变应性鼻炎的免疫治疗及进展
Progress on Immunotherapy for Allergic Rhinitis
DOI: 10.12677/acm.2025.1551605, PDF,   
作者: 蒋运运:河北北方学院研究生院,河北 张家口;河北省人民医院耳鼻咽喉科,河北 石家庄;皮丽宏, 刘玉东, 李 色, 张慧平, 屈永涛, 郭明丽*:河北省人民医院耳鼻咽喉科,河北 石家庄
关键词: 变应性鼻炎特异性免疫治疗皮下免疫治疗淋巴结内免疫治疗非特异性免疫治疗Allergic Rhinitis Allergen-Specific Immunotherapy Subcutaneous Immunotherapy Intralymphatic Immunotherapy Non-Specific Immunotherapy
摘要: 免疫治疗是针对变应性鼻炎病因的一种治疗方式,包括特异性免疫治疗和非特异性免疫治疗。特异性免疫治疗是唯一可以阻止疾病进展,降低变应性鼻炎继发为哮喘风险的方法,包括皮下免疫治疗、舌下免疫治疗和淋巴结内免疫治疗等方式;非特异性免疫治疗包括单克隆抗体生物制剂、Toll样受体激动剂等方式。本文就上述治疗及进展进行阐述。
Abstract: Immunotherapy is a form of treatment that targets the cause of allergic rhinitis, including both allergen-specific and non-specific immunotherapy. Allergen-specific immunotherapy is the only way to stop the progression of the disease and reduce the risk of allergic rhinitis becoming asthma. Allergen-specific immunotherapy includes subcutaneous immunotherapy, sublingual immunotherapy, and intralymphatic immunotherapy; non-specific immunotherapy includes biological agents of monoclonal antibodies and toll-like receptors agonists. This article describes the above immunotherapy and progress.
文章引用:蒋运运, 皮丽宏, 刘玉东, 李色, 张慧平, 屈永涛, 郭明丽. 变应性鼻炎的免疫治疗及进展[J]. 临床医学进展, 2025, 15(5): 2170-2177. https://doi.org/10.12677/acm.2025.1551605

参考文献

[1] 中华耳鼻咽喉头颈外科杂志编辑委员会鼻科组, 中华医学会耳鼻咽喉头颈外科学分会鼻科学组. 中国变应性鼻炎诊断和治疗指南(2022年, 修订版) [J]. 中华耳鼻咽喉头颈外科杂志, 2022, 57(2): 106-129.
[2] Luo, X., Hua, Z.X., Zhang, Y.N., et al. (2024) Review of the Development and Latest Perspectives in 2024 on Allergic Rhinitis and Its Impact on Asthma (ARIA). Chinese Journal of Otorhinolaryngology Head and Neck Surgery, 59, 1107-1114.
[3] Noon, L. (1911) Prophylactic Inoculation against Hay Fever. The Lancet, 177, 1572-1573. [Google Scholar] [CrossRef
[4] Frew, A.J. (2011) Hundred Years of Allergen Immunotherapy. Clinical & Experimental Allergy, 41, 1221-1225. [Google Scholar] [CrossRef] [PubMed]
[5] Huang, J., Zhang, W., Xiang, R., Tan, L., Liu, P., Tao, Z., et al. (2023) The Early-Phase Transcriptome and the Clinical Efficacy Analysis in Three Modes of Subcutaneous Immunotherapy for Allergic Rhinitis. World Allergy Organization Journal, 16, Article 100811. [Google Scholar] [CrossRef] [PubMed]
[6] 王玲, 高亚东, 王永博, 董翔. 变应原皮下特异性免疫治疗依从率及影响因素的系统评价与Meta分析[J]. 中华临床免疫和变态反应杂志, 2024, 18(2): 148-156.
[7] Greiwe, J. and Bernstein, J.A. (2022) Accelerated/Rush Allergen Immunotherapy. Allergy and Asthma Proceedings, 43, 344-349. [Google Scholar] [CrossRef] [PubMed]
[8] Jiang, Y.L. and Zhu, X.H. (2018) Research on Immune Regulation Mechanism of Immunotherapy for Allergic Rhinitis. Journal of Clinical Otorhinolaryngology Head and Neck Surgery, 32, 1440-1443.
