舌下免疫疗法治疗小儿过敏性鼻炎的疗效及免疫学变化
Efficacy and immunological changes of sublingual immunotherapy in pediatric allergic rhinitis.
作者信息
Zeng Yinhui, Xiao Haiqing, Gao Shengli, Li Jinyuan, Yang Chao, Zeng Qingxiang, Luo Xi, Luo Renzhong, Chen Xi, Liu Wenlong
机构信息
Department of Otolaryngology, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangdong Provincial Clinical Research Center for Child Health, Guangzhou, 510623, China.
Department of Anesthesiology, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangdong Provincial Clinical Research Center for Child Health, Guangzhou, 510623, China.
出版信息
World Allergy Organ J. 2023 Jul 23;16(7):100803. doi: 10.1016/j.waojou.2023.100803. eCollection 2023 Jul.
BACKGROUND
Allergen-specific immunotherapy, including subcutaneous immunotherapy (SCIT) and sublingual immunotherapy (SLIT), improves the disease progression of allergic rhinitis (AR). SCIT and SLIT exhibit similar efficacy, but SLIT has less systemic reactions. However, few studies have investigated the underlying mechanisms of SLIT treatment. In this study, we explored the efficacy of SLIT under different treatment durations and immunological changes.
METHODS
This retrospective study was conducted from August 2017 to August 2022 in our hospital. A total of 314 children who underwent SLIT were divided into the following groups based on their treatment duration: the 1 year group (6 months-1 year), the 2 years group (1-2 years), and the 3 years group (2-3 years). The treatment efficacy was confirmed using a combined symptom and medication score (SMS). Multiple serum cytokines were measured using Luminex. Various immune cells in PBMCs were determined using flow cytometry.
RESULTS
The total nasal symptom score (TNSS), rescue medication score (RMS), and SMS of the 3 years group was significantly different from those of the 1 years and 2 years groups. At the end of the 2 years following cessation of SLIT, the following results were observed in the 3 years group: 1) the TNSS, RMS, and SMS had significantly improved, 2) the serum IL-10, TGF-beta, and IL-35 levels had increased significantly, and 3) the percentages of regulatory T cell, regulatory B cell, and follicular regulatory T cell increased significantly.
CONCLUSION
Our results suggest that 3 years of SLIT is necessary for long-term effects and continued immunological changes.
背景
变应原特异性免疫疗法，包括皮下免疫疗法（SCIT）和舌下免疫疗法（SLIT），可改善过敏性鼻炎（AR）的疾病进展。SCIT和SLIT疗效相似，但SLIT的全身反应较少。然而，很少有研究探讨SLIT治疗的潜在机制。在本研究中，我们探讨了不同治疗持续时间下SLIT的疗效及免疫学变化。
方法
本回顾性研究于2017年8月至2022年8月在我院进行。共有314例接受SLIT治疗的儿童根据治疗持续时间分为以下几组：1年组（6个月至1年）、2年组（1至2年）和3年组（2至3年）。使用症状和药物综合评分（SMS）确认治疗效果。使用Luminex检测多种血清细胞因子。使用流式细胞术测定外周血单个核细胞（PBMC）中的各种免疫细胞。
结果
3年组的总鼻症状评分（TNSS）、急救药物评分（RMS）和SMS与1年组和2年组有显著差异。在停止SLIT治疗2年后，3年组出现以下结果：1）TNSS、RMS和SMS显著改善；2）血清白细胞介素-10（IL-10）、转化生长因子-β（TGF-β）和IL-35水平显著升高；3）调节性T细胞、调节性B细胞和滤泡调节性T细胞的百分比显著增加。
结论
我们的结果表明，3年的SLIT治疗对于长期疗效和持续的免疫学变化是必要的。
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