特异性免疫治疗在儿童哮喘中的应用
Application of Specific Immunotherapy in Childhood Asthma
DOI: 10.12677/ACM.2023.131003, PDF,   
作者: 宋崟铭, 闫 莉*:重庆医科大学附属儿童医院呼吸科,国家儿童健康与疾病临床医学研究中心,儿童发育疾病研究教育部重点实验室,儿科学重庆市重点实验室,重庆
关键词: 过敏原特异性免疫治疗哮喘作用机制安全性舌下特异性免疫治疗皮下特异性免疫治疗
摘要: 关于哮喘的治疗,在过去的数十年中,吸入或口服药物治疗取得了突飞猛进的成果,但其作用局限于抗炎及控制症状方面(对症治疗)。而过敏原特异性免疫治疗(AIT)作为“对因治疗”,世界卫生组织(WHO)称其为“唯一”可阻断或逆转过敏性疾病自然进程的疗法。在既往的一些临床研究表明,AIT具有控制症状、减少药物使用,且能降低气道高反应性的作用。在AIT治疗期间可以观察到各种免疫指标的变化,但对于其变化的具体机制及意义尚不清楚。故本篇综述基于近些年的临床研究,从临床方面来总结归纳AIT治疗哮喘的有效性和安全性。
Abstract: Inhalation or oral medications have made rapid progress in asthma treatment over the past dec-ades, but their effects are limited to anti-inflammatory and symptom control. And allergen immu-notherapy (AIT) as a “cause of treatment”, WHO called it “only” can block or reverse the natural process of allergic diseases. Some clinical studies have shown that AIT can control symptoms, re-duce drug use and reduce airway hyperresponsiveness. A variety of immune indicators can be ob-served during AIT treatment, but the specific mechanism of changes has not been fully understood. Therefore, this review summarizes the efficacy and safety of AIT in the treatment of asthma from clinical aspects based on clinical studies in recent years.
文章引用:宋崟铭, 闫莉. 特异性免疫治疗在儿童哮喘中的应用[J]. 临床医学进展, 2023, 13(1): 12-19. https://doi.org/10.12677/ACM.2023.131003

参考文献

[1] Asamoah, F., Kakourou, A., Dhami, S., et al. (2017) Allergen Immunotherapy for Allergic Asthma: A Systematic Over-view of Systematic Reviews. Clinical and Translational Allergy, 7, Article No. 25. [Google Scholar] [CrossRef] [PubMed]
[2] Arabkhazaeli, A., Vijverberg, S.J.H., Von Erp, F.C., Raaijmakers, J.A.M., van der Ent, C.K. and van der Zee, A.H.M. (2015) Characteristics and Severity of Asthma in Children with and without Atopic Conditions: A Cross-Sectional Study. BMC Pediatrics, 15, Article No. 172. [Google Scholar] [CrossRef] [PubMed]
[3] Tran, T.N., Zeiger, R.S., Peters, S.P., et al. (2016) Overlap of Atopic, Eosinophilic, and TH2-High Asthma Phenotypes in a General Population with Current Asthma. Annals of Allergy, Asthma & Immunology, 116, 37-42. [Google Scholar] [CrossRef] [PubMed]
[4] Durham, S.R., Emminger, W., Kapp, A., et al. (2012) SQ-Standardized Sublingual Grass Immunotherapy: Confirmation of Disease Modification 2 Years after 3 Years of Treatment in a Randomized Trial. Journal of Allergy and Clinical Immunology, 129, 717-725. [Google Scholar] [CrossRef] [PubMed]
[5] Durham, S.R., Walker, S.M., Varga, E.M., et al. (1999) Long-Term Clinical Efficacy of Grass-Pollen Immunotherapy. New England Journal of Medicine, 341, 468-475. [Google Scholar] [CrossRef
[6] Noon, L. (1953) Prophylactic Inoculation against Hay Fever. International Archives of Allergy and Immunology, 4, 285-288. [Google Scholar] [CrossRef] [PubMed]
[7] James, L.K., Shamji, M.H., Walker, S.M., et al. (2011) Long-Term Tolerance after Allergen Immunotherapy Is Accompanied by selective Persistence of Blocking Antibodies. Journal of Allergy and Clinical Immunology, 127, 509-516. [Google Scholar] [CrossRef] [PubMed]
