Nakagome Kazuyuki, Nagata Makoto
Department of Respiratory Medicine, Saitama Medical University, Saitama 350-0495, Japan.
Allergy Center, Saitama Medical University, Saitama 350-0495, Japan.
Pathogens. 2021 Oct 29;10(11):1406. doi: 10.3390/pathogens10111406.
Allergen immunotherapy (AIT) is a specific treatment involving the administration of relevant allergens to allergic patients, with subtypes including subcutaneous immunotherapy (SCIT) and sublingual immunotherapy (SLIT). In asthma, AIT using the house dust mite (HDM) alleviates clinical symptoms and decreases airway hyper responsiveness and medication dose. In addition, AIT can improve the natural course of asthma. For example, the effects of AIT can be preserved for at least a few years, even after ending treatment. AIT may increase the remission rate of asthma in children and suppress sensitization to new allergens. If AIT is introduced in pollinosis, AIT may prevent the development of asthma. Moreover, AIT can control other allergic diseases complicated by asthma, such as allergic rhinitis, which also improves the control of asthma. The indication of HDM-SCIT for asthma is mild-to-moderate HDM-sensitized allergic asthma in a patient with normal respiratory function. To date, HDM-SLIT is applicable in Japan for allergic rhinitis, not for asthma. However, the effect of SLIT on asthma has been confirmed internationally, and SLIT is available for asthma in Japan if allergic rhinitis is present as a complication.
变应原免疫疗法(AIT)是一种针对过敏患者给予相关变应原的特异性治疗方法,其亚型包括皮下免疫疗法(SCIT)和舌下免疫疗法(SLIT)。在哮喘治疗中,使用屋尘螨(HDM)进行的AIT可缓解临床症状,降低气道高反应性并减少药物剂量。此外,AIT可以改善哮喘的自然病程。例如,即使在治疗结束后,AIT的效果也可以维持至少几年。AIT可能会提高儿童哮喘的缓解率,并抑制对新变应原的致敏。如果在花粉症中采用AIT,可能会预防哮喘的发生。此外,AIT可以控制合并哮喘的其他过敏性疾病,如过敏性鼻炎,这也有助于改善哮喘的控制情况。HDM-SCIT治疗哮喘的适应证为呼吸功能正常的轻至中度HDM致敏性过敏性哮喘患者。目前在日本,HDM-SLIT适用于过敏性鼻炎,不适用于哮喘。然而,SLIT对哮喘的疗效已在国际上得到证实,在日本,如果合并过敏性鼻炎,SLIT也可用于哮喘治疗。