单磷酰脂质A佐剂特异性免疫疗法对草花粉过敏患者的长期影响。
Long-term effect of monophosphoryl lipid A adjuvanted specific immunotherapy in patients with grass pollen allergy.
作者信息
Zielen Stefan, Gabrielpillai Jennis, Herrmann Eva, Schulze Johannes, Schubert Ralf, Rosewich Martin
机构信息
Department for Children & Adolescents, Division of Allergology, Pulmonology & Cystic fibrosis, Children's Hospital, Goethe University, Theodor Stern Kai 7, 60590 Frankfurt, Germany.
Department of Biostatistics, Goethe University, Frankfurt am Main, Germany.
出版信息
Immunotherapy. 2018 Jun;10(7):529-536. doi: 10.2217/imt-2018-0004. Epub 2018 Mar 22.
BACKGROUND
Ultra-short course pollen immunotherapy adjuvanted with monophosphoryl lipid A (MPL) is attractive to conventional allergen-specific immunotherapy (AIT). Long term efficacy of MPL-AIT has not been evaluated.
METHODS
68 patients (age 16.75 ± 5.3 years) with allergic rhinitis to grass pollen were investigated. Group 1: 21 controls; Group 2: 19 after complete AIT, and Group 3: 28 with AIT and treatment cessation: 4 years range 3-6 years ago.
RESULTS
The clinical symptoms (running nose, sneezing, conjunctivitis and the weekly overall score) were significantly reduced in patients group 2 and 3 compared with controls without AIT p < 0.0001. T-regulatory cells and TH1/TH2 cytokine pattern did not differ between patient groups.
CONCLUSION
The patients in our trial with grass pollen allergy exhibited significant and long-lasting improvements after MPL-AIT, however larger trials are needed to support this finding.
背景
单磷酰脂质A（MPL）佐剂超短疗程花粉免疫疗法对比传统变应原特异性免疫疗法（AIT）更具吸引力。MPL-AIT的长期疗效尚未得到评估。
方法
对68例（年龄16.75±5.3岁）对草花粉过敏的变应性鼻炎患者进行调查。第1组：21名对照；第2组：19名完成AIT治疗后患者；第3组：28名曾接受AIT治疗且已停止治疗患者：停止治疗时间在4年（范围3 - 6年）前。
结果
与未接受AIT治疗的对照组相比，第2组和第3组患者的临床症状（流涕、打喷嚏、结膜炎及每周总体评分）显著减轻（p < 0.0001）。各患者组之间调节性T细胞及TH1/TH2细胞因子模式无差异。
结论
我们试验中对草花粉过敏的患者在MPL-AIT治疗后表现出显著且持久的改善，然而需要更大规模的试验来支持这一发现。
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