[8] Kucuksezer, U.C., Ozdemir, C., Cevhertas, L., Ogulur, I., Akdis, M. and Akdis, C.A. (2020) Mechanisms of Allergen-Specific Immunotherapy and Allergen Tolerance. Allergology In-ternational, 69, 549-560. [Google Scholar] [CrossRef] [PubMed]
[9] Golebski, K., Layhadi, J.A., Sahiner, U., et al. (2021) Induction of IL-10-Producing Type 2 Innate Lymphoid Cells by Allergen Immunotherapy Is Associated with Clinical Response. Im-munity, 54, 291-307. [Google Scholar] [CrossRef] [PubMed]
[10] Eljaszewicz, A., Ruchti, F., Radzikowska, U., et al. (2021) Trained Immunity and Tolerance in Innate Lymphoid Cells, Monocytes, and Dendritic Cells during Allergen-Specific Immunotherapy. Journal of Allergy and Clinical Immunology, 147, 1865-1877. [Google Scholar] [CrossRef] [PubMed]
[11] Burks, A.W., Calderon, M.A., Casale, T., et al. (2013) Update on Allergy Immunotherapy: American Academy of Allergy, Asthma & Immunology/European Academy of Allergy and Clinical Immunology/PRACTALL Consensus Report. Journal of Allergy and Clinical Immunology, 131, 1288-1296. [Google Scholar] [CrossRef] [PubMed]
[12] Canonica, G.W., Cox, L., Pawankar, R., et al. (2014) Sublingual Immunotherapy: World Allergy Organization Position Paper 2013 Update. World Allergy Organization Journal, 7, Arti-cle No. 6. [Google Scholar] [CrossRef] [PubMed]
[13] Agache, I., Lau, S., Akdis, C.A., et al. (2019) EAACI Guidelines on Allergen Immunotherapy: House Dust Mite-Driven Allergic Asthma. Allergy, 74, 855-873. [Google Scholar] [CrossRef] [PubMed]
[14] Yukselen, A., Kendirli, S.G., Yilmaz, M., Altintas, D.U. and Karakoc, G.B. (2012) Effect of One-Year Subcutaneous and Sublingual Immunotherapy on Clinical and Laboratory Parameters in Chil-dren with Rhinitis and Asthma: A Randomized, Placebo-Controlled, Double-Blind, Double-Dummy Study. International Archives of Allergy and Immunology, 157, 288-298. [Google Scholar] [CrossRef] [PubMed]
[15] Senti, G., Frei-burghaus, A. U., Larenas-Linnemann, D., et al. (2019) Intralymphatic Immunotherapy: Update and Unmet Needs. Inter-national Archives of Allergy and Immunology, 178, 141-149. [Google Scholar] [CrossRef] [PubMed]
[16] Konradsen, J. R., Grundström, J., Hellkvist, L., et al. (2020) Intralymphatic Immunotherapy in Pollen-Allergic Young Adults with Rhinoconjunctivitis and Mild Asthma: A Randomized Trial. Journal of Allergy and Clinical Immunology, 145, 1005-1007. [Google Scholar] [CrossRef] [PubMed]
[17] Głobińska, A., Boonpiyathad, T., Satitsuksanoa, P., et al. (2018) Mechanisms of Allergen-Specific Immunotherapy: Diverse Mechanisms of Immune Tolerance to Allergens. Annals of Allergy, Asthma & Immunology, 121, 306-312. [Google Scholar] [CrossRef] [PubMed]
[18] Canonica, G.W., Baena-Cagnani, C.E., Bousquet, J., et al. (2007) Recommendations for Standardization of Clinical Trials with Allergen Specific Immunotherapy for Respiratory Allergy. A Statement of a World Allergy Organization (WAO) Taskforce. Allergy, 62, 317-324. [Google Scholar] [CrossRef] [PubMed]
[19] 向莉, 赵京, 鲍一笑, 等. 儿童气道过敏性疾病螨特异性免疫治疗专家共识[J]. 中华实用儿科临床杂志, 2018, 33(16): 1215-1223.
