生物制剂联合过敏原特异性免疫治疗的适应症：究竟为谁而设？

文献信息

中文摘要

过敏原特异性免疫治疗（AIT）是治疗过敏性疾病和病症（如膜翅目昆虫毒液过敏、过敏性鼻炎、过敏性哮喘，以及近年来的食物过敏）的一种经过充分验证的疗法。为了提高过敏原免疫治疗的疗效和安全性，已引入奥马珠单抗和度普利尤单抗等生物制剂。奥马珠单抗与AIT联合使用已被证明是治疗过敏性哮喘患者和食物脱敏过程中的有效选择，特别是在不良反应更常见的剂量递增阶段。迄今为止，关于生物制剂与AIT联合用于膜翅目昆虫毒液过敏患者的精心设计的临床试验发表数量很少。正在进行的临床研究正在评估度普利尤单抗作为单一疗法或口服免疫治疗辅助疗法在花生过敏患者中的疗效。关于度普利尤单抗用于多种食物过敏患者以及作为牛奶蛋白过敏患者口服免疫治疗辅助疗法的研究也在进行中。需要进一步的研究来确定生物疗法与AIT联合使用的最佳剂量和持续时间，并识别可能从这种治疗方案中获益最多的患者。

英文摘要

Allergen-specific immunotherapy (AIT) is a well-proven treatment for allergic diseases and conditions such as Hymenoptera venom allergy, allergic rhinitis, allergic asthma, and, in recent years, food allergy. In order to enhance the efficacy and safety of allergen immunotherapy, biological agents such as omalizumab and dupilumab have been introduced. The use of omalizumab, in combination with AIT, has proven to be an effective option in treating patients with allergic asthma and during food desensitization, particularly in the dose escalation phase when adverse reactions are more common. To date, only a small number of well-structured clinical trials have been published on the combined use of biologics and AIT in patients with Hymenoptera venom allergy. Ongoing clinical studies are evaluating the efficacy of dupilumab as monotherapy or as an adjunct therapy to oral immunotherapy in patients with peanut allergy. Research is also underway on the use of dupilumab in patients with multiple food allergies and as an adjunct therapy to oral immunotherapy in patients with cow's milk protein allergy. Further studies are needed to determine the optimal dosing and duration of biological therapy in combination with AIT, as well as to identify patients who may benefit most from such treatment regimes.