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口服免疫疗法治疗卵清蛋白 IgE 介导反应患者:一项临床试验研究。

Oral Immunotherapy in Patients with IgE Mediated Reactions to Egg White: A Clinical Trial Study.

机构信息

Asthma and Allergy Center, Tehran Medical Sciences Branch of Academic Center for Education, Culture and Research (ACECR), Tehran, Iran.

Department of Allergy and Clinical Immunology, Rasool-e-Akram Hospital, Iran University of Medical Sciences, Tehran, Iran.

出版信息

Immunol Invest. 2022 Apr;51(3):630-643. doi: 10.1080/08820139.2020.1863979. Epub 2021 Jul 26.

Abstract

BACKGROUND

Oral immunotherapy (OIT) is under consideration as a promising treatment for desensitization of egg-allergic patients. The objective of this study was to assess the effectiveness of egg-white OIT in patients with IgE-mediated allergy to egg white and to compare the clinical and laboratory findings before and after OIT.

METHODS

This clinical trial was performed from February to August 2018 in Rasool e Akram Hospital, Tehran, Iran. Patients' selection criteria included a history of allergic symptoms, skin prick test (SPT) reactivity to egg white, and the inability to pass the Oral Food Challenge (OFC). Egg-white OIT was done for eight patients in the OIT group for 6 months while egg-white-free products were administrated for controls. The SPT reactivity, specific IgE, and IgG4 for egg white and ovomucoid were evaluated before and after OIT.

RESULTS

Hundred percent of the subjects in OIT group were desensitized and tolerated 40 cc raw egg white following 6-month maintenance whereas none of the controls was able to pass the OFC. The findings obtained from the evaluations indicated a significant decrease in the wheal size and specific IgE to egg white after OIT ( = .001). Furthermore, a significant decrease of IgE/IgG4 ratio to egg white was found in OIT group ( = .01).

CONCLUSION

This OIT protocol was successful as all OIT patients were able to continue 6-month OIT process and the reaction threshold to egg white increased in the OIT group. Therefore, it could be regarded as an effective and safe protocol to treat egg-allergic patients.

摘要

背景

口服免疫疗法(OIT)被认为是一种有前途的脱敏治疗方法,适用于对蛋清过敏的患者。本研究的目的是评估蛋清 OIT 对蛋清 IgE 介导过敏患者的有效性,并比较 OIT 前后的临床和实验室发现。

方法

本临床试验于 2018 年 2 月至 8 月在伊朗德黑兰的 Rasool e Akram 医院进行。患者的入选标准包括过敏症状史、蛋清皮肤点刺试验(SPT)反应性和无法通过口服食物挑战(OFC)。OIT 组的 8 名患者接受了蛋清 OIT 治疗 6 个月,而对照组则给予不含蛋清的产品。在 OIT 前后评估了蛋清和卵类黏蛋白的 SPT 反应性、特异性 IgE 和 IgG4。

结果

OIT 组的所有受试者均脱敏,并在 6 个月的维持治疗后耐受 40 毫升生蛋清,而对照组无一例能通过 OFC。OIT 后,评估结果显示蛋清的风团大小和特异性 IgE 显著降低( = 0.001)。此外,OIT 组的 IgE/IgG4 比值也显著降低( = 0.01)。

结论

该 OIT 方案是成功的,因为所有 OIT 患者都能够继续进行 6 个月的 OIT 过程,并且 OIT 组对蛋清的反应阈值增加。因此,它可以被认为是一种治疗鸡蛋过敏患者的有效和安全的方案。

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