Rapid Desensitization for Hypersensitivity Reactions to Medications
Rapid Desensitization for Hypersensitivity Reactions to Medications
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DOI：
10.1016/j.iac.2009.04.012
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发表时间：
2009-08-01
影响因子：
2.6
通讯作者：
Castells, Mariana
中科院分区：
文献类型：
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作者：
Castells, Mariana
药物脱敏是诱导患者对已出现严重超敏反应的药物抗原出现暂时的临床无应答。它通常是通过在固定的时间间隔逐渐重新引入小剂量的药物抗原来实现的，其目的是提供增加的安全性和对副作用的保护，包括过敏反应。在脱敏过程中实现全治疗剂量的递送，允许患者接受一线化疗、抗生素或单克隆抗体，以及其他药物，如胰岛素、阿司匹林和铁。脱敏是高风险的干预措施。在药物脱敏期间发生细胞活化机制的抑制，在大多数情况下允许保护性临床结果和缺乏副作用，但细胞和分子抑制机制尚未完全理解。脱敏方案的适应症只能由经过培训的过敏症专家和免疫学家完成，并且由于其高成功率和结局证明的安全性特征，应作为标准治疗实施。
Drug desensitization is the induction of temporary clinical unresponsiveness to drug antigens to which patients have presented severe hypersensitivity reactions. It is typically achieved by gradual reintroduction of small doses of drug antigens at fixed time intervals, and it is aimed at providing increased safety and protection from side effects, including anaphylaxis. Delivery of full therapeutic doses is achieved during desensitization, allowing patients to receive firstline chemotherapy, antibiotics, or monoclonal antibodies, as well as other drugs such as insulin, aspirin, and iron. Desensitizations are high-risk interventions. Inhibition of cellular activation mechanisms occurs during drug desensitization, allowing for the protective clinical outcomes and lack of side effects in the majority of cases, but the cellular and molecular inhibitory mechanisms are incompletely understood. The indication for desensitization protocols can only be done by trained allergists and immunologists and should be implemented as standard of care because of their high success rates and outcomes-demonstrated safety profile.