{"title":"表皮免疫疗法治疗食物过敏：系统回顾和荟萃分析","authors":"Péter Csonka, Bohee Lee, Ilari Kuitunen","doi":"10.1002/clt2.70045","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Background</h3>\n \n <p>Food allergies pose a global healthcare challenge, underscoring the need for effective interventions. This study evaluated the efficacy and safety of epicutaneous immunotherapy (EPIT) for food allergen desensitisation.</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>We conducted a systematic review of randomised controlled trials by searching Ovid EMBASE, PubMed and Scopus in April 2024. Using a random-effects meta-analysis, we evaluated the clinical effectiveness and harms of EPIT, reporting results as risk ratios with 95% confidence intervals (CI).</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>After screening 460 abstracts and 35 full reports, 11 were included: nine on peanuts and two on cow's milk (CM). Peanut EPIT had a 51.2% treatment response versus 22.4% for placebo (RR 2.16, CI 1.49–3.12; four studies; moderate certainty). The RR for milk EPIT response rate was 1.78 (CI 1.06–3.00; one study). Five peanut studies (1396 patients) reported EPIT-related adverse events (RR 1.39, CI 0.94–2.05; low certainty).</p>\n </section>\n \n <section>\n \n <h3> Conclusions</h3>\n \n <p>EPIT offers a moderate treatment response with a favourable safety profile and significant improvements in quality of life. Current knowledge of EPIT remains limited, with evidence confined to peanut and CM allergies. There is a lack of research on sustained unresponsiveness achieved through food EPIT.</p>\n </section>\n </div>","PeriodicalId":10334,"journal":{"name":"Clinical and Translational Allergy","volume":"15 3","pages":""},"PeriodicalIF":4.6000,"publicationDate":"2025-03-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/clt2.70045","citationCount":"0","resultStr":"{\"title\":\"Epicutaneous immunotherapy for food allergy: A systematic review and meta-analysis\",\"authors\":\"Péter Csonka, Bohee Lee, Ilari Kuitunen\",\"doi\":\"10.1002/clt2.70045\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div>\\n \\n \\n <section>\\n \\n <h3> Background</h3>\\n \\n <p>Food allergies pose a global healthcare challenge, underscoring the need for effective interventions. This study evaluated the efficacy and safety of epicutaneous immunotherapy (EPIT) for food allergen desensitisation.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Methods</h3>\\n \\n <p>We conducted a systematic review of randomised controlled trials by searching Ovid EMBASE, PubMed and Scopus in April 2024. Using a random-effects meta-analysis, we evaluated the clinical effectiveness and harms of EPIT, reporting results as risk ratios with 95% confidence intervals (CI).</p>\\n </section>\\n \\n <section>\\n \\n <h3> Results</h3>\\n \\n <p>After screening 460 abstracts and 35 full reports, 11 were included: nine on peanuts and two on cow's milk (CM). Peanut EPIT had a 51.2% treatment response versus 22.4% for placebo (RR 2.16, CI 1.49–3.12; four studies; moderate certainty). The RR for milk EPIT response rate was 1.78 (CI 1.06–3.00; one study). Five peanut studies (1396 patients) reported EPIT-related adverse events (RR 1.39, CI 0.94–2.05; low certainty).</p>\\n </section>\\n \\n <section>\\n \\n <h3> Conclusions</h3>\\n \\n <p>EPIT offers a moderate treatment response with a favourable safety profile and significant improvements in quality of life. Current knowledge of EPIT remains limited, with evidence confined to peanut and CM allergies. There is a lack of research on sustained unresponsiveness achieved through food EPIT.</p>\\n </section>\\n </div>\",\"PeriodicalId\":10334,\"journal\":{\"name\":\"Clinical and Translational Allergy\",\"volume\":\"15 3\",\"pages\":\"\"},\"PeriodicalIF\":4.6000,\"publicationDate\":\"2025-03-02\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://onlinelibrary.wiley.com/doi/epdf/10.1002/clt2.70045\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Clinical and Translational Allergy\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://onlinelibrary.wiley.com/doi/10.1002/clt2.70045\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"ALLERGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Clinical and Translational Allergy","FirstCategoryId":"3","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1002/clt2.70045","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"ALLERGY","Score":null,"Total":0}
引用次数: 0
摘要
食物过敏是一个全球性的卫生保健挑战，强调需要有效的干预措施。本研究评估了表皮免疫疗法（EPIT）对食物过敏原脱敏的有效性和安全性。方法通过检索Ovid EMBASE、PubMed和Scopus，于2024年4月对随机对照试验进行系统评价。采用随机效应荟萃分析，我们评估了EPIT的临床疗效和危害，并以95%置信区间（CI）的风险比报告结果。结果筛选460篇摘要和35篇完整报道，最终纳入11篇：9篇花生，2篇牛奶。花生EPIT治疗有效率为51.2%，安慰剂为22.4% (RR 2.16, CI 1.49-3.12；四个研究;温和的确定性)。牛奶EPIT反应率的RR为1.78 (CI 1.06-3.00；一项研究)。5项花生研究（1396例患者）报告了epit相关不良事件(RR 1.39, CI 0.94-2.05；低确定性)。结论：EPIT提供了一个中等的治疗反应，具有良好的安全性和显著的生活质量改善。目前对EPIT的了解仍然有限，证据仅限于花生和CM过敏。缺乏通过食品EPIT实现的持续无反应性的研究。
Epicutaneous immunotherapy for food allergy: A systematic review and meta-analysis
Background
Food allergies pose a global healthcare challenge, underscoring the need for effective interventions. This study evaluated the efficacy and safety of epicutaneous immunotherapy (EPIT) for food allergen desensitisation.
Methods
We conducted a systematic review of randomised controlled trials by searching Ovid EMBASE, PubMed and Scopus in April 2024. Using a random-effects meta-analysis, we evaluated the clinical effectiveness and harms of EPIT, reporting results as risk ratios with 95% confidence intervals (CI).
Results
After screening 460 abstracts and 35 full reports, 11 were included: nine on peanuts and two on cow's milk (CM). Peanut EPIT had a 51.2% treatment response versus 22.4% for placebo (RR 2.16, CI 1.49–3.12; four studies; moderate certainty). The RR for milk EPIT response rate was 1.78 (CI 1.06–3.00; one study). Five peanut studies (1396 patients) reported EPIT-related adverse events (RR 1.39, CI 0.94–2.05; low certainty).
Conclusions
EPIT offers a moderate treatment response with a favourable safety profile and significant improvements in quality of life. Current knowledge of EPIT remains limited, with evidence confined to peanut and CM allergies. There is a lack of research on sustained unresponsiveness achieved through food EPIT.
期刊介绍：
Clinical and Translational Allergy, one of several journals in the portfolio of the European Academy of Allergy and Clinical Immunology, provides a platform for the dissemination of allergy research and reviews, as well as EAACI position papers, task force reports and guidelines, amongst an international scientific audience.
Clinical and Translational Allergy accepts clinical and translational research in the following areas and other related topics: asthma, rhinitis, rhinosinusitis, drug hypersensitivity, allergic conjunctivitis, allergic skin diseases, atopic eczema, urticaria, angioedema, venom hypersensitivity, anaphylaxis, food allergy, immunotherapy, immune modulators and biologics, animal models of allergic disease, immune mechanisms, or any other topic related to allergic disease.
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