舌下特异性免疫治疗变应性鼻炎的疗效和安全性分析

目的：探讨舌下特异性免疫治疗变应性鼻炎（AR）的有效性和安全性。方法将2012年1月-2013年4月我院收治的48例变应性鼻炎患者,随机均分为观察组和对照组,对照组给予常规药物治疗,观察组在此基础上加用舌下特异性免疫治疗,对两组变异性鼻炎症状、体征评分、临床疗效和药物不良反应情况进行综合比较。结果治疗12个月后观察组变异性鼻炎症状、体征评分均显著低于对照组（P〈0.05）;观察组治疗总有效率为100%,显著高于对照组的75%（P〈0.05）;两组患者不良反应发生率比较无显著差异（P〉0.05）。结论舌下特异性免疫治疗变应性鼻炎效果显著,可有效改善患者临床症状,不良反应轻微。     

舌下特异性免疫疗法对过敏性鼻炎患者免疫系统影响的研究

目的：探讨舌下特异性免疫疗法对于过敏性鼻炎患者的疗效,及其对患者免疫功能的影响以研究其作用机制。方法该院自2012年2月—2013年2月共收治48例过敏性鼻炎患者并纳入试验组,选取48例同期体检的健康人作为对照组,给予过敏性鼻炎患者舌下特异性免疫疗法,分别在治疗前后测定试验组和对照组患者血清 IL-12、IL-10、TGF-β、IgE 水平。结果治疗前,试验组 IL-12、IL-10显著低于对照组（P ＜0．05）,TGF-β显著高于对照组（P ＜0．05）,IgE 无显著性差异（P ＞0．05）;经过一年的舌下特异性免疫疗法后,试验组患者症状积分、体征积分、药物积分均显著降低（P ＜0．05）,试验组 IL-12、IL-10显著升高（P ＜0．05）,与对照组无显著差异（P ＞0．05）,TGF-β进一步增高,显著高于对照组（P ＜0．05）,IgE 无显著性差异（P ＞0．05）。结论舌下特异性免疫疗法能够恢复过敏性鼻炎患者失衡的免疫功能,从而显著改善过敏性鼻炎患者的临床症状。     

舌下变应原特异性免疫疗法治疗儿童过敏性哮喘50例疗效分析

目的观察舌下变应原特异性免疫疗法治疗儿童过敏性哮喘的临床疗效。方法将110例患儿分为2组,治疗组给予粉尘螨滴剂舌下含服治疗;对照组常规给予糖皮质激素吸入治疗。结果治疗组临床控制率为49.09%,总有效率为92.73%;对照组临床控制率为38.00%,总有效率为82.00%。2组临床控制率、总有效率相比有明显差异(P<0.05)。CD3、CD4、CD8 2组治疗后均有显著变化,2组治疗后与治疗前组内相比,差异有统计学意义(P<0.05);治疗后治2组组间比较比差异有统计学意义(P<0.05)。结论舌下变应原特异性免疫疗法治疗儿童过敏性哮临床疗效显著。     

变应性鼻炎舌下免疫治疗的新进展

变应性鼻炎(AR)的特异性免疫治疗(SIT)又称脱敏治疗日益受到重视,舌下免疫治疗(SLIT)属于非注射免疫治疗,越来越多的研究证实其临床疗效和安全性.探讨AR的SLIT的研究进展,为AR的防治提供依据,具有极为重要的临床意义.     

50例儿童过敏性哮喘患者应用舌下变应原特异性免疫疗法的护理对策

<正>儿童过敏性哮喘复发率高,治疗周期长,传统单一的护理模式已不能适应新疗法的要求。为使SLIT更好发挥疗效,我院于2007年在常     

舌下特异性免疫治疗在儿童难治性哮喘中的疗效与安全性

目的研究分析舌下特异性免疫治疗在儿童难治性哮喘中的疗效与安全性。方法选取我院于2009年5月至2011年5月收治的100例儿童难治性哮喘者的临床资料,将其随机分为治疗组和对照组。治疗组50例患者采用舌下特异性治疗,对照组50例进行正常的特异性治疗。观察治疗前后哮喘症状变化、肺功能、不良反应、副作用等[3]。结果治疗组的五十例患者经舌下特异性免疫治疗后肺功能、不良反应（皮肤瘙痒、一过性皮疹、口腔不适、鼻塞）有所改善,临床表现喘息、气急、胸闷、咳嗽等症状都有所改善。两组患者治疗有效率对比有统计学意义（P〈0．05）;两组患者治疗后各临床症状改善,治疗组优于对照组,有统计学意义（P〈O．05）;两组不良反应率对比P〉O．05,无统计学意义。结论舌下特异性免疫治疗在儿童难治性哮喘中疗效显著,安全有效,值得推广。     

