免疫制御療法と呼吸器疾患
肺は外界に開かれた臓器であり，様々な環境刺激に暴露されるという特性を有している．よって，複雑な免疫機構の制御異常は，環境ストレスに対する過剰な生体応答，または，脆弱性をもたらし，様々な呼吸器疾患の発症や病態の進行と深く係わっている．近年，抗体産生や細胞性免疫を制御する複数の治療法が治療オプションとして臨床に登場し，呼吸器疾患の新たな治療法として注目されている．本稿では，アレルギーの根治療法の一つであるアレルゲン免疫療法，膠原病や血管炎を原因として間質性肺炎を呈する難知性病態に対する rituximab の使用，さらに，肺癌に対する免疫チェックポイント阻害薬の最近の知見について概説する．...
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| Published in | 日大医学雑誌 Vol. 76; no. 1; pp. 36 - 39 |
|---|---|
| Main Authors | , , , |
| Format | Journal Article |
| Language | Japanese |
| Published |
日本大学医学会
01.02.2017
|
| Subjects | |
| Online Access | Get full text |
| ISSN | 0029-0424 1884-0779 |
| DOI | 10.4264/numa.76.1_36 |
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| Abstract | 肺は外界に開かれた臓器であり，様々な環境刺激に暴露されるという特性を有している．よって，複雑な免疫機構の制御異常は，環境ストレスに対する過剰な生体応答，または，脆弱性をもたらし，様々な呼吸器疾患の発症や病態の進行と深く係わっている．近年，抗体産生や細胞性免疫を制御する複数の治療法が治療オプションとして臨床に登場し，呼吸器疾患の新たな治療法として注目されている．本稿では，アレルギーの根治療法の一つであるアレルゲン免疫療法，膠原病や血管炎を原因として間質性肺炎を呈する難知性病態に対する rituximab の使用，さらに，肺癌に対する免疫チェックポイント阻害薬の最近の知見について概説する． |
|---|---|
| AbstractList | 肺は外界に開かれた臓器であり，様々な環境刺激に暴露されるという特性を有している．よって，複雑な免疫機構の制御異常は，環境ストレスに対する過剰な生体応答，または，脆弱性をもたらし，様々な呼吸器疾患の発症や病態の進行と深く係わっている．近年，抗体産生や細胞性免疫を制御する複数の治療法が治療オプションとして臨床に登場し，呼吸器疾患の新たな治療法として注目されている．本稿では，アレルギーの根治療法の一つであるアレルゲン免疫療法，膠原病や血管炎を原因として間質性肺炎を呈する難知性病態に対する rituximab の使用，さらに，肺癌に対する免疫チェックポイント阻害薬の最近の知見について概説する． |
| Author | 橋本, 修 伊藤, 玲子 丸岡, 秀一郎 権, 寧博 |
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| References | 12) Virchow JC, Backer V, Kuna P, et al. Efficacy of a House Dust Mite Sublingual Allergen Immunotherapy Tablet in Adults With Allergic Asthma: A Randomized Clinical Trial. JAMA 2016; 315 (16): 1715-1725. 1) Noon L. Prophylactic inoculation against hay fever. Lancet 1911; 177 (4580): 1572-1573. 14) Dumoitier N, Terrier B, London J, et al. Implication of B lymphocytes in the pathogenesis of ANCA-associated vasculitides. Autoimmun Rev 2015; 14 (11): 996-1004. 2) Novak N, Bieber T, Allam JP. Immunological mechanisms of sublingual allergen-specific immunotherapy. Allergy 2011; 66 (6): 733-739. 5) Calderon MA, Casale TB, Nelson HS, et al. An evidencebased analysis of house dust mite allergen immunotherapy: a call for more rigorous clinical studies. Allergy Clin Immunol 2013; 132 (6): 1322-1336. 13) Guillevin L, Pagnoux C, Karras A, et al. French Vasculitis Study Group. Rituximab versus azathioprine for maintenance in ANCA-associated vasculitis. N Engl J Med 2014; 371 (19): 1771-1780. 3) Wilson DR, Torres LI, Durham SR. Sublingual immunotherapy for allergic rhinitis. Cochrane Database Syst Rev 2003; (2): CD002893. 4) Wise SK, Schlosser RJ. Evidence-based practice: sublingual immunotherapy for allergic rhinitis. Otolaryngol Clin North Am 2012; 45 (5): 1045-1054. 9) Mauro G, Bernardini R, Barberi S, et al. Prevention of food and airway allergy: consensus of the Italian Society of Preventive and Social Paediatrics, the Italian Society of Paediatric Allergy and Immunology, and Italian Society of Pediatrics. World Allergy Organ J 2016; 9: 28. 17) Nalotto L, Iaccarino L, Zen M, et al. Rituximab in refractory idiopathic inflammatory myopathies and anti synthetase syndrome: personal experience and review of the literature. Immunol Res 2013; 56 (2-3): 362-370. 