Allergic Rhinitis: What Do We Know About Allergen-Specific Immunotherapy?
Allergic Rhinitis: What Do We Know About Allergen-Specific Immunotherapy?
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DOI：
10.3389/falgy.2021.747323
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发表时间：
2021
影响因子：
--
通讯作者：
Morita H
中科院分区：
文献类型：
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作者：
Boonpiyathad T;Lao-Araya M;Chiewchalermsri C;Sangkanjanavanich S;Morita H
变应性鼻炎（Allergic rhinitis，AR）是一种IgE介导的以Th 2型关节炎为特征的疾病。过敏原特异性免疫疗法（AIT）适用于AR，当症状仍然不受控制，尽管药物和过敏原避免。如果AIT缓解了过敏症状，减少了药物使用，即使在治疗停止后也改善了生活质量，并阻止了AR进展为哮喘和新致敏作用的发生，则认为AIT是有效的。AIT可以皮下或舌下给药，新的给药途径仍在开发中，如脑内给药和上皮下给药。AIT的目的是通过修饰先天性和适应性免疫应答来诱导过敏原耐受。AIT的主要机制是通过诱导各种功能性调节性细胞如调节性T细胞（Tfr）、滤泡性T细胞（Tfr）、B细胞（Bfr）、树突状细胞（DC）、先天性淋巴样细胞（IL-10+ ILC）和自然杀伤细胞（NK）来控制2型炎性细胞。然而，AIT具有许多缺点：需要长的治疗期来实现更大的疗效、高成本、全身过敏反应以及缺乏用于预测治疗应答者的生物标志物。目前，正在研究预防性疗法、疫苗佐剂和新型疫苗技术以克服与AIT相关的问题。本综述介绍了AIT的最新概况，特别关注AR。
Allergic rhinitis (AR) is an IgE-mediated disease that is characterized by Th2 joint inflammation. Allergen-specific immunotherapy (AIT) is indicated for AR when symptoms remain uncontrolled despite medication and allergen avoidance. AIT is considered to have been effective if it alleviated allergic symptoms, decreased medication use, improved the quality of life even after treatment cessation, and prevented the progression of AR to asthma and the onset of new sensitization. AIT can be administered subcutaneously or sublingually, and novel routes are still being developed, such as intra-lymphatically and epicutaneously. AIT aims at inducing allergen tolerance through modification of innate and adaptive immunologic responses. The main mechanism of AIT is control of type 2 inflammatory cells through induction of various functional regulatory cells such as regulatory T cells (Tregs), follicular T cells (Tfr), B cells (Bregs), dendritic cells (DCregs), innate lymphoid cells (IL-10+ ILCs), and natural killer cells (NKregs). However, AIT has a number of disadvantages: the long treatment period required to achieve greater efficacy, high cost, systemic allergic reactions, and the absence of a biomarker for predicting treatment responders. Currently, adjunctive therapies, vaccine adjuvants, and novel vaccine technologies are being studied to overcome the problems associated with AIT. This review presents an updated overview of AIT, with a special focus on AR.