粉尘螨过敏的现有及新兴舌下免疫治疗

文献信息

中文摘要

引言： 屋尘螨（HDMs）是全球最常见的吸入性过敏原，可诱发包括过敏性鼻炎（AR）和哮喘在内的一系列过敏性疾病，显著损害患者的生活质量。舌下免疫治疗（SLIT）被认为是一种有前景的疾病修饰性干预措施，用于HDM相关过敏性疾病。
涵盖领域： 本文对HDM过敏的SLIT（HDM-SLIT）的最新临床证据进行叙述性综述，涵盖其治疗疗效、患者选择标准、剂量优化策略、安全性特征、潜在免疫学机制以及尚未解决的临床挑战。
专家意见： HDM-SLIT已被确立为HDM诱导的AR和哮喘的疾病修饰性治疗，支持证据表明其具有临床疗效、良好的安全性特征和长期耐受性。精准过敏学的未来发展，包括多组学衍生的生物标志物和数字健康应用，在指导临床决策方面显示出相当大的潜力。然而，由于保险报销缺口、患者依从性欠佳、各地区监管标准不一致、产品标准化不足以及医疗资源获取不公平，这些进展向常规临床实践的转化仍然受限。

英文摘要

INTRODUCTION: House dust mites (HDMs) are the most prevalent inhalant allergens globally, inducing a spectrum of allergic diseases including allergic rhinitis (AR) and asthma, which substantially impair patients' quality of life. Sublingual immunotherapy (SLIT) is recognized as a promising disease-modifying intervention for HDM-related allergic disorders.Areas covered: This paper presents a narrative review of up-to-date clinical evidence regarding SLIT for HDM allergy (HDM-SLIT), covering its therapeutic efficacy, patient selection criteria, dose optimization strategies, safety profiles, underlying immunological mechanisms, and unresolved clinical challenges.
EXPERT OPINION: HDM-SLIT has been established as a disease-modifying therapy for HDM-induced AR and asthma, with supporting evidence demonstrating its clinical efficacy, favorable safety profile, and long-lasting tolerability. Future developments in precision allergology, including multiomics-derived biomarkers and digital health applications, show considerable potential to guide clinical decision-making. However, the translation of these advances into routine clinical practice remains limited by gaps in insurance reimbursement, suboptimal patient adherence, inconsistent regulatory standards across regions, insufficient product standardization, and inequitable access to healthcare resources.