Rahman Rifat S, Wesemann Duane R
Harvard Medical School, Boston, MA, USA.
Department of Medicine, Division of Allergy and Clinical Immunology, Division of Genetics, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
Immunother Adv. 2022 Nov 25;2(1):ltac022. doi: 10.1093/immadv/ltac022. eCollection 2022.
Allergen immunotherapy (AIT) is the only disease-modifying therapy for allergic disease. Through repeated inoculations of low doses of allergen-either as whole proteins or peptides-patients can achieve a homeostatic balance between inflammatory effectors induced and/or associated with allergen contact, and mediators of immunologic non-responsiveness, potentially leading to sustained clinical improvements. AIT for airborne/respiratory tract allergens and insect venoms have traditionally been supplied subcutaneously, but other routes and modalities of administration can also be effective. Despite differences of allergen administration, there are some similarities of immunologic responses across platforms, with a general theme involving the restructuring and polarization of adaptive and innate immune effector cells. Here we review the immunology of AIT across various delivery platforms, including subcutaneous, sublingual, epicutaneous, intradermal, and intralymphatic approaches, emphasizing shared mechanisms associated with achieving immunologic non-responsiveness to allergen.
变应原免疫疗法（AIT）是唯一一种可改变过敏性疾病病情的疗法。通过反复接种低剂量变应原（全蛋白或肽），患者能够在变应原接触所诱导和/或相关的炎症效应细胞与免疫无反应性介质之间实现稳态平衡，这可能会带来持续的临床改善。传统上，针对空气传播/呼吸道变应原和昆虫毒液的AIT是通过皮下给药，但其他给药途径和方式也可能有效。尽管变应原给药方式存在差异，但各平台的免疫反应存在一些相似之处，其共同主题涉及适应性和先天性免疫效应细胞的重组和极化。在此，我们综述了包括皮下、舌下、皮内、皮上和淋巴内途径在内的各种给药平台的AIT免疫学，重点强调与实现对变应原免疫无反应性相关的共同机制。
