Treatment of anaphylactic sensitivity to peanuts by immunotherapy with injections of aqueous peanut extract
Treatment of anaphylactic sensitivity to peanuts by immunotherapy with injections of aqueous peanut extract
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DOI：
10.1016/s0091-6749(97)80006-1
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发表时间：
1997-06-01
影响因子：
14.2
通讯作者：
Leung, D
中科院分区：
文献类型：
--
作者：
Nelson, HS;Lahr, J;Leung, D
背景资料：对花生的速发型超敏反应是儿童和成人过敏反应和死亡的常见原因，目前，预防性治疗包括避免，这是困难的，因为广泛的，往往是变相使用花生在食品industry.Methods：12例立即过敏的摄入花生被招募。其中一半接受花生提取物注射治疗：首先通过紧急方案达到耐受性的维持水平，然后每周注射至少1年。其他6名未接受治疗的对照组受试者。所有患者进行了双盲，安慰剂对照，口服花生的挑战最初，约6周后，1 year.Results：所有治疗的患者达到了维持剂量的0.5毫升的1：100重量/体积花生提取物的匆忙注射协议。所有患者对双盲、安慰剂对照花生激发的耐受性增加，对花生提取物滴定皮肤点刺试验的敏感性降低，而未经治疗的对照组受试者对口服花生激发的阈值和对花生提取物的皮肤反应性不变。治疗组在紧急免疫治疗和维持注射期间均常见全身反应。仅3例患者仍耐受完整维持剂量。口服花生挑战的耐受性增加，保持在三个科目谁收到完整的维持剂量，但有部分（n = 2）或完全（n = 1）的保护损失的患者谁需要减少剂量，因为全身reactions.Conclusions：注射花生提取物增加花生过敏患者的耐受性口服摄入花生。在大多数患者中，即使在维持注射期间，注射也会导致反复的全身反应。对于这种治疗方法的临床应用，需要改良的花生提取物。
Background: Immediate hypersensitivity to peanuts is a frequent cause of anaphylactic reactions and deaths in children and adults, Currently, preventive treatment consists of avoidance, which is difficult because of the widespread and often disguised use of peanuts in the food industry.Methods: Twelve patients with immediate hypersensitivity to ingestion of peanuts were recruited. Half were treated with injections of peanut extract: a maintenance level of tolerance was first achieved by a rush protocol, then maintained with weekly injections for at least 1 year. The other six evert untreated control subjects. Ail patients underwent double-blind, placebo-controlled, oral peanut challenges initially, after approximately 6 weeks, and after 1 year.Results: All treated patients achieved the maintenance dose of 0.5 ml of 1:100 wt/vol peanut extract by the rush injection protocol. All experienced increased tolerance to double-blind, placebo-controlled peanut challenge and decreased sensitivity on titrated skin prick testing with peanut extract, whereas the threshold to oral peanut challenge and cutaneous reactivity to peanut extract sere unchanged in the untreated control subjects. Systemic reactions were common in the treated group both during rush immunotherapy and with maintenance injections. Only three patients remained tolerant of the full maintenance dose. The increased tolerance to oral peanut challenge was maintained in the three subjects who received full maintenance doses, but there was partial (n = 2) or complete (n = 1) loss of protection in the patients who required dose reduction because of systemic reactions.Conclusions: Injections of peanut extract increase the tolerance of patients with peanut allergy to oral ingestion of peanuts. Injections result in repeated systemic reactions in most patients, even during maintenance injections. For clinical application of this method of treatment, a modified peanut extract is needed.