抗原特異性免疫治療對花粉癥的長期療效

作者：林小平，何韶衡，高軍，遲秀麗
【關(guān)鍵詞】 表位
Longterm effect evaluation of antigen specific immunotherapy for patients with pollen allergy
　　【Abstract】 AIM: To evaluate the effectiveness of allergen specific immunotherapy (SIT) in treating patients with pollinosis. METHODS: A total of 235 patients with pollen allergy were recruited into the study and were randomly divided into two groups: SIT group with subgroups: allergic rhinitis group (n=65) and allergic rhinitis asthma group (n=60), and ST (symptomatic therapy) group with subgroups: allergic rhinitis group (n=56) and allergic rhinitis asthma group (n=54). Fortythree healthy individuals were taken as controls. The levels of serum total IgE (tIgE), specific IgE (sIgE) and eosinophil cantionic protein (ECP) were determined with Uni CAP system. IgG was measured and eosinophil numbers were counted. The abovementioned indices, lung function indices, symptomatic score and skin test results were compared between the two groups before and after treatment. RESULTS: The elevated levels of tIgE, sIgE, ECP and tIgE: IgG in the sera and eosinophil counts in peripheral blood of the patients were significantly reduced, whereas the level of IgG increased following treatment with SIT. Lung function, symptomatic score and skin test result all improved after the treatment with SIT. Approximately 40% of the patients were clinically cured and 57.7% responded to SIT. Only 2.3% remained unchanged and about 8.9% patients suffered side effects of SIT. No changes in the abovementioned indices were observed in ST group. CONCLUSION: SIT can improve the symptoms of the patients with allergic rhinitis and asthma by increasing the level of serum IgG, decreasing the IgE and inhibiting the eosinophil counts in peripheral blood.
　　【Keywords】 epitopes; immunotherapy; hay fever; Immunoglobulin E (IgE)
　　【摘要】 目的： 探討抗原特異性免疫治療(specific immunotherapy, SIT)對花粉癥患者的療效及作用機制. 方法： 選擇對夏秋季豚草(Ragweed)和蒿草(Atremisa vulgaris)過敏的花粉癥患者（過敏性鼻炎或哮喘）235例，隨機分為SIT組：包括過敏性鼻炎組（n=65）;過敏性鼻炎 哮喘組（n=60）；對癥治療組（symptomatic therapy, ST）,同樣包括過敏性鼻炎組（n=56），和過敏性鼻炎 哮喘組（n=54）. 健康對照組（n=43）. 應(yīng)用UniCAPsystem免疫熒光法、雙抗體夾心ELISA法、放射比濁法和瑞氏染色法分別測定血清特異性IgE（sIgE）、總IgE（tIgE）、嗜酸性粒細胞陽離子蛋白（ECP）、IgG水平和外周血嗜酸性粒細胞（Eos）計數(shù). 分別比較二組治療前、后上述各種參數(shù)、肺功能指標、癥狀評分和皮膚試驗指數(shù)的變化. 結(jié)果： 治療前，患者血清sIgE、tIgE、ECP水平、血Eos計數(shù)、tIgE: IgG值均明顯升高（P

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