Department of Pharmaceutics, Amrita School of Pharmacy, Amrita Institute of Medical Science (AIMS) Health Science Campus, Amrita Vishwa Vidyapeetham, Kochi, India.
Department of Pharmaceutics, Unaiza College of Pharmacy, Qassim University, Burayda, Al Qassim, Saudi Arabia.
Front Immunol. 2023 Sep 8;14:1229667. doi: 10.3389/fimmu.2023.1229667. eCollection 2023.
The increasing prevalence of food allergies worldwide and the subsequent life-threatening anaphylactic reactions often have sparse treatment options, providing only symptomatic relief. Great strides have been made in research and in clinics in recent years to offer novel therapies for the treatment of allergic disorders. However, current allergen immunotherapy has its own shortcomings in terms of long-term efficacy and safety, due to the local side effects and the possibility of anaphylaxis. Allergen-specific immunotherapy is an established therapy in treating allergic asthma, allergic rhinitis, and allergic conjunctivitis. It acts through the downregulation of T cell, and IgE-mediated reactions, as well as desensitization, a process of food tolerance without any allergic events. This would result in a protective reaction that lasts for approximately 3 years, even after the withdrawal of therapy. Furthermore, allergen-specific immunotherapy also exploits several routes such as oral, sublingual, and epicutaneous immunotherapy. As the safety and efficacy of allergen immunotherapy are still under research, the exploration of newer routes such as intra-lymphatic immunotherapy would address unfulfilled needs. In addition, the existence of nanoparticles can be exploited immensely in allergen immunotherapy, which would lead to safer and efficacious therapy. This manuscript highlights a novel drug delivery method for allergen-specific immunotherapy that involves the administration of specific allergens to the patients in gradual increasing doses, to induce desensitization and tolerance, as well as emphasizing different routes of administration, mechanism, and the application of nanoparticles in allergen-specific immunotherapy.
全球范围内食物过敏的患病率不断增加,随之而来的危及生命的过敏性休克反应往往治疗选择有限,只能提供对症缓解。近年来,在研究和临床方面都取得了巨大进展,为治疗过敏性疾病提供了新的治疗方法。然而,由于局部副作用和发生过敏反应的可能性,目前的过敏原免疫疗法在长期疗效和安全性方面存在自身的缺陷。过敏原特异性免疫疗法是治疗过敏性哮喘、过敏性鼻炎和过敏性结膜炎的既定疗法。它通过下调 T 细胞和 IgE 介导的反应以及脱敏起作用,脱敏是一种无任何过敏事件的食物耐受过程。这将导致大约 3 年的保护反应,即使在停止治疗后也是如此。此外,过敏原特异性免疫疗法还利用了口服、舌下和经皮免疫疗法等多种途径。由于过敏原免疫疗法的安全性和疗效仍在研究中,因此探索新的途径,如淋巴内免疫疗法,将可以满足未满足的需求。此外,纳米颗粒在过敏原免疫疗法中的应用也具有巨大的潜力,这将导致更安全和有效的治疗。本文强调了一种过敏原特异性免疫疗法的新型药物输送方法,该方法涉及以逐渐增加的剂量向患者给予特定过敏原,以诱导脱敏和耐受,以及强调不同的给药途径、机制以及纳米颗粒在过敏原特异性免疫疗法中的应用。