疑似变应性鼻炎患者尘螨阳性率及对舌下免疫治疗的接受度评估

目的 探讨在我院就诊的疑似变应性鼻炎患者的尘螨阳性率,并评估舌下免疫治疗(SLIT)的接受度.方法 对疑似变应性鼻炎患者进行尘螨点刺筛查,并首诊教育推荐尘螨阳性且相关性好的患者进行SLIT治疗,调查愿意接受免疫治疗的患者比率,并以SPSS 21.0软件对数据进行统计学处理.结果 3 922例疑似变应性鼻炎患者尘螨点刺筛查的阳性率为63.9％,其中4-10月份的阳性率比较高.尘螨阳性(点刺≥3+)且相关性好的患者对SLIT的接受度为73.1％.结论 在我院就诊的疑似变应性鼻炎患者主要是对尘螨过敏,这些患者经过首诊教育后对SLIT的接受度比较高.     

粉尘螨滴剂对儿童过敏性哮喘及变应性鼻炎的临床疗效

目的 评估粉尘螨滴剂治疗过敏性哮喘和变应性鼻炎的临床疗效和安全性.方法 对177例由粉尘螨引起的过敏性哮喘和变应性鼻炎患儿使用标准化粉尘螨变应原药物进行舌下脱敏治疗.定期随访,记录患儿的哮喘症状和鼻炎症状、对症用药情况、临床自我疗效评价以及治疗期间发生的不良反应,并在试验开始和结束时检测患儿的粉尘螨特异性抗体.结果 患儿治疗后的哮喘症状评分和鼻炎症状评分较治疗前显著降低(P＜0.01).对症用药评分:变应性鼻炎治疗前、后分别为(4.07±2.10)分、(1.32±0.99)分;过敏性哮喘分别为(6.31±2.94)分、(2.86±1.5.7)分(P＜0.01).粉尘螨特异性IgE在治疗结束时并没有发生显著的变化.但sIgG4浓度与治疗前相比明显上升(P＜0.01).治疗过程中无一例严重不良反应.结论 粉尘螨滴剂是治疗过敏性哮喘和变应性鼻炎安全、有效的舌下特异性免疫治疗药物.     

粉尘螨滴剂对3～14岁支气管哮喘和过敏性鼻炎的疗效及安全性分析

目的评估舌下特异性免疫治疗药物＂粉尘螨滴剂＂治疗3～14岁过敏性哮喘及变应性鼻炎患儿的疗效和安全性。方法对78例3～14岁由粉尘螨过敏引起的过敏性哮喘和（或）变应性鼻炎患儿进行为期25周的脱敏治疗,记录治疗前后患儿的哮喘症状评分和鼻炎症状评分,统计分析疗效及安全性。结果治疗后患儿的哮喘症状评分和鼻炎症状评分较治疗前均显著下降,差异具有统计学意义（P〈0.01）。治疗期间出现7例次局部不良反应,1例次全身不良反应,未出现严重全身不良反应。结论舌下特异性免疫治疗粉尘螨滴剂是治疗儿童过敏性哮喘和变应性鼻炎的一种安全、有效的治疗方法。     

粉尘螨滴剂舌下含服脱敏治疗变应性鼻炎117例疗效观察

变应性鼻炎(AR)是变应原刺激机体后产生的主要由IgE介导的速发型非感染性的慢性炎症[1].尘螨是我国引起AR和哮喘的主要致敏原之一[2].变应原特异性免疫治疗(ASIT) 是目前被认为是惟一可以针对变应性疾病病因的对因治疗方法,并可预防AR发展成哮喘或其它变态反应性疾病[3-5],ASIT初始给予最小剂量变应原刺激,后逐步增加患者变应原接触量,以逐渐诱导机体免疫耐受,使患者再次接触相应变应原时不产生临床症状或者症状较前减轻.近年来舌下含服特异性免疫治疗(SLIT)作为ASIT的一种新型给药方式,对IgE介导的I型过敏性疾病安全有效,它具有安全性高、使用方便、患者依从性好等优点.     

Sublingual immunotherapy of allergic diseases

The only disease-modifying treatment that is available for allergic patients is allergen-specific immunotherapy. Two competing application forms are used: subcutaneous immunotherapy, which has been used for > 90 years, and a relatively new immunotherapy where the allergen is applied sublingually. Numerous studies have shown efficacy for subcutaneous immunotherapy and have identified possible mechanisms that are responsible for the observed reduction in allergic responses. In contrast, the efficacy of sublingual immunotherapy has not been documented to the same degree and the responsible immunological mechanisms have not yet been clearly defined. This review focuses on the published clinical and experimental data on sublingual immunotherapy and points at possible mechanisms of how sublingual immunotherapy may differ from subcutaneous immunotherapy in its mode of action, and also discusses the potential advantages and pit falls of both therapies.     

