Clinical evaluation of rush immunotherapy using house dust mite allergen in Japanese asthmatics.
Clinical evaluation of rush immunotherapy using house dust mite allergen in Japanese asthmatics.
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DOI：
10.5415/apallergy.2021.11.e32
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发表时间：
2021-07
影响因子：
1.7
通讯作者：
Nagata M
中科院分区：
文献类型：
--
作者：
Uchida T;Nakagome K;Iemura H;Naito E;Miyauchi S;Uchida Y;Soma T;Nagata M
过敏原免疫疗法（AIT）是一种向患有过敏性疾病的患者给予临床重要过敏原的特异性治疗方法。在日本，用于皮下免疫治疗（SCIT）的标准化屋尘螨（HDM）过敏原于2015年获得批准，然后我们使用标准化HDM过敏原对HDM敏感的哮喘患者进行了快速免疫治疗（rush-IT）。然而，关于rush-HDM-IT的安全性和有效性的数据很少，特别是对于日本哮喘患者。本研究的目的是检查使用标准化HDM的rush-IT治疗对HDM敏感的日本哮喘患者的安全性和临床有效性。13名接受rush-HDM-IT治疗的HDM敏感性哮喘患者和12名HDM敏感性哮喘对照者入选。为了评价安全性，评估了全身反应（SR）事件（包括过敏反应）的数量。为了评价疗效，对治疗步骤、吸入性皮质类固醇剂量和快速HDM-IT和随后的维持SCIT后哮喘控制的变化进行了评估。还评价了HDM诱导的外周血单核细胞产生2型细胞因子的变化。在接受rush-IT的12例患者中，4例（30.7%）发生SR，3例（23.1%）发生速发型过敏反应。然而，所有病例的速发型过敏反应均不严重（3级），且均在短时间内恢复。急HDM-IT组治疗哮喘的步骤较好，吸入糖皮质激素的剂量较低。HDM诱导的外周血单个核细胞产生的白细胞介素（IL）-5和IL-13在快速HDM-IT组中显著低于对照组。Rush-HDM-IT在日本哮喘患者中可以相对安全地进行。此外，快速HDM-IT和随后的维持SCIT提供了哮喘患者的临床改善，并伴随着HDM特异性Th 2介导的全身免疫应答的抑制。
Allergen immunotherapy (AIT) is a specific treatment of administering clinically important allergens to patients who have allergic diseases. In Japan, the standardized house dust mite (HDM) allergen for subcutaneous immunotherapy (SCIT) was approved in 2015, and we then introduced rush-immunotherapy (rush-IT) using the standardized HDM allergen for HDM-sensitive asthmatics. However, little data are available on the safety and effectiveness of rush-HDM-IT, especially for Japanese asthmatics. The objective of this study was to examine the safety and clinical effectiveness of rush-IT using the standardized HDM for HDM-sensitive Japanese asthmatics. Thirteen HDM-sensitive asthmatics who received rush-HDM-IT and 12 HDM-sensitive asthmatic controls were enrolled. To evaluate the safety, the number of systemic reaction (SR) events, including anaphylaxis, was assessed. To evaluate the effectiveness, changes in the treatment step, dose of inhaled corticosteroid, and asthma control after rush-HDM-IT and the subsequent maintenance SCIT were assessed. Changes in the HDM-induced production of type 2 cytokines from peripheral blood mononuclear cells were also evaluated. Among the 12 patients who received rush-IT, 4 (30.7%) experienced a SR and 3 (23.1%) experienced anaphylaxis. However, the anaphylaxis was not severe (grade 3) in all cases, and they recovered in a short time. The treatment step of asthma was better and the dose of inhaled corticosteroid was lower in the rush-HDM-IT group than in the control group. The HDM-induced production of both interleukin (IL)-5 and IL-13 from peripheral blood mononuclear cells was significantly lower in the rush-HDM-IT group than in the control group. Rush-HDM-IT can be performed relatively safely in Japanese asthmatics. Furthermore, rush-HDM-IT and the subsequent maintenance SCIT provided clinical improvement in asthma patients, and was accompanied by the suppression of HDM-specific Th2-mediated systemic immune responses.
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影响因子：
1.2
作者：
NAGATA, M;YAMAMOTO, H;DOHI, Y
通讯作者：
DOHI, Y
影响因子：
14.2
作者：
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影响因子：
4.4
作者：
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作者：
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通讯作者：
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影响因子：
14.2
作者：
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通讯作者：
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