT) has shown the greatest promise for efficacy in terms of amount of protein that can be ingested, it has also demonstrated less tolerability and a less favorable safety profile as compared to sublingual immunotherapy (SLIT) and epicutaneous immunotherapy (EPIT), which offers the least protection but has the best safety and tolerability profile. Investigation is also underway for modified antigens that may be used for immunotherapy and for adjuncts that may help facilitate immunotherapy, including biologics such as anti-IgE therapy, and also probiotics. There are also a number of preclinical concepts that are being evaluated to manipulate the antigens and/or the immune system that may one day be translatable to patients.
IgE 介导的食物过敏的患病率是一个日益严重的公共卫生问题。目前的治疗标准是严格避免食用过敏食物。目前还没有 FDA 批准的食物过敏治疗方法。这篇综述将概述目前正在研究的治疗食物过敏的策略。研究的主要重点是各种形式的免疫疗法，包括口服、舌下和经皮给药途径。虽然口服免疫疗法 (OIT) 在可摄入的蛋白质量方面显示出最大的疗效潜力，但与舌下免疫疗法 (SLIT) 和经皮免疫疗法 (EPIT) 相比，它的耐受性和安全性较差，后者提供的保护作用最小，但安全性和耐受性最好。人们还在研究可能用于免疫治疗的改良抗原和可能有助于促进免疫治疗的辅助剂，包括抗 IgE 治疗等生物制剂，以及益生菌。还有许多临床前概念正在评估中，以操纵抗原和/或免疫系统，这些概念有朝一日可能会转化为患者治疗。
