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食物过敏免疫疗法中长期给药实现持续反应的可行性。

Feasibility of sustained response through long-term dosing in food allergy immunotherapy.

作者信息

Andorf Sandra, Manohar Monali, Dominguez Tina, Block Whitney, Tupa Dana, Kshirsagar Rohun A, Sampath Vanitha, Chinthrajah R Sharon, Nadeau Kari C

机构信息

Sean N. Parker Center for Allergy and Asthma Research at Stanford University, 269 Campus Drive, CCSR 3215, MC 5366, Stanford, CA 94305-5101 USA.

出版信息

Allergy Asthma Clin Immunol. 2017 Dec 21;13:52. doi: 10.1186/s13223-017-0224-7. eCollection 2017.

Abstract

BACKGROUND

Clinical trials using oral immunotherapy (OIT) for the treatment of food allergies have shown promising results. We previously demonstrated the feasibility of desensitization for up to 5 food allergens simultaneously through OIT. In this observational study, we report the findings of long-term follow-up (LTFU) of the participants treated through a single site OIT phase 1 trial.

METHODS

The participants (n = 46) were followed up to 72 months since the time they reached 2 g maintenance dose per food in the initial phase 1 trial. During the long-term maintenance dosing, participants continued or reduced the initial maintenance dose of food allergen protein to high (median 2 g protein) vs. low (median 300 mg protein). Participant follow-up included clinical monitoring, standardized OFCs, and in some cases, skin prick tests and measurement of allergen-specific IgE and IgG.

RESULTS

Irrespective of the high vs. low long-term maintenance dose during LTFU, all participants were able to ingest 2 g protein of each food allergen protein during OFCs performed at the end of our LTFU.

CONCLUSION

Our LTFU cohort of food OIT participants from a single site, phase 1 OIT study, supports the feasibility of sustained desensitization through long-term maintenance dosing. Registry: Clinicaltrial.gov. Registration numbers: NCT01490177 (original study); NCT03234764 (LTFU study). Date of registration: November 29, 2011 (original study); July 26, 2017 (LTFU study, registered).

摘要

背景

使用口服免疫疗法(OIT)治疗食物过敏的临床试验已显示出有前景的结果。我们之前证明了通过OIT同时对多达5种食物过敏原进行脱敏的可行性。在这项观察性研究中,我们报告了通过单中心OIT 1期试验治疗的参与者的长期随访(LTFU)结果。

方法

自参与者在初始1期试验中达到每种食物2g维持剂量起,对46名参与者进行了长达72个月的随访。在长期维持给药期间,参与者继续或降低食物过敏原蛋白的初始维持剂量至高剂量(中位数2g蛋白)与低剂量(中位数300mg蛋白)。对参与者的随访包括临床监测、标准化的口服食物激发试验(OFC),在某些情况下,还包括皮肤点刺试验以及过敏原特异性IgE和IgG的测量。

结果

在LTFU期间,无论长期维持剂量是高还是低,所有参与者在我们LTFU结束时进行的OFC中都能够摄入每种食物过敏原蛋白2g。

结论

我们来自单中心1期OIT研究的食物OIT参与者的LTFU队列支持通过长期维持给药进行持续脱敏的可行性。注册信息:Clinicaltrial.gov。注册号:NCT01490177(原始研究);NCT03234764(LTFU研究)。注册日期:2011年11月29日(原始研究);2017年7月26日(LTFU研究,注册)。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b4d3/5738818/8fe5b047e9eb/13223_2017_224_Fig1_HTML.jpg

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