Update on allergy immunotherapy: American Academy of Allergy, Asthma & Immunology/European Academy of Allergy and Clinical Immunology/PRACTALL consensus report
Update on allergy immunotherapy: American Academy of Allergy, Asthma & Immunology/European Academy of Allergy and Clinical Immunology/PRACTALL consensus report
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DOI：
10.1016/j.jaci.2013.01.049
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发表时间：
2013-05-01
影响因子：
14.2
通讯作者：
Akdis, Cezmi A.
中科院分区：
文献类型：
--
作者：
Burks, A. Wesley;Calderon, Moises A.;Akdis, Cezmi A.
过敏性免疫疗法（AIT）是治疗过敏性哮喘和鼻炎以及毒液诱导的过敏反应的有效方法。除了减轻症状外，AIT还可以改变过敏性疾病的病程，诱导过敏原特异性免疫耐受。在目前的临床实践中，免疫疗法是皮下或舌下递送的;一些过敏原，如草花粉，可以通过任一途径递送，而其他过敏原，如毒液，仅皮下递送。皮下和舌下免疫疗法似乎都具有长达12年的有效期，并且都可以预防哮喘和新过敏原敏感性的发展。尽管AIT取得了进展，但仍需要更安全有效的AIT策略，特别是对于哮喘、特应性皮炎或食物过敏患者。改善AIT的新方法包括使用佐剂或重组过敏原和替代给药途径。作为PRACTALL计划的一部分，欧洲过敏和临床免疫学学会和美国过敏、哮喘和免疫学学会提名了一个专家小组，就AIT的机制及其在临床实践中的应用，以及AIT未满足的需求和正在进行的发展，编写一份全面的共识报告。这份报告得到了两个学院的认可。
Allergy immunotherapy (AIT) is an effective treatment for allergic asthma and rhinitis, as well as venom-induced anaphylaxis. In addition to reducing symptoms, AIT can change the course of allergic disease and induce allergen-specific immune tolerance. In current clinical practice immunotherapy is delivered either subcutaneously or sublingually; some allergens, such as grass pollen, can be delivered through either route, whereas others, such as venoms, are only delivered subcutaneously. Both subcutaneous and sublingual immunotherapy appear to have a duration of efficacy of up to 12 years, and both can prevent the development of asthma and new allergen sensitivities. In spite of the advances with AIT, safer and more effective AIT strategies are needed, especially for patients with asthma, atopic dermatitis, or food allergy. Novel approaches to improve AIT include use of adjuvants or recombinant allergens and alternate routes of administration. As part of the PRACTALL initiatives, the European Academy of Allergy and Clinical Immunology and the American Academy of Allergy, Asthma & Immunology nominated an expert team to develop a comprehensive consensus report on the mechanisms of AIT and its use in clinical practice, as well as unmet needs and ongoing developments in AIT. This resulting report is endorsed by both academies.