[9] Cox, L. (2006) Accelerated Immunotherapy Schedules: Review of Efficacy and Safety. Annals of Allergy, Asthma & Immunology, 97, 126-138. [Google Scholar] [CrossRef] [PubMed]
[10] Lee, M.C., Puglisi, L.B. and Kelso, J.M. (2023) Comparison of Standard, Cluster, and Rush Allergy Immunotherapy Buildup Protocols. The Journal of Allergy and Clinical Immunology: In Practice, 11, 2884-2889. [Google Scholar] [CrossRef] [PubMed]
[11] Rodríguez Plata, E., Hernández Santana, G.L., Cubas Mesa, E., Coello Valeriano, K., Matas Ros, M. and Buendía Jiménez, I. (2021) Real-Life Safety Study of an Accelerated Cluster Immunotherapy with a House Dust Mite Native Extract in Patients with Allergic Rhinitis or Rhinoconjunctivitis. Allergo Journal International, 30, 259-260. [Google Scholar] [CrossRef
[12] Quiralte, J., Justicia, J.L., Cardona, V., Dávila, I., Moreno, E., Ruiz, B., et al. (2013) Is Faster Safer? Cluster versus Short Conventional Subcutaneous Allergen Immunotherapy. Immunotherapy, 5, 1295-1303. [Google Scholar] [CrossRef] [PubMed]
[13] Wang, C.S., Wang, X.D., Zhang, W., et al. (2012) Long-Term Efficacy of Dermatophagoides Pteronyssinus Immunotherapy in Patients with Allergic Rhinitis: A 3-Year Prospective Study. Chinese Journal of Otorhinolaryngology Head and Neck Surgery, 47, 804-808.
[14] Jutel, M., Klimek, L., Richter, H., Brüggenjürgen, B. and Vogelberg, C. (2024) House Dust Mite SCIT Reduces Asthma Risk and Significantly Improves Long‐Term Rhinitis and Asthma Control—A RWE Study. Allergy, 79, 1042-1051. [Google Scholar] [CrossRef] [PubMed]
[15] Senti, G. and Kündig, T.M. (2015) Intralymphatic Immunotherapy. World Allergy Organization Journal, 8, Article 9. [Google Scholar] [CrossRef] [PubMed]
[16] Johansen, P., Häffner, A.C., Koch, F., Zepter, K., Erdmann, I., Maloy, K., et al. (2005) Direct Intralymphatic Injection of Peptide Vaccines Enhances Immunogenicity. European Journal of Immunology, 35, 568-574. [Google Scholar] [CrossRef] [PubMed]
[17] Martínez-Gómez, J.M., Johansen, P., Erdmann, I., Senti, G., Crameri, R. and Kündig, T.M. (2009) Intralymphatic Injections as a New Administration Route for Allergen-Specific Immunotherapy. International Archives of Allergy and Immunology, 150, 59-65. [Google Scholar] [CrossRef] [PubMed]
[18] Senti, G., Prinz Vavricka, B.M., Erdmann, I., Diaz, M.I., Markus, R., McCormack, S.J., et al. (2008) Intralymphatic Allergen Administration Renders Specific Immunotherapy Faster and Safer: A Randomized Controlled Trial. Proceedings of the National Academy of Sciences, 105, 17908-17912. [Google Scholar] [CrossRef] [PubMed]
[19] Hylander, T., Latif, L., Petersson-Westin, U. and Cardell, L.O. (2013) Intralymphatic Allergen-Specific Immunotherapy: An Effective and Safe Alternative Treatment Route for Pollen-Induced Allergic Rhinitis. Journal of Allergy and Clinical Immunology, 131, 412-420. [Google Scholar] [CrossRef] [PubMed]
[20] Chabot, A., Senti, G., Erdmann, I., Prinz, B.M., Wüthrich, B., Šošić, L., et al. (2022) Intralymphatic Immunotherapy (ILIT) with Bee Venom Allergens: A Clinical Proof-of-Concept Study and the Very First ILIT in Humans. Frontiers in Allergy, 3, Article 832010. [Google Scholar] [CrossRef] [PubMed]
[21] Adlany, Y.K., Šošić, L., Senti, G., Lang, C.C.V., Wüthrich, B., Kündig, T.M., et al. (2023) Quality of Life in Allergic Rhinitis Patients Treated with Intralymphatic Immunotherapy (ILIT): A 19-Year Follow-Up. Journal of Allergy and Clinical Immunology: Global, 2, 43-50. [Google Scholar] [CrossRef] [PubMed]
[22] Senti, G., Crameri, R., Kuster, D., Johansen, P., Martinez-Gomez, J.M., Graf, N., et al. (2012) Intralymphatic Immunotherapy for Cat Allergy Induces Tolerance after Only 3 Injections. Journal of Allergy and Clinical Immunology, 129, 1290-1296. [Google Scholar] [CrossRef] [PubMed]
[23] Hylander, T., Larsson, O., Petersson-Westin, U., Eriksson, M., Kumlien Georén, S., Winqvist, O., et al. (2016) Intralymphatic Immunotherapy of Pollen-Induced Rhinoconjunctivitis: A Double-Blind Placebo-Controlled Trial. Respiratory Research, 17, Article 10.
