支气管哮喘抗原免疫治疗最新研究进展

Update on bronchial asthma allergen immunotherapy

目前世界范围内支气管哮喘(简称哮喘)抗原免疫治疗(allergen immunotherapy,AIT)应用严重不足,而其是惟一可以改变过敏性疾病进程的方法。最新相关国内指南提出中-重度过敏性鼻炎合并轻度哮喘的患者推荐使用AIT;部分控制或即使得到正规治疗而第一秒用力呼气量占预计值百分比<70%的哮喘患者禁用AIT。AIT与单纯对症治疗相比节省费用,无论短期还是长期其安全性好。哮喘AIT可以选择皮下和舌下免疫治疗,但与传统的皮下免疫治疗相比,多种变应原的舌下免疫治疗无效。AIT还可以选择经淋巴结免疫治疗,但主要针对草花粉过敏导致的鼻结膜炎患者。哮喘治疗需要重视AIT。

Despite allergen immunotherapy （AIT） is the only treatment that can change the course of allergic disease, AIT is still underused in clinical practice worldwide. The latest relevant China guidelines proposed that patients with moderate or severe allergic rhinitis coexisting with mild asthma be recommended AIT, but the patients with partly control or whose forced expiratory volume in 1 second was 〈70% even with regular treatment be forbidded to receive AIT. Compared with symptomatic treatment alone, AIT is costeffective and safe, whether in the short term or long term. Asthma AIT can be classified as subcutaneous immunotherapy（SCIT） or sublingual immunotherapy（SLIT）. However, compared with conventional SCIT, SLIT multi-allergen immunotherapy is not effective. AIT can also be clone by intralymphatic immunotherapy（ILIT）, but it is mainly for patients with pollen-induced rhinonjunctivis. MT should be paid attention to as a treatment for asthma.