山东大学耳鼻喉眼学报 ›› 2019, Vol. 33 ›› Issue (1): 33-37.doi: 10.6040/j.issn.1673-3770.1.2018.017

• 专家笔谈 • 上一篇    下一篇

特异性免疫治疗对过敏性鼻炎和哮喘的同步控制和远期疗效

邱前辉*(),高俊潇   

  1. 南方医科大学珠江医院耳鼻咽喉科，广东 广州 510282
  • 收稿日期:2018-09-21 出版日期:2019-01-20 发布日期:2019-01-28
  • 通讯作者: 邱前辉 E-mail:qiuqianhui@hotmail.com
  • 作者简介:邱前辉，医学博士，教授，主任医师，博士生导师。现任南方医科大学珠江医院耳鼻咽喉科主任。主要学术任职：中国医疗保健国际交流促进会过敏科学分会副主任委员，中华医学会变态反应学分会委员，中国中西医结合学会耳鼻咽喉科专业委员会变态反应专家委员会副主任委员，中国中西医结合学会耳鼻咽喉科专业委员会鼻颅底肿瘤和嗅觉专家委员会副主任委员，广东省医学会变态反应学分会主任委员，广东省医师协会变态反应工作委员会学术顾问，广东省医师协会耳鼻咽喉科医师分会鼻科专业组副组长，广东省医学会肿瘤学分会鼻咽癌学组组员，广东省医学会耳鼻咽喉科学分会鼻科学组组员，广东省自然科学基金、中国博士后基金、省医学科研基金评审专家。主要研究方向：鼻腔鼻窦炎症性疾病及颅底肿瘤的基础和临床研究。在广东省较早开展过敏性鼻炎过敏原检测和特异性免疫治疗，是国内首位开展变应性鼻炎标准化抗原冲击免疫治疗的专家，同时也是国内较早开展内镜下鼻窦炎手术以及内镜鼻颅底肿瘤手术的专家之一。主持国家和省部级课题15项，发表论文80余篇

Synchronous control and long-term efficacy of specific immunotherapy for allergic rhinitis and asthma

Qianhui QIU*(),Junxiao GAO   

  1. Department of Otorhinolaryngology, Zhujiang Hospital, Southern Medical University, Guangzhou 510282, Guangdong, China
  • Received:2018-09-21 Online:2019-01-20 Published:2019-01-28
  • Contact: Qianhui QIU E-mail:qiuqianhui@hotmail.com

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摘要：

近年来，过敏性鼻炎(AR)和哮喘的患病率呈明显增加的趋势。随着对特异性免疫治疗(SIT)的不断了解与深入，目前认为该方法可能是惟一通过调节免疫机制从而改变变应性疾病的自然进程，并且可以在治疗停止之后获得长期疗效。综述了SIT对AR和哮喘的同步控制和远期疗效，通过国内外文献回顾及分析对比，认为SIT在治疗AR和哮喘的过程中起着十分重要且积极的作用，并且能够预防AR向哮喘进展。但是，SIT也存在一些问题,值得进一步研究及探讨。

关键词: 变应性鼻炎, 哮喘, 特异性免疫治疗

Abstract:

In recent years, the prevalence of allergic rhinitis(AR)and allergic asthma has increased significantly. Because of a deeper understanding of specific immunotherapy(SIT), it is currently believed that SIT may be the only treatment that changes the natural course of allergic diseases by regulating the immune mechanisms and can maintain long-term effects after treatment has been discontinued. This article reviews the simultaneous control and long-term efficacy of SIT for AR and asthma. A literature review and analysis of domestic and international studies indicates that SIT plays an important and positive role in the treatment of AR and asthma and can prevent AR from progressing to asthma. However, SIT is also associated with some problems that merit further discussion.

