变应性真菌性鼻-鼻窦炎免疫治疗现状

Status of immunotherapy in allergic fungal rhinosinusitis

变应性真菌性鼻-鼻窦炎(AFRS)是一种真菌作为抗原接触特应性个体鼻黏膜后导致的变态反应性疾病,是Ⅰ型和Ⅲ型变态反应共同作用的结果。AFRS发病率较高,手术和术后药物治疗均容易复发,给患者生活质量带来严重影响,因此寻求安全有效的综合治疗方案显得尤为重要。作为AFRS综合治疗的一部分,免疫治疗可以显著改善AFRS患者临床症状,降低患者对皮质类固醇激素等药物的需要量,且无需反复施行手术,其临床效果是肯定的。但由于研究结果差异较大,该治疗方法仍有争议,还有待于在临床实践中进一步探索。

Allergic fungal rhinosinusitis （ AFRS ） is an allergic disease caused by a fungus that acts as an antigen at the nasal mucosa of atopic individuals, and produces a combination of type I and III allergic reactions. The incidence of AFRS is high, and it is easy to relapse after surgery and postoperative drug treatment. There are serious impacts on the quality of life in patients. Therefore, it is of great importance to seek a safe and effective comprehensive treatment plan. Immunotherapy performed as part of comprehensive therapy can significantly improve the clinical symptoms of AFRS and reduce the requirement for corticosteroids and other drugs. The clinical value of immunotherapy is confirmed further by the finding that patients with AFRS who receive this treatment do not need repeat surgery. However, the benefits of immunotherapy remain controversial owing to conflicting research findings, and therefore these benefits warrant further investigation in clinical practice.