Suko M, Mori A, Ito K, Okudaira H
Department of Medicine and Physical Therapy, Faculty of Medicine, University of Tokyo, Japan.
Int Arch Allergy Immunol. 1995 May-Jun;107(1-3):278-81. doi: 10.1159/000237002.
Recently, the induction of T cell anergy has been considered as a sophisticated form of immunotherapy. However, the multiplicity of T cell allergen epitopes discourages the practical use of this method. Since orally administered antigen proteins are digested to peptides and absorbed into the circulation, oral administration of antigen might be an apparently primitive but practically very useful therapeutic approach. Freeze-dried body extract of Dermatophagoides farinae mite in tight capsules was orally administered at 0.5-3 mg/day to 17 adult male mite-sensitive asthmatic patients for 12 weeks. Marked and moderate improvement of clinical symptoms judged by symptom scores and peak expiratory flow was observed in 47% (8/17) of the patients. Bronchial provocation tests carried out before and after oral immunotherapy showed a statistically significant improvement especially in the late asthmatic response. The peripheral blood eosinophil count decreased significantly after oral immunotherapy. Interleukin-5 spontaneously produced by patient peripheral mononuclear cells decreased significantly (p < 0.05) after the oral immunotherapy. These results suggest that T cell anergy might be achieved by oral immunotherapy.
最近，T细胞无能的诱导已被视为一种复杂的免疫治疗形式。然而，T细胞过敏原表位的多样性阻碍了该方法的实际应用。由于口服的抗原蛋白会被消化成肽并吸收进入循环系统，口服抗原可能是一种看似原始但实际上非常有用的治疗方法。将冻干的粉尘螨虫体提取物装入硬胶囊中，以0.5 - 3毫克/天的剂量口服给予17名成年男性螨敏感哮喘患者，持续12周。通过症状评分和呼气峰值流速判断，47%（8/17）的患者临床症状有显著和中度改善。口服免疫治疗前后进行的支气管激发试验显示有统计学意义的改善，尤其是在迟发性哮喘反应方面。口服免疫治疗后外周血嗜酸性粒细胞计数显著下降。口服免疫治疗后患者外周单核细胞自发产生的白细胞介素-5显著下降（p < 0.05）。这些结果表明，口服免疫治疗可能实现T细胞无能。
