Sun Z H, Gao Z H, Xue J M, Wang X S, Song M T
Shanxi Medical University, Taiyuan, 030001, China.
Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2019 Apr;33(4):332-336. doi: 10.13201/j.issn.1001-1781.2019.04.011.
The study aimed to investigate the efficacy of sublingual immunotherapy(SLIT) in treatment of adult allergic rhinitis, and to explore the predictive role of baseline serum cytokine levels in its therapeutic effect.Sixty patients with moderatesevere perennial AR sensitized with house dust mites were treated for 2 years. The SLIT group(n=30) were treated with standardized dust mite vaccine SLIT and conventional drugs, and the control group(n=30) were treated with placebo and conventional drugs. The combined symptom and medication score(CSMS) were compared between the two groups to evaluate the efficacy at baseline and 2 year endpoint. According to therapeutic effect, the SLIT group and the control group were divided into subgroups respectively, and the baseline IFN-γ and IL4, IL10, IL17 levels were compared between the effective group and the ineffective group in each group. The ROC curve was drawn to find the best predictive index and the best cut-off value was calculated. ①There was no significant difference between the SLIT group and the control group at baseline CSMS(>0.05). There was significant difference between the two groups at 2year endpoint CSMS(<0.05). ②In the SLIT group, there was no significant difference between the effective group and the ineffective group with the IFN-γ and IL17(>0.05). The IL4 level in the effective group was significantly higher than the ineffective group while the IL10 level was significantly lower(<0.05). In the control group, there were no significant differences in the levels of IFN-γ, IL4, IL10 and IL17 between the two subgroups(>0.05). ③Baseline IL4/IL10 has higher predictive value than IL4 and IL10 alone. The best cut-off value is 2.04, and the sensitivity and specificity of predictive value were 72.7% and 73.7% respectively. SLIT combined with conventional drug therapy is more effective than conventional drug therapy alone. IL4/IL10 has a better predictive role in SLIT effect than IL4 or IL10 alone. The higher the ratio, the better therapeutic effect is.
该研究旨在探讨舌下免疫疗法（SLIT）治疗成人变应性鼻炎的疗效，并探讨基线血清细胞因子水平对其治疗效果的预测作用。60例对屋尘螨致敏的中重度常年性变应性鼻炎患者接受了2年的治疗。SLIT组（n = 30）采用标准化尘螨疫苗SLIT和常规药物治疗，对照组（n = 30）采用安慰剂和常规药物治疗。比较两组的联合症状和用药评分（CSMS），以评估基线和2年终点时的疗效。根据治疗效果，将SLIT组和对照组分别分为亚组，比较每组有效组和无效组的基线IFN-γ以及IL4、IL10、IL17水平。绘制ROC曲线以找到最佳预测指标并计算最佳截断值。①SLIT组和对照组在基线CSMS时无显著差异（>0.05）。两组在2年终点CSMS时有显著差异（<0.05）。②在SLIT组中，有效组和无效组的IFN-γ和IL17无显著差异（>0.05）。有效组的IL4水平显著高于无效组，而IL10水平显著低于无效组（<0.05）。在对照组中，两个亚组之间的IFN-γ、IL4、IL10和IL17水平无显著差异（>0.05）。③基线IL4/IL10的预测价值高于单独的IL4和IL10。最佳截断值为2.04，预测价值的敏感性和特异性分别为72.7%和73.7%。SLIT联合常规药物治疗比单纯常规药物治疗更有效。IL4/IL10对SLIT效果的预测作用比单独的IL4或IL10更好。该比值越高，治疗效果越好。