[24] Kündig, T.M., Johansen, P., Bachmann, M.F., Cardell, L.O. and Senti, G. (2014) Intralymphatic Immunotherapy: Time Interval between Injections Is Essential. Journal of Allergy and Clinical Immunology, 133, 930-931. [Google Scholar] [CrossRef] [PubMed]
[25] Khoshkhui, M., Jabbari, F., Zargar, F.S., Motevalli Haghi, N.S. and Ariaee, N. (2024) Fluctuation of Disease Severity and Quality of Life Applying Intra-Lymphatic Immunotherapy for Patients with Seasonal Allergic Rhinitis. Iranian Journal of Allergy, Asthma and Immunology, 23, 149-157. [Google Scholar] [CrossRef] [PubMed]
[26] Wang, Q., Wang, K., Qin, Y., Huang, W., Li, Y., Yu, Q., et al. (2023) Intra-Cervical Lymphatic Immunotherapy for Dust Mite-Induced Allergic Rhinoconjunctivitis in Children: A 3-Year Prospective Randomized Controlled Trial. Frontiers in Immunology, 14, Article 1144813. [Google Scholar] [CrossRef] [PubMed]
[27] 王凯, 王跃建, 肖平, 等. 颈部淋巴结内特异性免疫治疗变应性鼻炎疗效及安全性的研究[J]. 临床耳鼻咽喉头颈外科杂志, 2019, 33(5): 432-436.
[28] 王凯, 秦扬, 王启幸, 等. 成人变应性鼻炎经颈部淋巴结内免疫治疗远期疗效的随机对照研究[J]. 中华耳鼻咽喉头颈外科杂志, 2023, 58(9): 871-877.
[29] Scadding, G.K. and Brostoff, J. (1986) Low Dose Sublingual Therapy in Patients with Allergic Rhinitis Due to House Dust Mite. Clinical & Experimental Allergy, 16, 483-491. [Google Scholar] [CrossRef] [PubMed]
[30] Tankersley, M., Han, J.K. and Nolte, H. (2020) Clinical Aspects of Sublingual Immunotherapy Tablets and Drops. Annals of Allergy, Asthma & Immunology, 124, 573-582. [Google Scholar] [CrossRef] [PubMed]
[31] Klimek, L., Brehler, R., Casper, I., Klimek, F., Hagemann, J., Cuevas, M., et al. (2023) Allergen Immunotherapy in House Dust Mite-Associated Allergic Rhinitis: Efficacy of the 300 IR Mite Tablet. Allergo Journal International, 32, 10-17. [Google Scholar] [CrossRef
[32] Gotoh, M., Maekawa, Y., Saito, S., Kato, N., Horikawa, E. and Nishino, N. (2024) Real-World Surveillance of Standardized Quality (SQ) House Dust Mite Sublingual Immunotherapy Tablets for 3 Years in Japan. Allergy and Asthma Proceedings, 46, 59-69. [Google Scholar] [CrossRef
[33] Marogna, M., Spadolini, I., Massolo, A., Canonica, G.W. and Passalacqua, G. (2010) Long-Lasting Effects of Sublingual Immunotherapy According to Its Duration: A 15-Year Prospective Study. Journal of Allergy and Clinical Immunology, 126, 969-975. [Google Scholar] [CrossRef] [PubMed]
[34] Passalacqua, G., Bagnasco, D. and Canonica, G.W. (2019) 30 Years of Sublingual Immunotherapy. Allergy, 75, 1107-1120. [Google Scholar] [CrossRef] [PubMed]
[35] Nelson, H., Bernstein, D., Biedermann, T. and Nolte, H. (2023) Efficacy of Sublingual Immunotherapy Tablets for Allergic Rhinoconjunctivitis in Adult Monosensitized and Polysensitized Subjects. Journal of Allergy and Clinical Immunology, 151, AB124. [Google Scholar] [CrossRef
[36] Hoshino, M., Akitsu, K., Ohtawa, J. and Kubota, K. (2024) Long-Term Efficacy of House Dust Mite Sublingual Immunotherapy on Clinical and Pulmonary Function in Patients with Asthma and Allergic Rhinitis. Journal of Allergy and Clinical Immunology: Global, 3, Article 100206. [Google Scholar] [CrossRef] [PubMed]