粉尘螨滴剂治疗儿童变应性鼻炎的疗效及安全性

目的：评价舌下含服标准化粉尘螨滴剂治疗儿童变应性鼻炎2年疗效及其安全性。方法螨过敏变应性鼻炎儿童240例随机分为观察组和对照组,各120例,对照组氯雷他定或／和康酸莫米松药物治疗,观察组加用舌下含服粉尘螨滴剂,疗程2年,评价治疗前后症状评分和药物评分及安全性。结果2年后,观察组患儿症状评分和药物评分为（3.46±0.85）,（0.28±0.43）分,较治疗前的（10.76±1.08）,（1.28±0.68）分均明显减少（P均＜0.05）,较对照组治疗后的（9.76±1.14）,（1.09±0.35）分均明显减少（P均＜0.05）。观察组随访期间出现皮疹、鼻咽痒等11例,对照组出现鼻腔出血,乏力、嗜睡等10例,均未出现过敏性休克等严重全身不良反应。结论舌下含服标准化尘螨滴剂治疗尘螨引起的儿童变应性鼻炎有效,并有较好的安全性。     

粉尘螨滴剂舌下含服治疗儿童支气管哮喘伴过敏性鼻炎的临床疗效

目的评估粉尘螨滴剂治疗儿童支气管哮喘伴过敏性鼻炎的临床疗效。方法将94例5～14岁粉尘螨过敏的患儿分常规组和脱敏组,分别采用常规治疗和粉尘螨舌下含服脱敏治疗,定期随访,记录患儿的哮喘症状和鼻炎症状,用药情况,并在治疗2 a后复查粉尘螨皮肤点刺。结果脱敏组和常规组治疗前哮喘症状评分分别为(2.55±0.52)和(2.60±0.49)分,治疗2 a均明显降低,分别为(0.30±0.59)和(0.85±0.87)分;鼻炎评分治疗前分别为(5.86±2.61)和(5.72±2.41)分,治疗2 a明显降低分别为(1.34±0.79)和(3.66±1.87)分;用药评分治疗前分别为(5.21±1.13)和(5.02±1.26)分,治疗2 a也明显降低,分别为(0.17±0.43)和(0.77±0.92)分。粉尘螨点刺结果分级评分治疗前(3.63±0.48)和(3.56±0.50)分,治疗2 a分别为(2.43±0.43)和(3.39±0.60)分。各项评分免疫组与常规组比较差异有高度统计学意义(P<0.001)。均未见严重的不良反应。结论粉尘螨滴剂吞下含服治疗儿童支气管哮喘伴过敏性鼻炎安全、有效。     

Observational study of sublingual specific immunotherapy in persistent and intermittent allergic rhinitis: the EFESO trial

ABSTRACT

Background: Sublingual specific immunotherapy (SLIT) is a valid treatment for allergies. However, there are few data on a large sample size regarding its clinical role in ‘real life’.

Study aim: We performed a multicentre, case-control study to evaluate the effectiveness of SLIT in patients with allergic rhinitis (AR).

Methods: A total of 305 patients with AR were enrolled. Cases (n?=?154) were defined as patients with intermittent (64%) or persistent (36%) AR who were treated daily for at least two consecutive years with specific SLIT. Controls (n?=?151) were defined as age-, sex- and type of allergen-matched AR subjects who were never treated with specific immunotherapy. The main outcomes of the study were the rhinoconjunctivitis symptom score (SS) and the symptomatic medication score (MS). SS and MS were evaluated at the end of the observational period in relation to the peak of relevant pollen season or during the period of maximum allergen exposure in case of non-seasonal allergens.

Results: SS mean (SD) value was 5.1 (3.0) in cases and 9.3 (3.3) in controls (?43%) (?p?=?0.0001). MS mean (SD) value was 2.6 (1.8) and 4.4 (2.6) in the case and control groups, respectively (?41%) (?p?=?0.0001). At the end of the observation period, asthma-related symptoms were present in 8.5% of cases and in 20% in the control group (?p?=?0.01).

Conclusion: The EFficacia nella rinitE allergica di SlitOne (EFESO) trial shows that SLIT treatment in AR is associated with lower SS and MS in comparison with controls. SLIT is also associated with a lower incidence of asthma and new sensitizations. As this was an observational study, our results need to be confirmed in randomized, double-blind, controlled trials.     

