片剂过敏原免疫疗法:过敏性休克问题。

IF 2.5 4区 医学 Q3 ALLERGY Allergologia et immunopathologia Pub Date : 2024-05-01 eCollection Date: 2024-01-01 DOI:10.15586/aei.v52i3.990
Giorgio Ciprandi, Matteo Naso, Maria Angela Tosca
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引用次数: 0

摘要

15 年前,片剂过敏原免疫疗法(T-AIT)制剂首次获得监管机构批准,用于治疗成人和 5 岁以上儿童由草花粉引起的过敏性鼻炎。关于过敏原免疫疗法的有效性和安全性已有大量证据。然而,儿童的安全性尤其令人担忧。一般来说,T-AIT 会引起局部反应,主要发生在口腔,通常为轻度至中度反应,且通常可自行缓解。然而,T-AIT 也会引起全身性过敏反应,其中过敏性休克是最可怕的不良反应,因为过敏性休克发生在接受过敏性鼻炎治疗的受试者身上。因此,我们对报告因使用 T-AIT 而发生过敏性休克的患者进行了文献检索。文献中报告了 9 例过敏性反应。值得注意的是,没有使用 T-AIT 导致死亡的报道。这一结果非常重要,因为它强调了 T-AIT 的高度安全性。然而,T-AIT 值得仔细关注,主要是在儿童群体中。在这方面,在首次报告首次使用 T-AIT 时出现过敏反应后,生产商建议首次给药应在医疗机构中进行,并由具有处理过敏性休克经验的工作人员在场,同时应观察患者至少 30 分钟。有趣的是,报告的过敏性反应都是由草花粉提取物引起的,没有关于其他过敏原提取物的报告。不过,值得注意的是,近年来并没有因使用 T-AIT 而导致过敏反应的报道。
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Tablet allergen immunotherapy: the anaphylaxis issue.

For the first time 15 years ago, tablet allergen immunotherapy (T-AIT) formulations were approved by regulatory agencies for treating allergic rhinitis caused by grass pollen in adults and children aged >5 years. Extensive evidences existed about effectiveness and safety of AIT. However, the safety profile is particularly compelling in children. Generally, T-AIT causes local reactions, mostly in the oral cavity, that are usually mild-to-moderate and often self-resolving. However, systemic allergic reactions are also observed with T-AIT, anaphylaxis representing the most fearsome adverse event, considering that it occurs in subjects treated for allergic rhinitis. Therefore, we conducted a literature search of patients reporting anaphylaxis because of T-AIT. Nine cases of anaphylactic reactions were reported in literature. Notably, no death was reported using T-AIT. This outcome was very important as it underscored the substantial safety of T-AIT. However, T-AIT deserves careful attention, mainly in the pediatric population. In this regard, after the first report of anaphylactic reaction at the first administration of T-AIT, manufacturers recommended that the first dose should be administered in a medical facility in the presence of staff with experience in managing anaphylaxis and the patient should be observed for at least 30 min. Interestingly, reported anaphylactic reactions were due to grass pollen extracts, with no report concerning other allergen extracts. However, it is relevant to note that anaphylactic reactions because of T-AIT are not reported in recent years.

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来源期刊
CiteScore
3.70
自引率
0.00%
发文量
131
审稿时长
6-12 weeks
期刊介绍: Founded in 1972 by Professor A. Oehling, Allergologia et Immunopathologia is a forum for those working in the field of pediatric asthma, allergy and immunology. Manuscripts related to clinical, epidemiological and experimental allergy and immunopathology related to childhood will be considered for publication. Allergologia et Immunopathologia is the official journal of the Spanish Society of Pediatric Allergy and Clinical Immunology (SEICAP) and also of the Latin American Society of Immunodeficiencies (LASID). It has and independent international Editorial Committee which submits received papers for peer-reviewing by international experts. The journal accepts original and review articles from all over the world, together with consensus statements from the aforementioned societies. Occasionally, the opinion of an expert on a burning topic is published in the "Point of View" section. Letters to the Editor on previously published papers are welcomed. Allergologia et Immunopathologia publishes 6 issues per year and is included in the major databases such as Pubmed, Scopus, Web of Knowledge, etc.
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