背景:变应原免疫疗法(AIT)是唯一已知的链格孢属变态反应的致病治疗方法,但标准化链格孢菌提取物的困难阻碍了其有效性和安全性。
结论:链格孢菌,一种有效的空气传播过敏原,具有较高的致敏率,并且已知会引发呼吸道过敏的发作和恶化,甚至在某些情况下诱发真菌食物过敏综合征。它可以引发2型炎症反应,导致2型炎症细胞因子和嗜酸性粒细胞的分泌增加,这是过敏症状背后的罪魁祸首。诊断链格孢菌过敏是一个多步骤的过程,包括仔细检查临床症状,病史,皮肤点刺试验,血清特异性IgE检测,或者挑衅测试。Alta1,Alternaria的主要组成部分,是通过成分解析诊断诊断链格孢菌过敏的重要参与者。有趣的是,当与花粉和猫皮屑混合时,链格孢菌可以降低其他过敏原的蛋白质活性。为了解决标准化问题,传统AlternariaAIT的功效和安全性,针对Alta1的新型AIT方法和创新疫苗,如表位,DNA,mRNA疫苗在绕过链格孢菌提取物的标准化问题方面似乎很有希望。但是这些研究还处于早期阶段,大多数研究仍然集中在动物模型上,呼吁更多的证据来验证它们在人类中的使用。
结论:本综述深入研究了链格孢菌过敏的各个方面,包括特征,流行病学,免疫机制,诊断,临床表现,以及AlternariaAIT的应用和局限性,旨在为链格孢菌过敏患者的管理提供基础。
BACKGROUND: Allergen immunotherapy (AIT) is the only known causative treatment for Alternaria allergy, but the difficulty in standardizing Alternaria extracts hampers its effectiveness and safety.
CONCLUSIONS: Alternaria, a potent airborne allergen, has a high sensitization rate and is known to trigger the onset and exacerbation of respiratory allergies, even inducing fungal food allergy syndrome in some cases. It can trigger a type 2 inflammatory response, leading to an increase in the secretion of type 2 inflammatory cytokines and eosinophils, which are the culprits behind allergic symptoms. Diagnosing Alternaria allergy is a multistep process, involving a careful examination of clinical symptoms, medical history, skin prick tests, serum-specific IgE detection, or provocation tests. Alt a1, the major component of Alternaria, is a vital player in diagnosing Alternaria allergy through component-resolved diagnosis. Interestingly, Alternaria can reduce the protein activity of other allergens like pollen and cat dander when mixed with them. In order to solve the problems of standardization, efficacy and safety of traditional Alternaria AIT, novel AIT methods targeting Alt a1 and innovative
vaccines such as epitope, DNA, and mRNA
vaccines seem promising in bypassing the standardization issue of Alternaria extracts. But these studies are in early stages, and most researches are still focused on animal models, calling for more evidence to validate their use in humans.
CONCLUSIONS: This review delves into the various aspects of Alternaria allergy, including characteristics, epidemiology, immune mechanisms, diagnosis, clinical manifestations, and the application and limitations of Alternaria AIT, aiming to provide a foundation for the management of patients with Alternaria allergy.