Mechanisms of allergen-specific immunotherapy
Mechanisms of allergen-specific immunotherapy
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DOI：
10.1016/j.jaci.2010.11.030
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发表时间：
2011-01-01
影响因子：
14.2
通讯作者：
Akdis, Muebeccel
中科院分区：
文献类型：
--
作者：
Akdis, Cezmi A.;Akdis, Muebeccel
过敏原特异性免疫疗法作为过敏性疾病的脱敏疗法已经使用了100年，并且代表了潜在的治愈性和特异性治疗方法。过敏原特异性免疫治疗的作用机制包括极早期脱敏效应、调节T细胞和B细胞应答及相关抗体同种型、嗜酸性粒细胞、嗜碱性粒细胞和肥大细胞向组织的迁移以及释放其介质。调节性T（Treg）细胞已被鉴定为对过敏原的外周耐受中的免疫过程的关键调节物。过敏原特异性效应T细胞向调节表型的偏移似乎是对过敏原的健康免疫应答的发展和接受过敏原特异性免疫治疗的患者的成功结果的关键事件。天然存在的叉头盒蛋白3阳性CD 4（+）CD 25（+）Treg细胞和诱导型T（R）1细胞以几种主要方式有助于控制过敏原特异性免疫应答，其可以概括为抑制支持效应T细胞产生的树突状细胞;抑制效应T（H）1、T（H）2和T（H）17细胞;抑制过敏原特异性IgE和诱导IgG 4;抑制肥大细胞、嗜碱性粒细胞和嗜酸性粒细胞;以及抑制效应T细胞向组织的迁移。免疫干预的新策略可能包括靶向过敏原耐受的分子机制以及效应细胞和Treg细胞亚群的相互调节。（J Allergy Clin Immunol 2011;127：18-27.）
Allergen-specific immunotherapy has been used for 100 years as a desensitizing therapy for allergic diseases and represents the potentially curative and specific method of treatment. The mechanisms of action of allergen-specific immunotherapy include the very early desensitization effects, modulation of T-and B-cell responses and related antibody isotypes, and migration of eosinophils, basophils, and mast cells to tissues, as well as release of their mediators. Regulatory T (Treg) cells have been identified as key regulators of immunologic processes in peripheral tolerance to allergens. Skewing of allergen-specific effector T cells to a regulatory phenotype appears as a key event in the development of healthy immune response to allergens and successful outcome in patients undergoing allergen-specific immunotherapy. Naturally occurring forkhead box protein 3-positive CD4(+)CD25(+) Treg cells and inducible T(R)1 cells contribute to the control of allergen-specific immune responses in several major ways, which can be summarized as suppression of dendritic cells that support the generation of effector T cells; suppression of effector T(H)1, T(H)2, and T(H)17 cells; suppression of allergen-specific IgE and induction of IgG4; suppression of mast cells, basophils, and eosinophils; and suppression of effector T-cell migration to tissues. New strategies for immune intervention will likely include targeting of the molecular mechanisms of allergen tolerance and reciprocal regulation of effector and Treg cell subsets. (J Allergy Clin Immunol 2011;127:18-27.)