过敏原特异性免疫治疗新进展  

New advances in allergen-specific immunotherapy

作　　者：姚红兵[1] YAO Hong-bing(Department of Otolaryngology,Head and Neck Surgery,Affiliated Children's Hospital,Chongqing Medical University/The National Clinical Medical Research Center for Child Health and Disease/Key Laboratory of Research on Childhood Developmental Diseases,Ministry of Education,Chongqing 401122,China)

机构地区：[1]重庆医科大学附属儿童医院耳鼻咽喉头颈外科,国家儿童健康与疾病临床医学研究中心,儿童发育疾病研究教育部重点实验室,重庆401122

出　　处：《中国实用儿科杂志》2025年第2期105-111,共7页Chinese Journal of Practical Pediatrics

摘　　要：过敏原特异性免疫治疗(llergen immunotherapy,AIT)是惟一一种能够改变过敏性鼻炎病程的治疗方法,它可以预防过敏性鼻炎发展为哮喘,并减少对药物的需求,也是惟一能够诱导过敏原长期耐受的疗法,但其传统方案耗时长且可能伴有不良反应。在过去的十年中,已开发了许多新型的AIT,研究重点关注优化过敏原识别、保留B或T细胞表位的结构修饰和通过化学修饰的翻译后改变以及佐剂的添加。这些修饰过的过敏原可以增加对其他相关过敏原的耐受性,但副反应更少。该文论述AIT的发展历程、作用机制,过敏原的改良、佐剂的应用、多肽和重组蛋白的使用、分子工程、生物信息学和计算机辅助设计、人工智能和机器学习在过敏性疾病治疗中的应用,以及精准医.疗和个体化医疗的重要性。探讨通过化学修饰捉高过敏原免疫原性、使用不同佐剂增强免疫反应,以及开发低分子量过敏原等策略。强调研究与临床实践融合对推动过敏性疾病治疗进步的重要性。回顾各类新型AIT改善过敏性疾病治疗的可能性的研究进展。Allergen-specificimmunotherapy(AIT)is the only treatment that can alter the course of allergic rhinitis,preventing the progression of rhinitis to asthma and reducing the need for medication.It is the only therapy that can induce long-term tolerance to allergens,but its traditional protocols are time-consuming and may be associated with adverse reactions.Over the past decade,many new types of AIT have been developed,focusing on optimizing allergen identification,structural modifications that preserve B or T cell epitopes,post-translational changes through chemical modifications,and the addition of adjuvants.These modified allergens can increase tolerance to other related allergens with fewer side effects.This article reviews the development of AIT,its mechanism of action,the modification of allergens,the application of adjuvants,the use of peptides and recombinant proteins,molecular engineering,bioinformatics and computeraided design,the application of artificial intelligence and machine learning in the treatment of allergic diseases,as well as the importance of precision and individualized medical treatment.It discusses the strategies to enhance the immunogenicity of allergens through chemical modifications,to strengthen the immune response using different adjuvants,and to develop low molecular weight allergens.It emphasizes the importance of integrating research with clinical practice to advance the treatment for allergic diseases.The review also covers the progress of research on the potential of various new types of AIT to improve the treatment for allergic diseases.

关 键 词：过敏原免疫疗法 免疫耐受 过敏原修饰 

分 类 号：R72[医药卫生—儿科]