在过敏性鼻炎的多敏感患者中,室内灰尘的皮下免疫疗法的有效性和预测因素:多中心回顾性研究
Zhouxian Pan1, Shengyang Yao1,2, Lisha Li1
1Department of Allergy, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing Key Laboratory of Precision Medicine for Diagnosis and Treatment on Allergic Diseases, Beijing, China.
概括
家庭灰尘 (HDM) 过敏原免疫疗法 (AIT) 在多敏感患者中有效治疗过敏性鼻炎 (AR),但结果因共存的过敏原和IgE水平而异. 对HDM和菌的高IgE表明反应较差.
科学领域:
- 免疫学 免疫学 免疫学
- 过敏学 过敏学
- 耳鼻喉科 耳鼻喉科 耳鼻喉科
背景情况:
- 在中国,有限的过敏原制剂限制了过敏性鼻炎 (AR) 的治疗选择.
- 家庭灰尘 (HDM) 过敏原免疫疗法 (AIT) 是主要治疗方法,但其在多敏感患者中的有效性尚不确定.
- 对多种过敏原的多重敏感性是常见的,使AIT策略复杂化.
研究的目的:
- 为了评估单个过敏原HDM AIT在多敏感性AR患者中的有效性.
- 评估HDM AIT对长期和同时存在的过敏原特异性症状的影响.
- 在这个患者群体中确定治疗反应的预测因素.
主要方法:
- 一个多中心的回顾性队列研究,包括81名多敏感性AR患者,接受HDM皮下免疫疗法 (SCIT) 12-36个月.
- 收集的基线数据包括血清过敏原特异性IgE (sIgE) 和并发症.
- 通过视觉模拟尺度 (VAS) 评估症状严重程度;治疗反应定义为≥30%的VAS减少. 统计分析包括费舍尔的精确测试,曼-惠特尼U测试和费尔特逻辑回归.
主要成果:
- 长期症状的总体应答率为68.8%.
- 响应率因同时存在的过敏原而异:菌72.7%,动物皮毛70.0%,树花粉65.5%,杂草花粉70.2%.
- 对HDM和菌的较高sIgE水平与共感染患者的反应率较低有关,这表明一种预测模型.
结论:
- 单个过敏原HDM AIT在许多多重敏感性AR患者中表现出有效性.
- 疗效受共存过敏原类型和特定IgE水平的影响.
- 患有高HDM和菌sIgE,同时感染菌的患者表现较差,需要进一步的前性研究来定制AIT策略.
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