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抗IgE单抗治疗变应性鼻炎专家共识(南昌,2022)

Expert consensus on use of anti-IgE monoclonal antibody in management of allergic rhinitis(Nanchang,2022)

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【作者】 叶菁； 徐睿； 邱前辉； 杨贵； 陈建军； 曾明； 余少卿； 李健； 杨玉成； 王洪田； 王向东； 姜彦； 王天生； 赵可庆； 张维天； 孟娟； 孟粹达； 许元腾； 谢志海； 孙悦奇； 唐隽； 文译辉； 石照辉； 许成利； 王英； 刘锋； 杨艳莉； 陆美萍； 娄鸿飞； 喻国冻； 叶惠平； 魏欣； 孙斌； 安云芳； 孙亚男； 顾瑜蓉； 张天虹； 巴罗； 孙娜； 罗庆； 邓玉琴； 杨钦泰； 许昱； 李华斌；

【Author】 YE Jing;XU Rui;QIU Qian-hui;YANG gui;CHEN Jian-jun;ZENG Ming;YU Shao-qing;LI Jian;YANG Yu-cheng;WANG Hong-tian;WANG Xiang-dong;JIANG Yan;WANG Tian-sheng;ZHAO Ke-qing;ZHANG Wei-tian;MENG Juan;MENG Cui-da;XU Yuan-teng;XIE Zhi-hai;SUN Yue-qi;TANG Jun;WEN Yi-hui;SHI Zhao-hui;XU Chen-li;WANG Ying;LIU Feng;YANG Yan-li;LU Mei-ping;LOU Hong-fei;YU Guo-dong;YE Hui-ping;WEI Xin;SUN Bin;AN Yun-fang;SUN Ya-nan;GU Yu-rong;ZHANG Tian-hong;BA Luo;SUN Na;LUO Qing;DENG Yu-qin;YANG Qin-tai;XU Yu;LI Hua-bin;Department of Otorhinolaryngology-Head and Neck Surgery,The First Affiliated Hospital of Nanchang University;Department of Otorhinolaryngology Hospital,The First Affiliated Hospital,Sun Yat-sen University;Department of Otolaryngology,Head and Neck Surgery;Department of Otorhinolaryngology,Shenzhen Longgang Central Hospital;Department of Otorhinolaryngology,Union Hospital,Tongji Medical College,Huazhong University of Science and Technology;Department of Otolaryngology,Head and Neck Surgery,Tongji Hospital,Huazhong University of Science and Technology;Department of Otorhinolaryngology Head and Neck Surgery,Tongji Hospital,Tongji University;Department of Otorhinolaryngology Head and Neck Surgery,The First Affiliated Hospital of Chongqing Medical University;Department of Allergy,Beijing Shijitan Hospital,Capital Medical University;Beijing Tongren Hospital,Capital Medical University;Department of Otolaryngology,Head and Neck Surgery,Affiliated Hospital,Qingdao University;Department of Otolaryngology Head and Neck Surgery,The Third Xiangya Hospital of Central South University;Department of Otolaryngology,Eye & ENT Hospital of Fudan University;Department of Otorhinolaryngology Head and Neck Surgery,Shanghai Jiao Tong University Affiliated Sixth People’s Hospital;Department of Otorhinolaryngology Head and Neck Surgery,West China Hospital,Sichuan University;Department of Otorhinolaryngology Head and Neck Surgery,China-Japan Uuion Hospital of Jilin University;Department of Otorhinolaryngology,The First Affiliated Hospital of Fujian Medical University;Department of Otorhinolaryngology Head and Neck Surgery,Xiangya Hospital of Central South University;Department of Otorhinolaryngology,The Seventh Affiliated Hospital,Sun Yat-sen University;Department of Otorhinolaryngology Head and Neck Surgery,The First People’s Hospital of Foshan;Department of Otolaryngology,Longgang District ENT Hospital of Shenzhen;Department of Otorhinolaryngology Head and Neck Surgery,The Second Affiliated Hospital of Guangxi Medical University;Department of Rhinology,The First Affiliated Hospital of Zhengzhou University;Department I of Otorhinolaryngology,The First Affiliated Hospital of Kunming Medical University;Department of Otorhinolaryngology,The First Affiliated Hospital of Nanjing Medical University;Department of Otorhinolaryngology,Affiliated Hospital of Guizhou Medical University;Department of Otolaryngology,Guizhou Provincial People’s Hospital;Hainan Provincial People’s Hospital Otorhinolaryngology Hospital;Department of Otorhinolaryngology Head and Neck Surgery,The Second Affiliated Hospital of Xi’an Jiaotong University;Department of Otorhinolaryngology,Second Hospital of Shanxi Medical University;Department of Otorhinolaryngology Head and Neck Surgery,The Second Affiliated Hospital of Harbin Medical University;Department of Otorhinolaryngology Head and Neck Surgery,The First Affiliated Hospital of Harbin Medical University;Department of Otorhinolaryngology,People’s Hospital of Tibet Autonomous Region;Department of Otolaryngology,Huadong Hospital Affiliated to Fudan University;Department of Otolaryngology Head and Neck Surgery,Renmin Hospital of Wuhan University;Department of Otorhinolaryngology Head and Neck Surgery and Allergy,The Third Affiliated Hospital,Sun Yat-sen University;Chinese Rhinology Research Collaborative Group;

【通讯作者】 叶菁;杨钦泰;许昱;李华斌;

