Allergen-specific immunotherapy at the extremes of age: below 5 years and elderly: evidence beyond indications?

IF 3 4区医学 Q2 ALLERGY Current Opinion in Allergy and Clinical Immunology Pub Date : 2024-12-01 Epub Date: 2024-09-19 DOI:10.1097/ACI.0000000000001030

Cansu Özdemiral, Deniz Ilgun Gurel, Umit Sahiner

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Abstract

Purpose of review: Allergen-specific immunotherapy (AIT) has been used in clinical practice to treat allergic diseases for over 100 years. The effectiveness and safety of AIT have been substantiated in numerous studies; however, children before 5 years of age and elderly are not encompassed generally. This review aims to present the current understanding of AIT in the extremes of age.

Recent findings: Early allergen immunotherapy during infancy or early childhood may prevent the development of allergic sensitization to common allergens, thereby reducing the risk of developing allergic diseases later in life. In the elderly, improved symptoms and quality of life and reduced dependence on medication are indicated the importance on the implementation of AIT. Both clinical and immunological parameters demonstrated that the treatment was effective at the time of cessation and trend to sustained tolerance.

Summary: There is no specific lower or upper age limit for initiating immunotherapy; however, it is important to thoroughly evaluate the severity of disease and the risks and benefits in each case.

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极端年龄段的过敏原特异性免疫疗法：5 岁以下和老年人：适应症之外的证据？

综述目的：过敏原特异性免疫疗法（AIT）用于临床治疗过敏性疾病已有 100 多年的历史。大量研究证实了过敏原特异性免疫疗法的有效性和安全性，但一般不包括 5 岁以下儿童和老年人。本综述旨在介绍目前对极端年龄段过敏原免疫疗法的理解：婴儿期或幼儿期的早期过敏原免疫疗法可预防对常见过敏原产生过敏反应，从而降低日后罹患过敏性疾病的风险。在老年人中，改善症状和生活质量以及减少对药物的依赖表明了实施过敏原免疫疗法的重要性。临床和免疫学参数都表明，治疗在停止时是有效的，并有持续耐受的趋势。小结：启动免疫疗法并没有特定的年龄下限或上限；但重要的是要彻底评估疾病的严重程度以及每个病例的风险和益处。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Current Opinion in Allergy and Clinical Immunology 医学-过敏

CiteScore

5.90

自引率

3.60%

发文量

109

审稿时长

6-12 weeks

期刊介绍： This reader-friendly, bimonthly resource provides a powerful, broad-based perspective on the most important advances from throughout the world literature. Featuring renowned guest editors and focusing exclusively on one to three topics, every issue of Current Opinion in Allergy and Clinical Immunology delivers unvarnished, expert assessments of developments from the previous year. Insightful editorials and on-the-mark invited reviews cover key subjects such as upper airway disease; mechanisms of allergy and adult asthma; paediatric asthma and development of atopy; food and drug allergies; and immunotherapy.

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