Washio Y, Ohashi Y, Tanaka A, Kakinoki Y, Sugiura Y, Sakamoto H, Yamada K, Matsuda M, Uekawa M, Okamoto H, Nakai Y
Department of Otolaryngology, Osaka City University Medical School, Japan.
Acta Otolaryngol Suppl. 1998;538:126-32.
Suplatast tosilate can inhibit IL-4 production and suppress IgE synthesis in vitro. However, the theory that the agent causes changes in production of IL-4 and IgE in vivo has little experimental support. Immunotherapy could decrease the specific IgE response, but such a favourable effect is only possible with prolonged therapy after an initial increase in specific IgE. The use of suplatast tosilate together with immunotherapy may blunt the initial rise in specific IgE and decrease serum levels of specific IgE more quickly. Eighty-three adult patients with perennial allergic rhinitis due to Dermatophagoides farinae (D. farinae) were treated for 6 months with one of 3 treatments. Seventeen patients were treated with oral administration of 300 mg/day suplatast tosilate alone. Forty-six patients were treated with immunotherapy using standardized D. farinae alone. Twenty patients were treated with immunotherapy together with concurrent oral administration of 300 mg/day suplatast tosilate. Serum samples were collected 3 times from each patient, at enrollment, at 3 months and at 6 months after enrollment. Oral administration of suplatast tosilate for 3 and 6 months significantly decreased serum levels of IL-4 and specific IgE, and the rate of decrease in specific IgE correlated significantly with the rate of decrease in IL-4. The rates of decrease in IL-4 and specific IgE at 3 and 6 months were significantly greater in the patients treated with suplatast tosilate and immunotherapy than in those treated with immunotherapy alone. In conclusion, suplatast tosilate is able significantly to decrease serum levels of IL-4 and specific IgE, and the use of the drug together with immunotherapy can blunt the initial increase in specific IgE during the first 6 months of immunotherapy.
甲苯磺酸舒普拉泰在体外可抑制白细胞介素-4（IL-4）的产生并抑制免疫球蛋白E（IgE）的合成。然而，关于该药物在体内引起IL-4和IgE产生变化的理论几乎没有实验依据。免疫疗法可降低特异性IgE反应，但这种良好效果只有在特异性IgE最初升高后进行长期治疗才有可能实现。甲苯磺酸舒普拉泰与免疫疗法联合使用可能会抑制特异性IgE的最初升高，并更快地降低特异性IgE的血清水平。83例因粉尘螨引起的常年性变应性鼻炎成年患者接受了3种治疗方法之一的治疗，为期6个月。17例患者单独口服每日300毫克甲苯磺酸舒普拉泰。46例患者单独使用标准化粉尘螨进行免疫疗法。20例患者在接受免疫疗法的同时口服每日300毫克甲苯磺酸舒普拉泰。从每位患者身上在入组时、入组后3个月和6个月采集3次血清样本。口服甲苯磺酸舒普拉泰3个月和6个月可显著降低血清IL-4和特异性IgE水平，特异性IgE的降低率与IL-4的降低率显著相关。在接受甲苯磺酸舒普拉泰与免疫疗法联合治疗的患者中，3个月和6个月时IL-4和特异性IgE的降低率显著高于单独接受免疫疗法的患者。总之，甲苯磺酸舒普拉泰能够显著降低血清IL-4和特异性IgE水平，该药物与免疫疗法联合使用可抑制免疫疗法前6个月内特异性IgE的最初升高。
