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食物过敏的治疗:口服免疫疗法、生物制剂及其他方法。

Treatment of food allergy: Oral immunotherapy, biologics, and beyond.

机构信息

Department of Medicine, Sean N. Parker Center for Allergy and Asthma Research at Stanford University, Stanford, California.

Department of Medicine, Sean N. Parker Center for Allergy and Asthma Research at Stanford University, Stanford, California.

出版信息

Ann Allergy Asthma Immunol. 2023 Jul;131(1):29-36. doi: 10.1016/j.anai.2023.04.023. Epub 2023 Apr 25.

Abstract

The prevalence of food allergy (FA) has been increasing globally and comes with a heavy burden not just economically, but also on quality of life. Although oral immunotherapy (OIT) is effective at inducing desensitization to food allergens, it has several limitations that weaken its success. Limitations include a long duration of build-up, especially when used for multiple allergens, and a high rate of reported adverse events. Furthermore, OIT may not be effective in all patients. Efforts are underway to identify additional treatment options, either as monotherapy or in combination, to treat FA or enhance the safety and efficacy of OIT. Biologics such as omalizumab and dupilumab, which already have US Food and Drug Administration approval for other atopic conditions have been the most studied, but additional biologics and novel strategies are emerging. In this review, we discuss therapeutic strategies including immunoglobulin E inhibitors, immunoglobulin E disruptors, interleukin-4 and interleukin-13 inhibitors, antialarmins, JAK1 and BTK inhibitors, and nanoparticles, and the data surrounding their application in FA and highlighting their potential.

摘要

食物过敏(FA)的患病率在全球范围内呈上升趋势,不仅给经济带来了沉重负担,还给生活质量带来了沉重负担。虽然口服免疫疗法(OIT)能有效地诱导食物过敏原脱敏,但它有几个限制,削弱了它的成功。限制包括建立时间长,尤其是当用于多种过敏原时,以及报告的不良事件发生率高。此外,OIT 可能并不适用于所有患者。目前正在努力寻找其他治疗选择,无论是单独使用还是联合使用,以治疗 FA 或增强 OIT 的安全性和疗效。已经有生物制剂如omalizumab 和 dupilumab 获得了美国食品和药物管理局(FDA)批准用于其他特应性疾病,这些药物已经得到了最多的研究,但其他生物制剂和新策略也在不断涌现。在这篇综述中,我们讨论了治疗策略,包括免疫球蛋白 E 抑制剂、免疫球蛋白 E 破坏剂、白细胞介素-4 和白细胞介素-13 抑制剂、抗警报素、JAK1 和 BTK 抑制剂以及纳米颗粒,并围绕它们在 FA 中的应用及其潜在应用的数据进行了讨论。

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