Mary H. Weiser Food Allergy Center, University of Michigan, Ann Arbor, MI, United States.
Mary H. Weiser Food Allergy Center, University of Michigan, Ann Arbor, MI, United States.
Adv Pharmacol. 2021;91:229-258. doi: 10.1016/bs.apha.2021.01.003. Epub 2021 Mar 4.
Food allergy is a growing public health epidemic with few available treatments beyond allergen avoidance and rescue medications for accidental exposures. A major focus of therapeutic development for food allergies is allergen-specific immunotherapy (AIT) in which patients are exposed to increasing amounts of allergen in controlled dosing to induce desensitization or tolerance. The work of the past few decades has culminated in the recent FDA approval of a peanut product for oral AIT for peanut allergies. Despite these advances, current AIT protocols are cumbersome, take a long time to reach clinical benefit and often have significant side effects. Therefore, there is a great need to develop new therapeutics for food allergy. One area of research aims to improve AIT through the use of adjuvants which are substances traditionally added to vaccines to stimulate or direct a specific immune response. Adjuvants that induce Th1-polarized and regulatory immune responses while suppressing Th2 immunity have shown the most promise in animal models. The addition of adjuvants to AIT may reduce the amount and frequency of allergen required to achieve clinical benefit and may induce more long-lasting immune responses. In this chapter, we highlight examples of adjuvanted AIT and vaccines in development to treat food allergies.
食物过敏是一种日益严重的公共卫生问题，除了避免过敏原和意外暴露时使用急救药物外，几乎没有其他治疗方法。食物过敏治疗的一个主要重点是过敏原特异性免疫疗法（AIT），通过在受控剂量下逐渐暴露于过敏原来诱导脱敏或耐受。过去几十年的工作最终促成了 FDA 最近批准一种花生产品用于口服 AIT 治疗花生过敏。尽管取得了这些进展，但目前的 AIT 方案繁琐，需要很长时间才能达到临床效果，并且经常有严重的副作用。因此，非常有必要开发新的食物过敏疗法。研究的一个领域旨在通过使用佐剂来改善 AIT，佐剂是传统上添加到疫苗中以刺激或指导特定免疫反应的物质。在动物模型中，诱导 Th1 极化和调节性免疫反应同时抑制 Th2 免疫的佐剂显示出最大的希望。在 AIT 中添加佐剂可能会减少达到临床效果所需的过敏原的量和频率，并可能诱导更持久的免疫反应。在本章中，我们重点介绍了正在开发用于治疗食物过敏的佐剂 AIT 和疫苗的例子。
