Long-term sublingual immunotherapy provides better effects for patients with Japanese cedar pollinosis
Long-term sublingual immunotherapy provides better effects for patients with Japanese cedar pollinosis
复制标题
长期舌下免疫治疗为日本柳杉花粉病患者提供更好的疗效
DOI：
10.1016/j.anl.2021.01.003
复制
发表时间：
2021
影响因子：
1.7
通讯作者：
Iwai Hiroshi
中科院分区：
文献类型：
--
作者：
Hamada Satoko;Kobayashi Yoshiki;Sakamoto Daiki;Shimamura Akihiro;Kuroda Kazumichi;Kawachi Risaki;Kanda Akira;Asako Mikiya;Gotoh Minoru;Okubo Kimihiro;Tomoda Koichi;Iwai Hiroshi
日本雪松花粉症是一种影响日本大部分人口的地方病。自从舌下免疫疗法（SLIT）治疗日本雪松花粉症被纳入日本公共保险范围以来，已经过去了五个赛季。在这项研究中，我们评估了长期SLIT治疗日本雪松花粉症对2019年季节主要以鼻部症状和呼吸道炎症为代表的上呼吸道症状的临床效果，方法本研究涉及95名患者，他们在2014年至2019年期间的某个时间点开始接受SLIT治疗日本雪松花粉症。2018年，将这组患者与对照组进行比较，对照组包括21名接受季前预防性治疗的患者（使用第二代抗组胺药物）。根据相关指南评价患者的鼻/眼症状、鼻症状和药物治疗总评分（TNSMS）以及生活质量。此外，外周血嗜酸性粒细胞，血清总IgE，日本雪松抗原特异性IgE，Cryj 1-特异性IgG 4，和分数呼出一氧化氮（FENO）的水平进行了测量作为客观indexs.ResultsFrom第四个赛季（SLIT 4），鼻涕，打喷嚏，鼻塞症状，TNSMS显着减少相比，在季前预防性治疗和SLIT 1组。在怀疑有嗜酸性粒细胞性气道炎症（基线FENO ≥25 ppb）的患者，FENO水平的年际变异显着减少后5 years of treatment.ConclusionThe SLIT的疗效从治疗的第一年，即使在一年的花粉大量分散。因此，SLIT长期连续治疗可缓解鼻部症状以及嗜酸性粒细胞气道炎症。
ObjectiveJapanese cedar pollinosis is an endemic disease affecting a large proportion of Japan's population. Five seasons have passed since sublingual immunotherapy (SLIT) for Japanese cedar pollinosis was included in the public insurance coverage in Japan. In this study, we evaluated the clinical effects of long-term SLIT for Japanese cedar pollinosis on upper respiratory symptoms primarily represented by nasal symptoms and inflammation of the respiratory tract in the 2019 season, in which considerable amount of cedar pollen was dispersed.MethodsThis study involved 95 patients who were undergoing SLIT for Japanese cedar pollinosis after the initiation at some point between 2014 and 2018, and this group of patients was compared with a control group comprising 21 patients receiving preseasonal prophylactic treatment (with a second-generation antihistaminic drug). We evaluated the patients’ nasal/eye symptoms, total nasal symptom and medication score (TNSMS), and quality of life according to relevant guidelines. In addition, the levels of peripheral blood eosinophils, serum total IgE, Japanese cedar antigen-specific IgE, Cryj1-specific IgG4, and fractional exhaled nitric oxide (FENO) were measured as objective indices.ResultsFrom the fourth season (SLIT4), nasal discharge, sneezing, nasal obstruction symptoms, and TNSMS significantly decreased compared with those in the preseasonal prophylactic treatment and SLIT1 groups. In the patients suspected to have eosinophilic airway inflammation (with a baseline FENO ≥25 ppb), the interannual variability of FENO levels significantly reduced after 5 years of treatment.ConclusionThe efficacy of SLIT was noted from the first year of treatment, even in a year when pollen profusely dispersed. Thus, long-term continuous treatment with SLIT may alleviate nasal symptoms as well as eosinophilic airway inflammation.