中国寄生虫学与寄生虫病杂志 ›› 2009, Vol. 27 ›› Issue (5): 8-425.

• 特约综述 • 上一篇    下一篇

上海粉尘螨变应原及特异性免疫治疗(英文)

温廷桓   

  1. 复旦大学上海医学院医学螨类研究室, 上海 200032
  • 收稿日期:1900-01-01 修回日期:1900-01-01 出版日期:2009-10-30 发布日期:2009-10-30

Dermatophagoides farinae Mite Allergen and Specific Immunotherapy in Shanghai

WEN Ting-huan   

  1. Medical Acarology Laboratory,Shanghai Medical College,Fudan University,Shanghai 200032,China
  • Received:1900-01-01 Revised:1900-01-01 Online:2009-10-30 Published:2009-10-30

摘要: 我国螨性变态反应的研究开始于1970年代上海第一医学院(现为复旦大学上海医学院)。上海当地的粉尘螨螨种制备的变应原SMU-Df,其过敏活性与国外同种比较,超过许多倍属于最高的,包括美国食品药品管理局参考品、弗吉尼亚大学标准品、丹麦哥本哈根变态反应研究所标准质量品等。SMU-Df 经凝胶层析所显示的蛋白峰曲线型与粉尘螨代谢培养基者基本相似,其变应原性也相仿。过敏病例可用皮肤点刺试验、鼻腔激发试验和血清IgE水平测定方法诊断,80%左右的过敏患者呈阳性反应。粉尘螨注射液是我国第一种由卫生主管部门批准生产的商品变应原,用传统的皮下注射免疫治疗,通过季节性脱敏,大多数患者可减轻过敏症状,具有极好的疗效。尘螨特异性免疫治疗具有远期疗效而无严重不良反应。对于粉尘螨粗抗原的改良处方和不同给药途径进行过研究,尤其舌下含服粉尘螨滴剂制备和临床应用从1992年与国外同步开始,对于儿童尤其适用而无年龄限制,疗效极好。螨苗冲击特异性免疫疗法具有快速改善过敏症状且有远期疗效。粉尘螨变应原具有诱导人体免疫调节作用,不论过敏患者或健康人群都产生免疫应答。

关键词: 粉尘螨, 变应原, 特异性免疫治疗, 哮喘, 过敏性鼻炎, 特异性皮炎

Abstract: Studies on mite allergy had been launched by the Shanghai First Medical College since 1970′s in this country. The preparations of SMU-Df from the local specimens of Dermatophagoides farinae(Df) in Shanghai have been shown the highest allergenic potency in comparison with that of the foreign ones, including the Df preparations from USFDA, VUS and ALK. Similar patterns of the protein curves were yielded by gel filtration, indicating almost similar allergenicities with both Df pure mite body and its spent culture medium. Around 80% of the allergic cases were sensitive to mite allergen and can be diagnosed by skin prick test, nasal provocation test and serum IgE level assay. Seasonal classic immunotherapy for allergic patients by Injectio Dermatophagoidei farinae, the first commercial allergen licensed by the Chinese government, achieved significant effect in relieving symptoms of allergic disorders in majority of cases, and long lasting effect of mite specific immunotherapy was also documented with minimal adverse reactions. Modifications of the Df crude extract and various modes of treatment have been studied. Studies on sublingual mite vaccine for mite allergic disorders developed synchronously with foreign trend since 1992. Sublingual drops were well acceptable by child cases almost without age restriction with higher efficacy. Rush schedule of mite immunotherapy led to a quick relief of allergic symptoms and long lasting curative effects. The Df allergen induced immunological regulation of human beings was established not only among the atopic patients, but also in healthy persons.

Key words: Dermatophagoides farinae, Allergen, Immunotherapy, Asthma, Allergic rhinitis, Atopic dermatitis