变应性鼻结膜炎的淋巴内免疫治疗：系统评价和荟萃分析。
Intralymphatic immunotherapy for allergic rhinoconjunctivitis: a systematic review and meta-analysis.
机构信息
Department of Otolaryngology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand; Endoscopic Nasal and Sinus Surgery Excellent Center, King Chulalongkorn Memorial Hospital, Bangkok, Thailand; Department of Otolaryngology, Hue University of Medicine and Pharmacy, Hue University, Vietnam.
Department of Otolaryngology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand; Endoscopic Nasal and Sinus Surgery Excellent Center, King Chulalongkorn Memorial Hospital, Bangkok, Thailand.
出版信息
Rhinology. 2021 Jun 1;59(3):236-244. doi: 10.4193/Rhin20.572.
BACKGROUND
Intralymphatic immunotherapy (ILIT) is a new route of allergen-specific immunotherapy. Data confirming its effect is restricted to a small number of studies.
METHODOLOGY
A systematic review with meta-analysis was conducted. The short-term (less than 24 weeks), medium-term (24-52 weeks), and long-term (more than 52 weeks) effects of ILIT in patients with allergic rhinoconjunctivitis (ARC) were assessed. The outcomes were combined symptom and medication scores (CSMS), symptoms visual analog scale (VAS), disease-specific quality of life (QOL), specific IgG4 level, specific IgE level, and adverse events.
RESULTS
Eleven randomized controlled trials and 2 cohorts (483 participants) were included. Compared with placebo, short term benefits of ILIT for seasonal ARC improved CSMS, improved VAS and increased specific IgG4 level but did not change QOL or specific IgE level. Medium-term effect improved VAS. Data on the long-term benefit of ILIT remain unavailable and require longer term follow-up studies. There were no clinical benefits of ILIT for perennial ARC. ILIT was safe and well-tolerated.
CONCLUSION
ILIT showed short-term benefits for seasonal ARC. The sustained effects of ILIT were inconclusive. It was well tolerated.
背景
局部免疫疗法（ILIT）是一种新的过敏原特异性免疫治疗途径。证实其疗效的数据仅限于少数研究。
方法
进行了系统评价和荟萃分析。评估了 ILIT 对过敏性鼻结膜炎（ARC）患者的短期（<24 周）、中期（24-52 周）和长期（>52 周）疗效。结局包括综合症状和药物评分（CSMS）、症状视觉模拟评分（VAS）、疾病特异性生活质量（QOL）、特异性 IgG4 水平、特异性 IgE 水平和不良反应。
结果
纳入了 11 项随机对照试验和 2 项队列研究（483 名参与者）。与安慰剂相比，季节性 ARC 的 ILIT 短期治疗可改善 CSMS、减轻 VAS 和提高特异性 IgG4 水平，但不改变 QOL 或特异性 IgE 水平。中期疗效可改善 VAS。ILIT 长期疗效的数据尚不可用，需要进行更长时间的随访研究。ILIT 对常年性 ARC 无临床获益。ILIT 安全且耐受良好。
结论
ILIT 对季节性 ARC 显示出短期疗效。ILIT 的持续疗效尚不确定。其耐受性良好。
Zotero 插件