Safety and tolerability of 5-grass pollen tablet sublingual immunotherapy: pooled analysis and clinical review

Introduction: The 5-grass pollen tablet (Oralair®, Stallergenes, Antony, France) is a once-daily preseasonal and coseasonal sublingual immunotherapy (SLIT) that is effective in controlling the symptoms of allergic rhinoconjunctivitis and in reducing the need for symptomatic medication.

Areas covered: The body of safety data gathered from the 5-grass pollen tablet clinical development program, post-approval studies, and more than 6 years of real-life experience demonstrates the safety and tolerability profile of the 5-grass pollen tablet across all age groups. Adverse events (AEs) are generally mild or moderate in severity, and rarely lead to treatment discontinuation. AEs also tend to decline in frequency and severity over time and with repeated treatment. The most frequent treatment-emergent AEs are local-site oropharyngeal reactions (e.g., oral pruritus, throat irritation, tongue pruritus, mouth edema, ear pruritus), which are consistent with the sublingual route of administration.

Expert opinion: The first dose of the 5-grass pollen tablet should be administered under the supervision of an experienced physician, to allow for optimal monitoring and timely management of AEs, should they occur. The 5-grass pollen tablet can be administered at home after the first dose, and patients and carers should be educated on how to manage adverse reactions, unplanned treatment interruptions and situations in which SLIT should be withheld.     

The Safety of available immunotherapy for the treatment of glioblastoma

Introduction: Glioblastoma (GBM) is the most common malignant primary brain tumor in adults. Current standard of care involves maximal surgical resection combined with adjuvant chemoradiation. Growing support exists for a role of immunotherapy in treating these tumors with the goal of targeted cytotoxicity. Here we review data on the safety for current immunotherapies being tested in GBM.

Areas covered: Safety data from published clinical trials, including ongoing clinical trials were reviewed. Immunotherapeutic classes currently under investigation in GBM include various vaccination strategies, adoptive T cell immunotherapy, immune checkpoint blockade, monoclonal antibodies, and cytokine therapies. Trials include children, adolescents, and adults with either primary or recurrent GBM.

Expert opinion: Based on the reviewed clinical trials, the current immunotherapies targeting GBM are safe and well-tolerated with minimal toxicities which should be noted. However, the gains in patient survival have been modest. A safe and well-tolerated combinatory immunotherapeutic approach may be essential for optimal efficacy towards GBM.     

粉尘螨滴剂治疗变应性鼻炎的临床疗效及安全性观察

目的观察舌下含服粉尘螨滴剂治疗变应性鼻炎的临床疗效和安全性。方法对62例4～60岁粉尘螨皮肤点刺试验阳性的变应性鼻炎患者,采用＂粉尘螨滴剂＂舌下含服特异性免疫治疗,疗程满25周以上,根据变应性鼻炎疗效评定标准,进行临床疗效分析。结果 62例患者中显效13例,有效37例,无效12例。总有效率为80.65%,且70%的患者在一个月内起效。出现3例轻微不良反应,无严重不良反应病例。结论舌下含服＂粉尘螨滴剂＂能够安全有效的治疗变应性鼻炎,并且有很好的临床应用价值。     

舌下含服粉尘螨滴剂治疗变应性鼻炎临床疗效观察

目的：舌下含服粉尘螨滴剂脱敏和传统注射脱敏在变应性鼻炎患者中的疗效，观察舌下脱敏的治疗效果及安全性。方法：选择80例对尘螨过敏的变应性鼻炎患者，随机分成两组。分别舌下粉尘螨滴剂含服和皮下注射脱敏方法治疗1年，统计治疗前后患者症状评分的变化及不良反应的发生。结果：两组患者治疗前后症状评分的变化差异均具极显著性（P〈0．01），两组间对比差异无显著性（P〉0．05）；两组间不良反应发生率差异具极显著性（P〈0．01）。结论：舌下含服粉尘螨滴剂对变应性鼻炎具有明显的治疗作用，且患者使用方便，不良反应发生率低。     

变应性鼻炎特异性免疫治疗的疗效

目的 评价变应原特异性免疫治疗(SIT)对螨虫引起的常年变应性鼻炎的疗效.方法 90例以尘螨为主要变应原的中-重度常年性变应性鼻炎患者分为两组:A组60例,采用SIT治疗及必要时药物对症治疗;B组30例,仅采用药物治疗.比较两组治疗前、治疗6个月和12个月症状的VAS评分和用药评分变化.结果 治疗6个月和12个月后,两组VAS评分均较治疗前下降(P＜0.05);A组低于B组(P＜0.05).治疗后A组用药评分下降,B组无明显变化.治疗12个月后,A组有效率93.33％,高于B组的76.67％ (P＜0.05).结论 SIT对于尘螨引起的常年性变应性鼻炎有较好的疗效.