減敏療法治療家塵過敏之氣喘病兒

Hyposensitization in the Treatment of House-Dust-Sensitive Asthmatic Children

呂克桓(Ko-Huang Lue) ； 謝貴雄(Kue-Hsiung Hsieh)

《Acta Paediatrica Sinica》 28卷1期 (1987/02) Pp. 1-10

摘要

過敏病人白於血清中IgE和特異性IgE抗體異常升高結果造成種種過敏病，諸如氣喘、過敏性鼻炎、異位性濕疹、蕁麻疹、胃腸過敏和偏頭痛等。為了瞭解過敏病人IgE抗體不正常升高原因以及滅敏治療的效果和作用機轉，因此參考許多國外文默報告和我們自己研究結果加以整理分析。
結果發現(1)滅敏治療確實是一有效治療過敏病的方法（尤其是呼吸道過敏），約有90%以上病人可以減少發作次數和藥物使用。(2)可增加特異性IgG阻斷抗體，使血清中IgE和特異性IgE抗體降低。(3)過敏病人之嗜中性白血球功能有缺陷，減敏治療可恢復其功能。(4)過敏病人的嗜堿細胞和肥胖細胞釋放介體(Mediators)包括組織胺和Leukotrienes等的能力過強，經減敏治療之後釋放能力降低。(5)減敏治療可恢複過敏病人壓制性T細胞的功能。(6)過敏病人之第二介白質可作為滅敏治療之開始和終止的指標。
因此減敏治療確實是一種有效且特異性的過敏治療法，尤其對過敏性鼻炎、氣喘和有翅蟲叮咬過敏等三種最有效，可改善具特異體質的人其免疫調節機能之缺陷。

並列摘要

Patients with allergic diseases are characterized by the presence of elevated total serum IgE and specific IgE antibodies against a variety of environmental allergens, especially house dust, mites and molds in Taiwan. To explore the causes for augmented IgE antibody production and the working mechanisms of hyposensitization (HS), a series of studies has been conducted on house-dust-sensitive, newly diagnosed, and hyposensitized asthmatic children and normals.
The specific IgE and IgG antibodies were measured by radioallergosorbent test; the lymphoproliferative capability was measured by (superscript 3)H-thymidine incorporation; the allergen-specific suppressor activity was determined by the extent of houseduct-activated, interleukin-2 (IL-2)-expanded lymphocytes to suppress the allergen- induced proliferation of autologous mononuclear cells (MNC); and IL-2 was produced by stimulating MNC with allergen or phytohemagglutinin (PHA) and quantitated by its capability to support the proliferation of mouse IL-2-dependent cytotoxic T-celI line.
The results showed: 1) HS was effective in 90% of patients in terms of decreased attacks and medication taken; 2) the patients were defective in suppressor T-cell function for IgE production; 3) HS was able to restore the regulatory T-cell function and defective phagocyte functions, and increase the production of IgG-blocking antibody; and 4) IL-2 production may be used as an indicator for initiation and discontinuation of HS.
Therefore, hyposensitization is an effective and specific treatment for allergic bronchial asthma and can partially correct the immunoregulatory aberration in atopic individuals.

並列關鍵字

hyposensitization ； house dust ； asthmatic children ； immunologic changes