19) Gettinger SN, Horn L, Gandhi L, et al. Overall Survival and Long-Term Safety of Nivolumab (Anti-Programmed Death 1 Antibody, BMS-936558, ONO-4538) in Patients With Previously Treated Advanced Non-Small-Cell Lung Cancer. J Clin Oncol 2015; 33 (18): 2004-2012. 11) Demoly P, Emminger W, Rehm D, et al. Effective treatment of house dust mite-induced allergic rhinitis with 2 doses of the SQ HDM SLIT-tablet: Results from a randomized, double-blind, placebo-controlled phase III trial. J Allergy Clin Immunol 2016; 137 (2): 444-451.e8. 16) Sakkas LI, Bogdanos DP. Systemic sclerosis: New evidence re-enforces the role of B cells. Autoimmun Rev 2016; 15 (2): 155-161. 6) Compalati E, Passalacqua G, Bonini M, et al. The efficacy of sublingual immunotherapy for house dust mites respiratory allergy: results of a GA2LEN meta-analysis. Allergy 2009; 64 (11): 1570-1579. 10) Taramarcaz P, Gibson PG. The effectiveness of intranasal corticosteroids in combined allergic rhinitis and asthma syndrome. Clin Exp Allergy 2004; 34 (12): 1883-1889. 7) Okamoto Y, Fujieda S, Okano M, et al. House dust mite sublingual tablet is effective and safe in patients with allergic rhinitis. Allergy 2016; 72 (3): 435-443. 8) Klimek L, Mosbech H, Zieglmayer P, et al. SQ house dust mite (HDM) SLIT-tablet provides clinical improvement in HDM-induced allergic rhinitis. Expert Rev Clin Immunol 2016; 12 (4): 369-377. 20) Brahmer J, Reckamp KL, Baas P, et al. Nivolumab versus Docetaxel in Advanced Squamous-Cell Non-Small-Cell Lung Cancer. N Engl J Med 2015; 373 (2): 123-135. 21) Borghaei H, Paz-Ares L, Horn L, et al. Nivolumab versus Docetaxel in Advanced Nonsquamous Non-Small-Cell Lung Cancer. N Engl J Med 2015; 373 (17): 1627-1639. 15) Lopez-Olivo MA, Amezaga Urruela M, McGahan L, et al. Rituximab for rheumatoid arthritis. Cochrane Database Syst Rev 2015; (1): CD007356. 18) Hirsch FR, Suda K, Wiens J, et al. New and emerging targeted treatments in advanced non-small-cell lung cancer. Lancet 2016; 388 (10048): 1012-1024. |
| References_xml | – reference: 2) Novak N, Bieber T, Allam JP. Immunological mechanisms of sublingual allergen-specific immunotherapy. Allergy 2011; 66 (6): 733-739. – reference: 4) Wise SK, Schlosser RJ. Evidence-based practice: sublingual immunotherapy for allergic rhinitis. Otolaryngol Clin North Am 2012; 45 (5): 1045-1054. – reference: 12) Virchow JC, Backer V, Kuna P, et al. Efficacy of a House Dust Mite Sublingual Allergen Immunotherapy Tablet in Adults With Allergic Asthma: A Randomized Clinical Trial. JAMA 2016; 315 (16): 1715-1725. – reference: 19) Gettinger SN, Horn L, Gandhi L, et al. Overall Survival and Long-Term Safety of Nivolumab (Anti-Programmed Death 1 Antibody, BMS-936558, ONO-4538) in Patients With Previously Treated Advanced Non-Small-Cell Lung Cancer. J Clin Oncol 2015; 33 (18): 2004-2012. – reference: 1) Noon L. Prophylactic inoculation against hay fever. Lancet 1911; 177 (4580): 1572-1573. – reference: 9) Mauro G, Bernardini R, Barberi S, et al. Prevention of food and airway allergy: consensus of the Italian Society of Preventive and Social Paediatrics, the Italian Society of Paediatric Allergy and Immunology, and Italian Society of Pediatrics. World Allergy