Development of cockroach immunotherapy by the Inner-City Asthma Consortium.
Development of cockroach immunotherapy by the Inner-City Asthma Consortium.
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DOI：
10.1016/j.jaci.2013.08.047
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发表时间：
2014-03
影响因子：
14.2
通讯作者：
Busse, William W.
中科院分区：
文献类型：
--
作者：
Wood, Robert A.;Togias, Alkis;Wildfire, Jeremy;Visness, Cynthia M.;Matsui, Elizabeth C.;Gruchalla, Rebecca;Hershey, Gurjit;Liu, Andrew H.;O'Connor, George T.;Pongracic, Jacqueline A.;Zoratti, Edward;Little, Frederic;Granada, Mark;Kennedy, Suzanne;Durham, Stephen R.;Shamji, Mohamed H.;Busse, William W.
蟑螂过敏是生活在城市环境中的儿童哮喘发病率的关键因素。我们试图记录蟑螂变应原的免疫反应，为蟑螂变态反应免疫治疗的发展提供方向。开展了四项试点研究：(1)评估蟑螂舌下免疫疗法(Sit)在成人和儿童中的安全性的开放研究；(2)成年蟑螂Sit与安慰剂的随机双盲生物标记物研究；(3)2剂蟑螂狭缝与安慰剂在儿童中的随机双盲生物标记物研究；(4)成人蟑螂皮下免疫疗法(SCIT)的开放标签安全性和生物标记物研究。成人Sit试验(n=54；年龄，18-54岁)发现，在主动组和安慰剂组之间，蟑螂特异性IgE水平显著增加(几何平均比率为1.92；P<；0.0001)，在积极治疗的受试者中，蟑螂特异性IgG4水平有增加的趋势(P=0.09)，但没有证据表明有功能性阻断抗体反应的证据。儿童Sit试验(n=99；年龄，5-17岁)发现，在两个活动组和安慰剂组之间的IgE、IgG和IgG4反应有显著差异，但在高剂量组和低剂量组之间没有一致的差异。在SCIT的研究中，治疗导致蟑螂IgE、IgG4和封闭抗体水平与基线相比发生了显著变化。蟑螂免疫疗法的安全性在所有研究中都是令人放心的。通过SCIT给药的蟑螂变应原在免疫学上比SLIT更活跃，特别是在IgG4水平和阻断抗体反应方面。在任何年龄段都没有提出安全问题。这些初步研究表明，蟑螂变应原免疫疗法更有可能对SCIT有效。
Cockroach allergy is a key contributor to asthma morbidity in children living in urban environments. We sought to document immune responses to cockroach allergen and provide direction for the development of immunotherapy for cockroach allergy. Four pilot studies were conducted: (1) an open-label study to assess the safety of cockroach sublingual immunotherapy (SLIT) in adults and children; (2) a randomized, double-blind biomarker study of cockroach SLIT versus placebo in adults; (3) a randomized, double-blind biomarker study of 2 doses of cockroach SLIT versus placebo in children; and (4) an open-label safety and biomarker study of cockroach subcutaneous immunotherapy (SCIT) in adults. The adult SLIT trial (n = 54; age, 18–54 years) found a significantly greater increase in cockroach-specific IgE levels between the active and placebo groups (geometric mean ratio, 1.92; P < .0001) and a trend toward increased cockroach-specific IgG4 levels in actively treated subjects (P = .09) but no evidence of functional blocking antibody response. The pediatric SLIT trial (n = 99; age, 5–17 years) found significant differences in IgE, IgG, and IgG4 responses between both active groups and the placebo group but no consistent differences between the high- and low-dose groups. In the SCIT study the treatment resulted in significant changes from baseline in cockroach IgE, IgG4, and blocking antibody levels. The safety profile of cockroach immunotherapy was reassuring in all studies. The administration of cockroach allergen by means of SCIT is immunologically more active than SLIT, especially with regard to IgG4 levels and blocking antibody responses. No safety concerns were raised in any age group. These pilot studies suggest that immunotherapy with cockroach allergen is more likely to be effective with SCIT.
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影响因子：
2.2
作者：
Shamji, Mohamed H.;Wilcock, Louisa K.;Francis, James N.
通讯作者：
Francis, James N.
影响因子：
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作者：
Esch, Robert E.;Bush, Robert K.;Lockey, Richard F.
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Lockey, Richard F.
影响因子：
158.5
作者：
Rosenstreich, DL;Eggleston, P;Malveaux, F
通讯作者：
Malveaux, F
影响因子：
158.5
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Frew, Anthony J.
通讯作者：
Frew, Anthony J.
影响因子：
14.2
作者：
Bush, Robert K.;Swenson, Cheri;Busse, William W.
通讯作者：
Busse, William W.