[20] Dinakar, C., Chipps, B.E., et al. (2017) Clinical Tools to Assess Asthma Control in Children. Pediatrics, 139, e20163438. [Google Scholar] [CrossRef] [PubMed]
[21] Rodinkova, V., Yuriev, S.D., Kryvopustova, M.V., et al. (2022) Mo-lecular Profile Sensitization to House Dust Mites as an Important Aspect for Predicting the Efficiency of Allergen Im-munotherapy. Frontiers in Immunology, 13, Article 848616. [Google Scholar] [CrossRef] [PubMed]
[22] Diamant, Z., Vijverberg, S., Alving, K., et al. (2019) Toward Clinically Applicable Biomarkers for Asthma: An EAACI Position Paper. Allergy, 74, 1835-1851. [Google Scholar] [CrossRef] [PubMed]
[23] Passalacqua, G., Compalati, E. and Canonica, G.W. (2010) Sublingual Im-munotherapy: Clinical Indications in the WAO-SLIT Position Paper. World Allergy Organization Journal, 3, 216-219. [Google Scholar] [CrossRef
[24] Passalacqua, G., Bagnasco, D. and Canonica, G.W. (2020) 30 Years of Sublingual Immunotherapy. Allergy, 75, 1107- 1120. [Google Scholar] [CrossRef] [PubMed]
[25] Pitsios, C., Demoly, P., Bilò, M. B., et al. (2015) Clinical Contraindications to Allergen Immunotherapy: An EAACI Position Paper. Allergy, 70, 897-909. [Google Scholar] [CrossRef] [PubMed]
[26] (1993) 1993 Revised Classification System for HIV Infection and Expanded Surveillance Case Definition for AIDS among Adolescents and Adults. JAMA, 269, Article No. 460. [Google Scholar] [CrossRef
[27] Dhami, S., Kakourou, A., Asamoah, F., et al. (2017) Allergen Immunotherapy for Allergic Asthma: A Systematic Review and Meta-Analysis. Allergy, 72, 1825-1848. [Google Scholar] [CrossRef] [PubMed]
[28] de Vos, G., Viswanathan, S., Pichardo, Y., et al. (2021) A Randomized Trial of Subcutaneous Allergy Immunotherapy in Inner-City Children with Asthma Less than 4 Years of Age. Annals of Al-lergy, Asthma & Immunology, 126, 367-377. [Google Scholar] [CrossRef] [PubMed]
[29] Demoly, P., Corren, J., Creticos, P., et al. (2021) A 300 IR Sub-lingual Tablet Is an Effective, Safe Treatment for House Dust Mite-Induced Allergic Rhinitis: An International, Dou-ble-Blind, Placebo-Controlled, Randomized Phase III Clinical Trial. Journal of Allergy and Clinical Immunology, 147, 1020-1030. [Google Scholar] [CrossRef] [PubMed]
[30] Tanaka, A., Tohda, Y., Okamiya, K., et al. (2020) Effi-cacy and Safety of HDM SLIT Tablet in Japanese Adults with Allergic Asthma. The Journal of Allergy and Clinical Immunology: In Practice, 8, 710-720. [Google Scholar] [CrossRef] [PubMed]
[31] Chaker, A.M., Shamji, M.H., Dumitru, F.A., et al. (2016) Short-Term Subcutaneous Grass Pollen Immunotherapy under the Umbrella of Anti-IL-4: A Randomized Controlled Tri-al. Journal of Allergy and Clinical Immunology, 137, 452-461. [Google Scholar] [CrossRef] [PubMed]
[32] Park, H.J., Kim, S.H., Shin, Y.S., et al. (2021) Intralymphatic Immunotherapy with Tyrosine-Adsorbed Allergens: A Dou-ble-Blind, Placebo-Controlled Trial. Respiratory Research, 22, Article No. 170. [Google Scholar] [CrossRef] [PubMed]