【机构】 南昌大学第一附属医院耳鼻咽喉-头颈外科； 中山大学附属第一医院耳鼻咽喉科医院； 广东省人民医院耳鼻咽喉头颈外科； 深圳市龙岗区中心医院耳鼻咽喉科； 华中科技大学同济医学院附属协和医院耳鼻咽喉科； 华中科技大学同济医学院附属同济医院耳鼻咽喉头颈外科； 同济大学附属同济医院耳鼻咽喉头颈外科； 重庆医科大学附属第一医院耳鼻咽喉头颈外科； 首都医科大学附属北京世纪坛医院变态反应科； 首都医科大学附属北京同仁医院耳鼻咽喉头颈外科； 青岛大学附属医院耳鼻咽喉头颈外科； 中南大学湘雅三医院耳鼻咽喉头颈外科； 复旦大学附属眼耳鼻喉科医院耳鼻喉科； 上海交通大学附属第六人民医院耳鼻咽喉头颈外科； 四川大学华西医院耳鼻咽喉头颈外科； 吉林大学中日联谊医院耳鼻咽喉头颈外科； 福建医科大学附属第一医院耳鼻咽喉科； 中南大学湘雅医院耳鼻咽喉头颈外科； 中山大学附属第七医院耳鼻咽喉科； 佛山市第一人民医院耳鼻咽喉头颈外科； 深圳市龙岗区耳鼻喉医院耳鼻喉科； 广西医科大学第二附属医院耳鼻咽喉头颈外科； 郑州大学第一附属医院鼻科； 昆明医科大学第一附属医院耳鼻咽喉一科； 南京医科大学第一附属医院耳鼻咽喉科； 贵州医科大学附属医院耳鼻咽喉科； 贵州省人民医院耳鼻咽喉科； 海南省人民医院耳鼻咽喉科医院； 西安交通大学第二附属医院耳鼻咽喉头颈外科病院； 山西医科大学第二医院耳鼻咽喉科； 哈尔滨医科大学附属第二医院耳鼻咽喉头颈外科； 哈尔滨医科大学附属第一医院耳鼻咽喉头颈外科； 西藏自治区人民医院耳鼻咽喉科； 复旦大学附属华东医院耳鼻咽喉科； 武汉大学人民医院耳鼻咽喉头颈外科； 中山大学附属第三医院耳鼻咽喉头颈外科和变态反应(过敏)科； 中国鼻病研究协作组；

【摘要】 变应性鼻炎(allergic rhinitis, AR)是特应性个体接触变应原后，主要由免疫球蛋白E(immunoglobulin E,IgE)介导的，辅助型T细胞2(T helper type 2,Th2)驱动的鼻黏膜炎症性疾病。AR主要以鼻用激素、抗组胺药物、白三烯受体拮抗剂以及特异性免疫治疗为主，但仍有部分患者疗效不佳或不良反应过大，疾病反复发作，逐年加重，且容易并发过敏性哮喘。目前，国际上有多项研究证实，抗IgE治疗能够较为有效且安全地应用于AR等疾病的治疗。为了规范并促进临床医生对抗IgE单抗治疗AR的认识和应用，基于国内外指南及近年相关研究报道，中国鼻病研究协作组召集国内中青年鼻科专家，制定了抗IgE单抗治疗AR的专家共识。本共识从AR的临床特点、发病机制与IgE的病理生理学特征出发，以奥马珠单抗为代表，详细阐述了抗IgE单抗治疗AR的具体机制、应用方案和注意事项，以期为进一步提升AR的治疗提供相应的理论依据和临床指导。

【Abstract】 Allergic rhinitis(AR) is one kind of inflammatory conditions of nasal mucosa driven by Th2 and other cells, which is mainly mediated by specific immunoglobulin E(IgE) after re-exposure to sensitized allergens.Currently, AR is effectively controlled by using nasal corticosteroids, antihistamines, leukotriene receptor antagonists, and allergen-specific immunotherapy.However, there are still some patients who show poor efficacy, excessive side effects, recurrent or worsen symptoms or even asthmatic complication.Recently, results of a number of international researches have confirmed that anti-IgE therapy can be an effective and safe therapeutic method for allergic diseases such as AR.For Further understanding and standardized application of anti-IgE monoclonal antibody in treatment of AR,Chinese Rhinology Research Collaborative Group organized youth experts to draw up an expert consensus of anti-IgE therapy for treatment of AR,based on intornal and international guidelines and relevant literatures.Specific mechanism, protocol and precautions of anti-IgE therapy by using omalizumab for AR are introduced in detail in this consensus, aim to provide theoretical basis and clinical recommendation for more effective treatment of AR,which based on clinical manifestations and pathogenesis characteristics of AR and combined with pathophysiological characteristics of IgE.

【关键词】 鼻炎,变应性； 免疫球蛋白E； 抗IgE单抗；
【Key words】 rhinitis,allergic； immunoglobulin E； anti-IgE monoclonal antibody；
【基金】 国家自然科学基金杰出青年基金(81725004);国家自然科学基金(81873689、81860182、81873693、82071014、81870700、81970850、82271138、82271139);上海市科委优秀学科带头人项目(19XD4010000);上海市耳鼻咽喉疾病临床中心重大专项(20MC920200);国家重点研发计划(2022YFC2504100)~~
  • 【文献出处】 中华临床免疫和变态反应杂志 ,Chinese Journal of Allergy & Clinical Immunology , 编辑部邮箱 ,2022年05期
  • 【分类号】R765.21
  • 【下载频次】101
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