Organ J 2016; 9: 28. – reference: 8) Klimek L, Mosbech H, Zieglmayer P, et al. SQ house dust mite (HDM) SLIT-tablet provides clinical improvement in HDM-induced allergic rhinitis. Expert Rev Clin Immunol 2016; 12 (4): 369-377. – reference: 7) Okamoto Y, Fujieda S, Okano M, et al. House dust mite sublingual tablet is effective and safe in patients with allergic rhinitis. Allergy 2016; 72 (3): 435-443. – reference: 16) Sakkas LI, Bogdanos DP. Systemic sclerosis: New evidence re-enforces the role of B cells. Autoimmun Rev 2016; 15 (2): 155-161. – reference: 20) Brahmer J, Reckamp KL, Baas P, et al. Nivolumab versus Docetaxel in Advanced Squamous-Cell Non-Small-Cell Lung Cancer. N Engl J Med 2015; 373 (2): 123-135. – reference: 10) Taramarcaz P, Gibson PG. The effectiveness of intranasal corticosteroids in combined allergic rhinitis and asthma syndrome. Clin Exp Allergy 2004; 34 (12): 1883-1889. – reference: 21) Borghaei H, Paz-Ares L, Horn L, et al. Nivolumab versus Docetaxel in Advanced Nonsquamous Non-Small-Cell Lung Cancer. N Engl J Med 2015; 373 (17): 1627-1639. – reference: 13) Guillevin L, Pagnoux C, Karras A, et al. French Vasculitis Study Group. Rituximab versus azathioprine for maintenance in ANCA-associated vasculitis. N Engl J Med 2014; 371 (19): 1771-1780. – reference: 15) Lopez-Olivo MA, Amezaga Urruela M, McGahan L, et al. Rituximab for rheumatoid arthritis. Cochrane Database Syst Rev 2015; (1): CD007356. – reference: 6) Compalati E, Passalacqua G, Bonini M, et al. The efficacy of sublingual immunotherapy for house dust mites respiratory allergy: results of a GA2LEN meta-analysis. Allergy 2009; 64 (11): 1570-1579. – reference: 14) Dumoitier N, Terrier B, London J, et al. Implication of B lymphocytes in the pathogenesis of ANCA-associated vasculitides. Autoimmun Rev 2015; 14 (11): 996-1004. – reference: 17) Nalotto L, Iaccarino L, Zen M, et al. Rituximab in refractory idiopathic inflammatory myopathies and anti synthetase syndrome: personal experience and review of the literature. Immunol Res 2013; 56 (2-3): 362-370. – reference: 11) Demoly P, Emminger W, Rehm D, et al. Effective treatment of house dust mite-induced allergic rhinitis with 2 doses of the SQ HDM SLIT-tablet: Results from a randomized, double-blind, placebo-controlled phase III trial. J Allergy Clin Immunol 2016; 137 (2): 444-451.e8. – reference: 3) Wilson DR, Torres LI, Durham SR. Sublingual immunotherapy for allergic rhinitis. Cochrane Database Syst Rev 2003; (2): CD002893. – reference: 5) Calderon MA, Casale TB, Nelson HS, et al. An evidencebased analysis of house dust mite allergen immunotherapy: a call for more rigorous clinical studies. Allergy Clin Immunol 2013; 132 (6): 1322-1336. – reference: 18) Hirsch FR, Suda K, Wiens J, et al. New and emerging targeted treatments in advanced non-small-cell lung cancer. Lancet 2016; 388 (10048): 1012-1024. |
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| Snippet | 肺は外界に開かれた臓器であり，様々な環境刺激に暴露されるという特性を有している．よって，複雑な免疫機構の制御異常は，環境ストレスに対する過剰な生体応答，または，... |
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| SubjectTerms | rituximab アレルゲン免疫療法 免疫チェックポイント阻害薬 気管支喘息 間質性肺炎 |
| Title | 免疫制御療法と呼吸器疾患 |
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