[33] Baba, S.M., Rasool, R., Gull, A., et al. (2021) Effectiveness of Sublingual Immunotherapy in the Treatment of HDM-Induced Nasobronchial Allergies: A 3-Year Randomized Case-Control Study from Kashmir. Frontiers in Immunology, 12, Article 723814. [Google Scholar] [CrossRef] [PubMed]
[34] Rondón, C., Blanca-López, N., Campo, P., et al. (2018) Specific Immunotherapy in Local Allergic Rhinitis: A Randomized, Double-Blind Placebo-Controlled Trial with Phleum pratense Subcutaneous Allergen Immunotherapy. Allergy, 73, 905-915. [Google Scholar] [CrossRef] [PubMed]
[35] Abrams, E.M. and Szefler, S.J. (2020) Managing Asthma during Coronavirus Disease-2019: An Example for Other Chronic Conditions in Children and Adolescents. Journal of Pediatrics, 222, 221-226. [Google Scholar] [CrossRef] [PubMed]
[36] Castro-Rodriguez, J.A. and Forno, E. (2020) Asthma and COVID-19 in Children: A Systematic Review and Call for Data. Pediatric Pulmonology, 55, 2412-2418. [Google Scholar] [CrossRef] [PubMed]
[37] Wark, P.A.B., Ramsahai, J.M., Pathinayake, P., Malik, B. and Bartlett, N.W. (2018) Respiratory Viruses and Asthma. Seminars in Respiratory and Critical Care Medicine, 39, 45-55. [Google Scholar] [CrossRef] [PubMed]
[38] Skevaki, C., Karsonova, A., Karaulov, A., Xie, M. and Renz, H. (2020) Asthma-Associated Risk for COVID-19 Development. Journal of Allergy and Clinical Immunology, 146, 1295-1301. [Google Scholar] [CrossRef] [PubMed]
[39] Klimek, L., Jutel, M., Akdis, C., et al. (2020) Handling of Allergen Immunotherapy in the COVID-19 Pandemic: An ARIA-EAACI Statement. Allergy, 75, 1546-1554. [Google Scholar] [CrossRef] [PubMed]
[40] Farraia, M., Paciência, I., Castro Mendes, F., et al. (2022) Allergen Immu-notherapy for Asthma Prevention: A Systematic Review and Meta-Analysis of Randomized and Non-Randomized Con-trolled Studies. Allergy, 77, 1719-1735. [Google Scholar] [CrossRef] [PubMed]
[41] Beigh, A.H., Rasool, R., Kawoosa, F., et al. (2021) Improved Pulmonary Function Test (PFT) after 1 One Year of Sublingual Immunotherapy (SLIT) in Unison with Pharmacotherapy in Mild Allergic Asthmatics. Immunology Letters, 230, 36-41. [Google Scholar] [CrossRef] [PubMed]
[42] Nadir Bahceciler, N., Galip, N. and Babayigit, A. (2017) Steroid Sparing Effect of Sublingual Immunotherapy: Real Life Study in Mono/Polisensitized Children with Asthma. Immunotherapy, 9, 1263-1269. [Google Scholar] [CrossRef] [PubMed]
[43] Parra-Padilla, D., Zakzuk, J., Carrasquilla, M., et al. (2021) Cost-Effectiveness of the Subcutaneous House Dust Mite Allergen Immunotherapy plus Pharmacotherapy for Allergic Asthma: A Mathematical Model. Allergy, 76, 2229-2233. [Google Scholar] [CrossRef] [PubMed]
[44] Biddiscombe, M.F. and Usmani, O.S. (2021) Delivery and Adherence with Inhaled Therapy in Asthma. Minerva Medica, 112, 564-572. [Google Scholar] [CrossRef