Kim Chang-Keun, Compalati Enrico, Callaway Zak
Asthma & Allergy Center, Inje University Sanggye Paik Hospital, Seoul, Korea.
Casa di Cura Villa Serena, GVM Care & Research, Genoa, Italy.
Asia Pac Allergy. 2025 Jun;15(2):104-114. doi: 10.5415/apallergy.0000000000000203. Epub 2025 Jun 2.
Allergen immunotherapy (AIT) is an evidence-based therapy for allergic rhinitis and allergic asthma. AIT is largely recognized as the only causal treatment of allergic diseases that targets the underlying pathophysiology and may have a disease-modifying effect in addition to the antisymptomatic effect. Carbamylated monomeric allergoids (CMAs) are chemically modified allergens with reduced IgE-binding activity (reduced allergenicity) but full immunogenicity. The carbamylation process allows them to be much smaller than other modified allergens, making them ideal for sublingual immunotherapy (SLIT), and reduced allergenicity makes them safe and well tolerated. CMAs have several advantages over other SLIT products: smaller size for easier absorption through mucosa, greater resistance to proteolytic degradation, greater bioavailability, and reduced allergenicity with full immunogenicity. The tablet form allows for accurate dosing and compliance is easy to monitor. Safety is an especially important consideration when treating conditions in pediatric populations, as is patient compliance. This review focused on the efficacy, safety, and clinical application of monomeric allergoid SLIT for allergic disease in children and its suitability as an alternative to subcutaneous immunotherapy.
变应原免疫疗法（AIT）是一种针对变应性鼻炎和变应性哮喘的循证疗法。AIT在很大程度上被认为是唯一针对潜在病理生理学的变应性疾病的病因治疗方法，除了具有抗症状作用外，还可能具有疾病修饰作用。氨甲酰化单体变应原制剂（CMA）是化学修饰的变应原，其IgE结合活性降低（变应原性降低）但免疫原性完整。氨甲酰化过程使它们比其他修饰的变应原小得多，使其成为舌下免疫疗法（SLIT）的理想选择，变应原性降低使其安全且耐受性良好。与其他SLIT产品相比，CMA具有几个优点：尺寸更小，便于通过粘膜吸收；对蛋白水解降解的抵抗力更强；生物利用度更高；变应原性降低但免疫原性完整。片剂形式便于精确给药，且易于监测依从性。在治疗儿科人群的疾病时，安全性是一个特别重要的考虑因素，患者依从性也是如此。本综述重点关注单体变应原制剂SLIT治疗儿童变应性疾病的疗效、安全性和临床应用，以及其作为皮下免疫疗法替代方案的适用性。
