过敏性鼻炎特异性免疫治疗的几个临床问题

Specific Immunotherapy for Allergic Rhinitis:a discussion of the clinical questions

过敏性鼻炎是IgE介导的鼻黏膜变态反应性炎症性疾病,其主要症状为鼻塞、鼻痒、打喷嚏和清水样涕。最常见的致病因素是吸入性过敏原(也称气传过敏原),如花粉、尘螨、动物皮屑、霉菌和蟑螂等。防治原则包括环境控制、药物治疗、免疫治疗和患者教育。过敏原特异性免疫治疗在临床应用迄今已有100多年历史,是目前唯一有可能通过免疫调节机制改变变态反应性疾病自然进程的治疗方式,因而备受重视。本文对过敏性鼻炎特异性免疫治疗的几个临床问题展开讨论,以进一步提高认识。

Allergic rhinitis is defined as an IgE-mediated allergy and inflammation of the membranes lining the nose. The main symptoms are nasal obstruction, itching, sneezing and rhinorrhea induced after allergen exposure. The most common triggers are inhaled allergens （i.e., aeroallergens） including pollens, dust mites, animal dander, fungi, cockroaches, and so on. The principle of management includes environment control, pharmacotherapy, immunotherapy, and patient education. After more than 100 years of clinical application, allergen-specific immunotherapy （ASIT） remains the only treatment method with the potential for altering the natural history of allergic diseases by immunoregulatory mechanism, and its importance also receives more and more attention. The purpose of this article is to give a discussion of some questions related to the clinical practice of ASIT for allergic rhinitis to further increase awareness in this field. 