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皮下、舌下和口服变应原免疫疗法的疗效:一项比较研究。

Efficacy of Subcutaneous, Sublingual and Oral Immunotherapy for Allergens: A Comparative Study.

作者信息

Lisiecka Maria Zofia

机构信息

Department of Allergology, National Medical Institute of the Ministry of the Interior and Administration, Warsaw, Poland.

出版信息

Immunology. 2025 Apr;174(4):423-433. doi: 10.1111/imm.13898. Epub 2025 Jan 12.

Abstract

The purpose of this study was to compare the efficacy and safety of subcutaneous, sublingual, oral specific immunotherapy in patients who suffer from allergic conditions to pollen from trees, grasses and weeds, house dust mites and Alternaria alternata spores. A literature search was performed separately for each type of allergen and each administration route of the drug. As a result, it was found that all administration routes were quite effective. However, each type of immunotherapy was most effective for certain allergens. Subcutaneous and sublingual immunotherapy have proven effective for aeroallergens such as pollen from grass, trees, weeds and house dust mites. Despite this, subcutaneous immunotherapy had a number of disadvantages in the form of the duration of treatment and a greater prevalence of side effects. Some authors suggest that for allergies to house dust mites, the most effective method of immunotherapy was the subcutaneous method of administration, compared with sublingual and nasal. Sublingual therapy was safe enough for all types of allergens under study, however, to achieve the same effect as the subcutaneous method of administration. In addition, oral immunotherapy has been shown to be effective for food allergies with obvious symptoms of gastrointestinal disorders. In addition, oral immunotherapy is the only approved treatment for allergies in the elderly, due to the low risk of side effects. The time-accelerated and dosage-enhanced immunotherapy was also effective and safe. These data prove the effectiveness and safety of each administration route of specific allergens for specific immunotherapy in patients suffering from allergic rhinitis, bronchial asthma and even atopic dermatitis.

摘要

本研究的目的是比较皮下、舌下、口服特异性免疫疗法在对树木、草类、杂草的花粉、屋尘螨和链格孢菌孢子过敏的患者中的疗效和安全性。针对每种过敏原和药物的每种给药途径分别进行了文献检索。结果发现,所有给药途径都相当有效。然而,每种免疫疗法对某些过敏原最为有效。皮下和舌下免疫疗法已被证明对草、树、杂草的花粉和屋尘螨等气传过敏原有效。尽管如此,皮下免疫疗法在治疗持续时间和副作用发生率方面存在一些缺点。一些作者认为,对于屋尘螨过敏,与舌下和鼻腔给药相比,最有效的免疫疗法是皮下给药方法。舌下疗法对所有研究类型的过敏原都足够安全,然而,要达到与皮下给药方法相同的效果。此外,口服免疫疗法已被证明对有明显胃肠道紊乱症状的食物过敏有效。此外,由于副作用风险低,口服免疫疗法是老年人过敏的唯一获批治疗方法。时间加速和剂量增强的免疫疗法也有效且安全。这些数据证明了特异性过敏原的每种给药途径在患有过敏性鼻炎、支气管哮喘甚至特应性皮炎的患者中进行特异性免疫疗法的有效性和安全性。

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