Key words: Allergic rhinitis, Asthma, Specific immunotherapy

中图分类号: 

  • R765
1 Alessandro Fiocchi . Setting the stage of innovations in allergy globally[J]. World Allergy Organ J, 2014, 7 (1): 5.
doi: 10.1186/1939-4551-7-5
2 Morjaria JB , Caruso M , Emma R , et al. Treatment of allergic rhinitis as a strategy for preventing asthma[J]. Curr Allergy Asthma Rep, 2018, 18 (4): 23.
doi: 10.1007/s11882-018-0781-y
3 Linneberg A , Henrik Nielsen N , Frølund L , et al. The link between allergic rhinitis and allergic asthma: a prospective population-based study. The Copenhagen Allergy Study[J]. Allergy, 2002, 57 (11): 1048- 1052.
doi: 10.1034/j.1398-9995.2002.23664.x
4 Farid R , Ghasemi R , Baradaran-Rahimi M , et al. Evaluation of six years allergen immunotherapy in allergic rhinitis and allergic asthma[J]. Iran J Allergy Asthma Immunol, 2006, 5 (1): 29- 31.
doi: 05.01/ijaai.2931
5 Demoly P , Bousquet PJ . Links between allergic rhinitis and asthma still reinforced[J]. Allergy, 2008, 63 (3): 251- 254.
doi: 10.1111/j.1398-9995.2008.01628.x
6 Sin B , Togias A . Pathophysiology of allergic and nonallergic rhinitis[J]. Proc Am Thorac Soc, 2011, 8 (1): 106- 114.
doi: 10.1513/pats.201008-057RN
7 Schmitt J , Schwarz K , Stadler E , et al. Allergy immunotherapy for allergic rhinitis effectively prevents asthma: Results from a large retrospective cohort study[J]. J Allergy Clin Immunol, 2015, 136 (6): 1511- 1516.
doi: 10.1016/j.jaci.2015.07.038
8 Brozek JL , Bousquet J , Baena-Cagnani CE , et al. Allergic Rhinitis and its Impact on Asthma (ARIA) guidelines: 2010 revision[J]. J Allergy Clin Immunol, 2010, 126 (3): 466- 476.
doi: 10.1016/j.jaci.2010.06.047
9 Brożek JL , Bousquet J , Agache I , et al. Allergic Rhinitis and its Impact on Asthma (ARIA) guidelines-2016 revision[J]. J Allergy Clin Immunol, 2017, 140 (4): 950- 958.
doi: 10.1016/j.jaci.2017.03.050
10 邱前辉. 变应性鼻炎免疫治疗的现状和未来[J]. 临床耳鼻咽喉头颈外科杂志, 2017, 31 (1): 9- 12.
doi: 10.13201/j.issn.1001-1781.2017.01.004
QIU Qianhui . Current status and future of immunotherapy for allergic rhinitis[J]. Journal of Clinical Otorhinolaryngology Head and Neck Surgery, 2017, 31 (1): 9- 12.
doi: 10.13201/j.issn.1001-1781.2017.01.004
11 Ring J , Gutermuth J . 100 years of hyposensitization: history of allergen-specific immunotherapy (ASIT)[J]. Allergy, 2011, 66 (6): 713- 724.
doi: 10.1111/j.1398-9995.2010.02541.x
12 Bousquet J , Anto JM , Wickman M , et al. Are allergic multimorbidities and IgE polysensitization associated with the persistence or re-occurrence of foetal type 2 signalling? The MeDALL hypothesis[J]. Allergy, 2015, 70 (9): 1062- 1078.
doi: 10.1111/all.12637
13 Aguilar D , Pinart M , Koppelman GH , et al. Computational analysis of multimorbidity between asthma, eczema and rhinitis[J]. PLoS One, 2017, 12 (6): e0179125.
doi: 10.1371/journal.pone.0179125
14 Canonica G , Baiardini I . Minimal persistent inflammation in allergic rhinitis[J]. Allergy Clin Immunol Inter J World Allergy Organ, 2006, 18 (4): 169- 171.
doi: 10.1027/0838-1925.18.4.169
15 Ciprandi G , Cirillo I . The lower airway pathology of rhinitis[J]. J Allergy Clin Immunol, 2006, 118 (5): 1105- 1109.
