最近在过敏性鼻炎的治疗方面取得的进展
Yoshiaki Kitamura1, Seiichiro Kamimura1, Tatsuya Fujii2
1Department of Otorhinolaryngology-Head and Neck surgery, Institute of Biomedical Sciences, Tokushima University Graduate School,Tokushima, Japan.
The journal of medical investigation : JMI
|April 23, 2025
概括
过敏性鼻炎 (AR) 管理的进展包括阻断组胺素H1受体信号的抗组胺药物和改善鼻腔症状的舌下免疫疗法 (SLIT). 双SLIT和后鼻神经切除术为AR患者提供了进一步的治疗选择.
科学领域:
- 免疫学 免疫学 免疫学
- 耳鼻喉科 耳鼻喉科 耳鼻喉科
- 药理学 药理学是指药理学的学科.
背景情况:
- 过敏性鼻炎 (AR) 是一种普遍的I型过敏性疾病,影响约50%的日本人口,其特点是打喷,鼻和鼻腔阻塞.
- 组胺,通过组胺H1受体 (H1R) 作用,是AR症状的关键媒介.
- 抗胰岛素可以通过抑制胰岛素诱导和基底H1R转录来发挥逆激素作用.
研究的目的:
- 审查最近在过敏性鼻炎管理方面的进展.
- 探索抗组胺剂的机制以及免疫疗法和手术干预的疗效.
主要方法:
- 关于过敏性鼻炎治疗的当前文献的综述.
- 对抗胰岛素对H1R信号传递的影响的分析.
- 用日本香柏树 (JC) 花粉和室内灰尘虫 (HDM) 进行语言下免疫疗法 (SLIT) 的评估.
- 对严重多年性AR的后鼻神经切除术 (PNN) 的评估.
主要成果:
- 抗组胺药物阻断了组胺信号传递并抑制了H1R转录,可能起到逆激动剂的作用.
- 用JC花粉进行的语言下免疫疗法 (SLIT) 改善了JC花粉症的鼻腔症状和睡眠障碍.
- 双SLIT与JC花粉和HDM有效地抑制了季节性和多年性鼻症状,特别是花粉旺季的鼻阻塞.
- 后鼻神经切除术 (PNN) 改善了严重多年性AR患者的鼻症状和降低了药物评分.
结论:
- 最近的进展为过敏性鼻炎提供了改进的管理策略.
- 抗胰岛素,SLIT和PNN为AR患者提供了有效的治疗选择.
- 双SLIT对双敏感个体和管理严重症状特别有希望.
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