[37] Owenier, C., Barnowski, C., Leineweber, M., Yu, D., Verhagen, M. and Distler, A. (2023) Tolerability and Safety of Sublingual Immunotherapy in Patients with Tree Pollen Allergy in Daily Practice—An Open, Prospective, Non-Interventional Study. Journal of Clinical Medicine, 12, Article 5517. [Google Scholar] [CrossRef] [PubMed]
[38] Okamoto, Y., Kato, M., Ishii, K., Sato, Y., Hata, T. and Asaka, Y. (2023) Safety and Effectiveness of a 300 IR House Dust Mite Sublingual Tablet: Descriptive 4-Year Final Analysis of a Post-Marketing Surveillance in Japan. Immunotherapy, 15, 1401-1414. [Google Scholar] [CrossRef] [PubMed]
[39] Sasamoto, K., Nagakura, K., Asaumi, T., Fusayasu, N., Ohashi‐Doi, K., Yanagida, N., et al. (2024) Efficacy and Safety of Sublingual Immunotherapy Using House Dust Mite Tablet for 1-4 Years Old Children with Perennial Allergic Rhinitis. Pediatric Allergy and Immunology, 35, e14203. [Google Scholar] [CrossRef] [PubMed]
[40] 孙楚东, 郝钧, 罗丽华, 等. 皮下免疫与舌下免疫治疗变应性鼻炎的临床疗效分析[J]. 标记免疫分析与临床, 2020, 27(6): 957-961.
[41] 赵艳, 何荆培, 赵喜桂, 等. 皮下免疫和舌下免疫治疗变应性鼻炎的有效性及安全性[J]. 中国实用医药, 2020, 15(3): 153-155.
[42] Hamada, M., Saeki, K. and Tanaka, I. (2023) Comparison of Rush-Subcutaneous and Sublingual Immunotherapy with House Dust Mite Extract for Pediatric Allergic Rhinitis: A Prospective Cohort Study. Allergology International, 72, 573-579. [Google Scholar] [CrossRef] [PubMed]
[43] Pongdee, T. and Li, J.T. (2024) Omalizumab Safety Concerns. The Journal of Allergy and Clinical Immunology, 155, 31-35.
[44] Shen, W., Zhou, Q., Zhang, Q., Han, L., Chen, L., Li, X., et al. (2024) Efficacy and Safety of Omalizumab Combined with Allergen Immunotherapy in Children with Moderate to Severe Allergic Asthma. International Forum of Allergy & Rhinology, 15, 208-211. [Google Scholar] [CrossRef] [PubMed]
[45] Antosz, K., Batko, J., Błażejewska, M., Gawor, A., Sleziak, J. and Gomułka, K. (2024) Insight into IL-5 as a Potential Target for the Treatment of Allergic Diseases. Biomedicines, 12, Article 1531. [Google Scholar] [CrossRef] [PubMed]
[46] AbuJabal, R., Ramakrishnan, R.K., Bajbouj, K. and Hamid, Q. (2024) Role of il‐5 in Asthma and Airway Remodelling. Clinical & Experimental Allergy, 54, 538-549. [Google Scholar] [CrossRef] [PubMed]
[47] Shirley, M. (2017) Dupilumab: First Global Approval. Drugs, 77, 1115-1121. [Google Scholar] [CrossRef] [PubMed]
[48] Layritz, A., Galicia‐Carreón, J., Benfadal, S. and Novak, N. (2023) Differences in Allergen‐Specific Basophil Activation and T Cell Proliferation in Atopic Dermatitis Patients with Comorbid Allergic Rhinoconjunctivitis Treated with a Monoclonal Anti‐IL‐4Rα Antibody or Allergen‐Specific Immunotherapy. Immunity, Inflammation and Disease, 11, e808. [Google Scholar] [CrossRef] [PubMed]
[49] von Bubnoff, D., Sell, U., Arriens, S., Specht, S., Hoerauf, A. and Bieber, T. (2012) Differential Expression of Toll-Like Receptor 2 on Dendritic Cells from Asymptomatic and Symptomatic Atopic Donors. International Archives of Allergy and Immunology, 159, 41-50. [Google Scholar] [CrossRef] [PubMed]
[50] Kirtland, M.E., Tsitoura, D.C., Durham, S.R. and Shamji, M.H. (2020) Toll-Like Receptor Agonists as Adjuvants for Allergen Immunotherapy. Frontiers in Immunology, 11, Article 599083. [Google Scholar] [CrossRef] [PubMed]