doi: 10.1016/j.jaci.2006.05.010
16 Cox L , Compalati E , Kundig T , et al. New directions in immunotherapy[J]. Curr Allergy Asthma Rep, 2013, 13 (2): 178- 195.
doi: 10.1007/s11882-012-0335-7
17 Jacobsen L , Niggemann B , Dreborg S , et al. Specific immunotherapy has long-term preventive effect of seasonal and perennial asthma: 10-year follow-up on the PAT study[J]. Allergy, 2007, 62 (8): 943- 948.
doi: 10.1111/j.1398-9995.2007.01451.x
18 Holgate ST , Polosa R . Treatment strategies for allergy and asthma[J]. Nat Rev Immunol, 2008, 8 (3): 218- 230.
doi: 10.1038/nri2262
19 Burks AW , Calderon MA , Casale T , et al. Update on allergy immunotherapy: american academy of allergy, asthma & Immunology/European academy of allergy and clinical Immunology/PRACTALL consensus report[J]. J Allergy Clin Immunol, 2013, 131 (5): 1288- 1296.e3.
doi: 10.1016/j.jaci.2013.01.049
20 Şahin E , Ali Bafaqeeh S , Güven SG , et al. Mechanism of action of allergen immunotherapy[J]. Am J Rhinol Allergy, 2016, 30 (5suppl): S1- S3.
doi: 10.2500/ajra.2016.30.4367
21 Allam JP , Novak N . Immunological mechanisms of allergen-specific immunotherapy[J]. Hautarzt, 2017, 68 (4): 265- 270.
doi: 10.1007/s00105-017-3961-0
23 罗志红, 李彬, 万浪, 等. 变应性鼻炎集群免疫治疗与常规免疫治疗的临床疗效及安全性对照研究[J]. 中华耳鼻咽喉头颈外科杂志, 2015, 50 (2): 105- 109.
doi: 10.3760/cma.j.issn.1673-0860.2015.02.004
LUO Zhihong , LI Bin , WAN Lang , et al. Comparative study on cluster and conventional immunotherapy in patients with allergic rhinitis[J]. Chinese Journal of Otorhinolaryngology Head and Neck Surgery, 2015, 50 (2): 105- 109.
doi: 10.3760/cma.j.issn.1673-0860.2015.02.004
24 Calderon MA , Alves B , Jacobson M , et al. Cochrane review: Allergen injection immunotherapy for seasonal allergic rhinitis[J]. Evid Based Child Health, 2010, 5 (3): 1279- 1379.
doi: 10.1002/ebch.582
25 Cox LS , Larenas Linnemann D , Nolte H , et al. Sublingual immunotherapy: a comprehensive review[J]. J Allergy Clin Immunol, 2006, 117 (5): 1021- 1035.
doi: 10.1016/j.jaci.2006.02.040
26 Braido F , Baiardini I , Stagi E , et al. RhinAsthma patient perspective: a short daily asthma and rhinitis QoL assessment[J]. Allergy, 2012, 67 (11): 1443- 1450.
doi: 10.1111/all.12014
27 Canonica GW , Baena-Cagnani CE , Bousquet J , et al. Recommendations for standardization of clinical trials with Allergen Specific Immunotherapy for respiratory allergy. A statement of a World Allergy Organization (WAO) taskforce[J]. Allergy, 2007, 62 (3): 317- 324.
doi: 10.1111/j.1398-9995.2006.01312.x
28 王忠喜, 李文静. 特异性免疫治疗疗效起始时间研究[J]. 中国医院药学杂志, 2009, 29 (19): 1688- 1689.
29 Nolte H , Maloney J , Nelson HS , et al. Onset and dose-related efficacy of house dust mite sublingual immunotherapy tablets in an environmental exposure chamber[J]. J Allergy Clin Immunol, 2015, 135 (6): 1494- 1501.e6.
doi: 10.1016/j.jaci.2014.12.1911
30 Cox L , Nelson H , Lockey R , et al. Allergen immunotherapy: a practice parameter third update[J]. J Allergy Clin Immunol, 2011, 127 (1 Suppl): S1- 55.
doi: 10.1016/j.jaci.2010.09.034
31 程雷. 变应性鼻炎特异性舌下免疫治疗[J]. 临床耳鼻咽喉头颈外科杂志, 2015, 29 (3): 197- 199.
doi: 10.13201/j.issn.1001-1781.2015.03.001
