Atipas Kawita, Kanjanawasee Dichapong, Tantilipikorn Pongsakorn
Division of Rhinology and Allergy, Department of Otorhinolaryngology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand.
Center of Research Excellence in Allergy & Immunology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand.
J Pers Med. 2022 Aug 21;12(8):1341. doi: 10.3390/jpm12081341.
Allergic rhinitis (AR) is an immunoglobulin E (IgE)-mediated inflammatory disease that is induced by allergen introduction to the nasal mucosa, which triggers an inflammatory response. The current treatments for AR include allergen avoidance and pharmacotherapy; however, allergen-specific immunotherapy (AIT) is the only treatment that can be employed to modify immunologic responses and to achieve a cure for allergic diseases. The current standard routes of AIT administration are the subcutaneous and sublingual routes. Alternatively, the dermis contains a high density of dermal dendritic cells that act as antigen-presenting cells, so intradermal administration may confer added advantages and increase the efficacy of AIT. Moreover, intradermal immunotherapy (IDIT) may facilitate a reduction in the allergen dosage and a shortening of the treatment duration. The aim of this review was to search and evaluate the current evidence specific to IDIT, including its modified formulations, such as allergoids and peptides. The results of this review reveal conflicting evidence that suggests that the overall benefit of IDIT remains unclear. As such, further clinical trials are needed to establish the clinical utility of IDIT, and to determine the optimal treatment-related protocols.
变应性鼻炎（AR）是一种由免疫球蛋白E（IgE）介导的炎症性疾病，由变应原进入鼻黏膜引发炎症反应所致。目前AR的治疗方法包括避免接触变应原和药物治疗；然而，变应原特异性免疫疗法（AIT）是唯一可用于改变免疫反应并治愈变应性疾病的治疗方法。目前AIT的标准给药途径是皮下和舌下途径。另外，真皮含有高密度的真皮树突状细胞，可作为抗原呈递细胞，因此皮内给药可能具有额外优势并提高AIT的疗效。此外，皮内免疫疗法（IDIT）可能有助于减少变应原剂量并缩短治疗时间。本综述的目的是检索和评估目前关于IDIT的具体证据，包括其改良制剂，如变应原提取物和肽。本综述结果显示存在相互矛盾的证据，表明IDIT的总体益处仍不明确。因此，需要进一步的临床试验来确立IDIT的临床实用性，并确定最佳的治疗相关方案。
