Multiple-allergen and single-allergen immunotherapy strategies in polysensitized patients: Looking at the published evidence

JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY

卷:129

Article

Calderon, Moises A.¹  Casale, Thomas B.²  Demoly, Pascal³ 

[1] Univ London Imperial Coll Sci Technol & Med, Sect Allergy & Clin Immunol, Natl Heart & Lung Inst, Royal Brompton Hosp, London, England

[2] Creighton Univ, Div Allergy & Immunol, Dept Med, Omaha, NE 68178 USA

[3] Univ Hosp Montpellier, INSERM U657, Dept Pneumol, Allergy Div,Hop Arnaud de Villeneuve, Montpellier, France

关键词: Allergy;    allergen immunotherapy;    polysensitization;    monosensitization;    polyallergic;    subcutaneous immunotherapy;    sublingual immunotherapy;    safety;    efficacy;   

DOI  :  10.1016/j.jaci.2011.11.019

来源: Elsevier

【 摘 要 】

In allergen immunotherapy there is debate as to whether polysensitized patients are best treated with many allergens simultaneously (chosen according to the sensitization profile, a predominantly North American approach) or a single allergen (chosen according to the most clinically problematic allergy, a predominantly European approach). In patients seeking treatment for moderate-to-severe respiratory allergies, polysensitization is more prevalent (range, 50% to 80%) than monosensitization in both the United States and Europe. Safe, effective, single-allergen preparations will most likely have been tested in polysensitized patients. In robust, large-scale clinical trials of grass pollen sublingual tablets, polysensitized patients benefited at least as much from allergen immunotherapy as monosensitized patients. A recent review of multiallergen immunotherapy concluded that simultaneous delivery of multiple unrelated allergens can be clinically effective but that there was a need for additional investigation of therapy with more than 2 allergen extracts (particularly in sublingual allergen immunotherapy). More work is also required to determine whether single-allergen and multiallergen immunotherapy protocols elicit distinct immune responses in monosensitized and polysensitized patients. Sublingual and subcutaneous multiallergen immunotherapy in polysensitized patients requires more supporting data to validate its efficacy in practice. (J Allergy Clin Immunol 2012;129:929-34.)

【 授权许可】

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