CHENG Lei . Sublingual specific immunotherapy for allergic rhinitis[J]. J Clinical Otorhinolaryngology Head and Neck Surgery, 2015, 29 (3): 197- 199.
doi: 10.13201/j.issn.1001-1781.2015.03.001
32 Zhang L , Wang CS , Han DM , et al. Comparative study of cluster and conventional immunotherapy schedules with dermatophagoides pteronyssinus in the treatment of persistent allergic rhinitis[J]. Int Arch Allergy Immunol, 2009, 148 (2): 161- 169.
doi: 10.1159/000155747
33 Ross RN , Nelson HS , Finegold I . Effectiveness of specific immunotherapy in the treatment of allergic rhinitis: an analysis of randomized, prospective, single- or double-blind, placebo-controlled studies[J]. Clin Ther, 2000, 22 (3): 342- 350.
doi: 10.1016/S0149-2918(00)80038-7
34 王成硕, 王向东, 张伟, 等. 变应性鼻炎屋尘螨变应原皮下免疫治疗的远期疗效研究[J]. 中华耳鼻咽喉头颈外科杂志, 2012, 47 (10): 804- 808.
doi: 10.3760/cma.j.issn.1673-0860.2012.10.003
WANG Chengshuo , WANG Xiangdong , ZHANG Wei , et al. Long-term efficacy of Dermatophagoides pteronyssinus immunotherapy in patients with allergic rhinitis: a 3-year prospective study[J]. Chin J Otorhinolaryngol Head Neck Surg, 2012, 47 (10): 804- 808.
doi: 10.3760/cma.j.issn.1673-0860.2012.10.003
35 Karthikeyan P , Pulimoottil DT , Sankar R . Long-term effects of allergen-specific subcutaneous immunotherapy for house dust mite induced allergic rhinitis[J]. J Laryngol Otol, 2018, 132 (7): 665.
doi: 10.1017/S0022215118000683
36 Keles S , Karakoc-Aydiner E , Ozen A , et al. A novel approach in allergen-specific immunotherapy: combination of sublingual and subcutaneous routes[J]. J Allergy Clin Immunol, 2011, 128 (4): 808- 815.e7.
doi: 10.1016/j.jaci.2011.04.033
37 Yukselen A , Kendirli SG . Role of immunotherapy in the treatment of allergic asthma[J]. World J Clin Cases, 2014, 2 (12): 859- 865.
doi: 10.12998/wjcc.v2.i12.859
38 Wang H , Lin X , Hao C , et al. A double-blind, placebo-controlled study of house dust mite immunotherapy in Chinese asthmatic patients[J]. Allergy, 2006, 61 (2): 191- 197.
doi: 10.1111/j.1398-9995.2005.00913.x
39 Karakoc-Aydiner E , Eifan AO , Baris S , et al. Long-term effect of sublingual and subcutaneous immunotherapy in dust mite-allergic children with Asthma/Rhinitis: a 3-year prospective randomized controlled trial[J]. J Investig Allergol Clin Immunol, 2015, 25 (5): 334- 342.
40 Valovirta E , Petersen TH , Piotrowska T , et al. Results from the 5-year SQ grass sublingual immunotherapy tablet asthma prevention (GAP) trial in children with grass pollen allergy[J]. J Allergy Clin Immunol, 2018, 141 (2): 529- 538.e13.
doi: 10.1016/j.jaci.2017.06.014
41 Kristiansen M , Dhami S , Netuveli G , et al. Allergen immunotherapy for the prevention of allergy: A systematic review and meta-analysis[J]. Pediatr Allergy Immunol, 2017, 28 (1): 18- 29.
doi: 10.1111/pai.12661
42 陈壮桂, 李鸣, 李宝琴, 等. 变应原特异性免疫治疗对变应性哮喘患儿远期预后的影响[J]. 新医学, 2013, 44 (9): 598- 602.
doi: 10.3969/g.issn.0253-9802.2013.09.004
CHEN Zhuanggui , LI Ming , LI Baoqin , et al. Influence of the long-term prognosis of specific immunotherapy in allergic asthma[J]. New Medicine, 2013, 44 (9): 598- 602.
doi: 10.3969/g.issn.0253-9802.2013.09.004
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