特异性口服免疫耐受治疗食物过敏的研究进展

Specific oral tolerance induction for the treatment of food allergy

儿童食物过敏(food allergy,FA)发病率有逐年增高趋势,双盲安慰剂激发试验是诊断食物过敏的金标准,回避不适宜食物是目前治疗食物过敏的标准方法.但严格的食物回避依从性较差,可能导致营养不良,长期饮食回避可增加意外摄入时产生严重过敏反应的风险.特异性口服免疫耐受(specific oral tolerance induction,SOTI)通过口服使患者过敏的蛋白抗原,刺激机体形成对该抗原无应答状态,是治疗食物过敏的新方向.由于缺乏双盲安慰剂激发试验,其有效性、安全性以及经济效益仍受到置疑.本文通过对特异性口服免疫耐受的方法、机制以及与传统治疗方法相比较,探讨其临床应用可能性.

The morbidity of food allergy in children has a tendency to increase these years. Double-blind placebo-controlled food challenge （DBPCFC） is the gold standard for the diagnosis of food allergy, and the standard treatment for food allergy is strict food avoidance. However, longtime strict food avoidance is difficult in everyday life, and may lead to malnutrition and even can increase the risk for developing severe anaphylaxis after accidental ingestion. Specific oral tolerance induction （SOTI） is a new and possible way to treat food allergy, which is performed by limited ingestion of the allergen to make the body become unresponsive to it. However, the effectiveness, safety and economic benefit are still controversial, because of the deficiency of DBPCFC. Our paper will introduce the methods and mechanism of SOTI, compare it with traditional treatments for food allergy, and discuss the possibility of clinical use of SOTI.