Division of Allergy, Asthma and Clinical Immunology, Department of Medicine, Mayo Clinic Arizona, 13400 E. Shea Boulevard Scottsdale, AZ 85259, USA; Division of Allergy/Immunology, Phoenix Children's, 1919 E. Thomas Road, Phoenix, AZ 85054, USA.
Division of Allergy and Immunology, Children's Hospital of Philadelphia, 3401 Civic Center Boulevard, Philadelphia, PA 19104, USA.
Immunol Allergy Clin North Am. 2024 May;44(2):281-291. doi: 10.1016/j.iac.2024.01.001. Epub 2024 Feb 14.
Immunotherapy is a treatment approach based on the principle of incremental allergen exposure to achieve desensitization. Recently, oral immunotherapy has been introduced as a treatment of IgE-mediated food allergy. Some patients receiving oral immunotherapy for food allergy may develop eosinophilic esophagitis. Here, we summarize the literature examining this association, its treatment, and outcomes and discuss possible explanations for this clinical phenomenon. We further identify potential associations with aeroallergen sensitivity and other forms of immunotherapy including subcutaneous immunotherapy and sublingual immunotherapy. Finally, we discuss management of immunotherapy-induced eosinophilic esophagitis. Epicutaneous immunotherapy is highlighted as an area of therapeutic investigation.
免疫疗法是一种基于逐步过敏原暴露以实现脱敏的治疗方法。最近,口服免疫疗法已被引入作为 IgE 介导的食物过敏的治疗方法。一些接受食物过敏口服免疫治疗的患者可能会发展为嗜酸性食管炎。在这里,我们总结了检查这种关联的文献,包括其治疗和结果,并讨论了这种临床现象的可能解释。我们还进一步确定了与过敏原敏感性和其他形式的免疫疗法(包括皮下免疫疗法和舌下免疫疗法)的潜在关联。最后,我们讨论了免疫治疗引起的嗜酸性食管炎的治疗方法。经皮免疫疗法是治疗研究的重点。