Significant progress has been made in drugs for allergic diseases, and sublingual immunotherapy becomes the first choice

Introduction: In the past 70 years, Chinese scientists have made great contributions to the global understanding of allergies.

On April 2, 2021, the China Sublingual Desensitization Forum was held in Shanghai.
This forum announced the world's first standardization for the treatment of allergic rhinitis (or conjunctivitis) caused by Artemisia annua/Mugwort pollen allergy.
The desensitization drug-Artemisia annua pollen allergen sublingual drops was approved for marketing.

The launch of this drug fills the gap in desensitization of pollen allergens in northern my country, and brings a milestone in the treatment of Artemisia pollen desensitization in my country.

 Allergic diseases are major diseases that affect human health.
Allergic diseases are the sixth largest chronic disease in the world.
The World Health Organization lists allergic diseases as one of the key diseases for research and prevention in the 21st century.
Beijing Tongren Hospital, Capital Medical University Professor Chang Zhang Luo said: "Allergic rhinitis (ie allergic rhinitis) is a chronic and refractory disease, with an increasing incidence year by year.
It is
conservatively estimated that there are more than 1 billion patients with allergic rhinitis worldwide.

Allergic rhinitis persists for a long time.
It is the source of chronic diseases such as asthma, chronic obstructive pulmonary disease, cardiovascular and cerebrovascular diseases, and diabetes.

"In China, pollen is the main inducing factor of allergic diseases, and pollen-induced allergic rhinitis is one of the most common allergic diseases.
One, the disease is mainly manifested as inflammation of the upper and lower airways, eyes and skin.Lou, H.
, Ma, S.
, Zhao, Y.
et al.
Sensitization patterns and minimum screening panels for aeroallergens in self-reported allergic rhinitis in China.
Sci Rep 7, 9286 (2017).
https://doi.
org /10.
1038/s41598-017-10111-9 There are obvious differences in allergens between North and South in China.
The study published in Scientific Reports shows that Artemisia pollen is the most important allergen in northern my country.
The skin prick test of Artemisia pollen for patients with allergic rhinitis in my country The positive rate reached 14.
9%-58.
2%, and as many as 70 million people were sick.

Artemisia annua and istock southern regions use mites as the main allergen.
As early as 2006, the "Dust Mite Drops" independently developed by Wowu Biotech was launched and became the first domestic desensitization drug for dust mite allergens taken sublingually.
.

The approval of Artemisia annua pollen allergen sublingual drops has created a new pattern of multi-directional desensitization of my country's "South mites and North Artemisia".

So far, most of China's allergy sufferers have drugs to treat the cause.

In the past, the treatment of allergies mainly relied on "temporary treatment" to relieve symptoms, such as the use of antihistamines, nasal spray hormones and other symptomatic drugs.

However, allergens are widely present in the indoor and outdoor living environment.
Once the patient is exposed again, allergies will relapse.
If you want to "cure the root cause", you need to treat the cause.
Specific immunotherapy (also called desensitization therapy) is a kind of cause.
treatment. Desensitization mechanism and classification, CNKI, Head Leopard Research Institute desensitization therapy, also known as specific desensitization therapy, is a treatment for allergic diseases that is stimulated by multiple allergens to promote the body's immune system to produce immune tolerance Method, its mechanism of action is as follows: through continuous allergen stimulation, change the allergen-specific T cell response mode in the patient's body, regulate the immune balance between Th1/Th2 lymphocytes in the immune system, and produce blocking at the same time The slgG antibody inhibits the expression of adhesion molecules, thereby inhibiting the recruitment of eosinophils and neutrophils stimulated by allergens, reducing effector cell degranulation, affecting the natural course of allergic diseases, and promoting allergic symptoms to be alleviated or completely disappear.

Professor Zhang Luo, dean of Beijing Tongren Hospital of Capital Medical University, said in an exclusive interview with Metz Medicine that the current main methods of desensitization treatment include subcutaneous injection desensitization and sublingual desensitization.

Some clinical trial results show that compared with subcutaneous injection desensitization, sublingual desensitization is safer and more effective.
In addition, it is easy to use and convenient to carry.
The clinical treatment effect is more and more recognized by clinical experts.
China has become the first-line treatment for allergic rhinitis.

"China Guidelines for Sublingual Immunotherapy for Allergic Rhinitis and Allergic Asthma" and SLIT treatment process, J Thorac Dis 2019;11(12):4936-4950, http://dx.
doi.
org/10.
21037/jtd.
2019.
12 .
37 In January 2020, the Allergy Branch of the Chinese Medical Association (CSA) issued the first "China Guidelines for Sublingual Immunotherapy for Allergic Rhinitis and Allergic Asthma", covering the epidemiology, epidemiology, and allergic asthma of allergic rhinitis and allergic asthma.
Sublingual immunotherapy mechanism, indications and contraindications, standardized allergen preparations, development of standardized sublingual immunotherapy, evaluation of efficacy and management of adverse events, etc.
, aim to guide the clinical application of sublingual immunotherapy and promote sublingual immunity The clinical penetration rate of treatment has increased.

This also confirms once again that this therapy is the only counter-cause therapy that may change the natural progression of allergic diseases.
It has early, sustained, long-term, and preventive effects.

However, Professor Zhang Luo pointed out that there are insufficient diagnosis and treatment methods that limit the popularization of immunotherapy.

Artemisia annua pollen allergen sublingual drops is a sublingual drug that is administered under the tongue.
It is a desensitization treatment for specific allergens.
It is clinically used to treat Artemisia annua/Mugwort pollen allergy after allergen detection.
For adult allergic rhinitis (or conjunctivitis), it is recommended to start the treatment at least 4 months before the expected annual pollen season of Artemisia annua/Artemisia wormwood, and continue to use it throughout the pollen season.
No symptoms in the non-pollen season It is necessary to adhere to the medication, and the effect is more stable.
It is recommended to use it continuously for at least 3 years.

The latest research data shows that long-term desensitization treatment can effectively prevent re-allergies in the pollen season in the coming year.

The effect of multi-center Artemisia annua sublingual immunotherapy on the daily composite score of rhinoconjunctivitis symptoms (CSMRS), Lou et al.
World Allergy Organization Journal (2020) 13:100458, http://doi.
org/10.
1016/j.
waojou.
2020.
100458 The approval of the new drug is based on the important data obtained from the Phase III clinical trial led by Professor Zhang Luo, Dean of Beijing Tongren Hospital Affiliated to Capital Medical University.
The Phase III clinical trial of Artemisia annua pollen allergen sublingual drops is a multiple A central, randomized, double-blind, placebo-controlled trial, 13 centers enrolled a total of 702 subjects, and they were randomly divided into a trial group (468 people) and a placebo group (234 people).

The test results showed that compared with the placebo group, the 32-week standardized Artemisia annua drops sublingual desensitization treatment can significantly improve the patients' nasal symptoms and reduce the use of symptomatic drugs.

Artemisia annua-sublingual immunotherapy for seasonal allergic rhinitis: A randomized controlled trial, First published: 07 February 2020 https://doi.
org/10.
1111/all.
14218 Another single-center randomized double-blind placebo-controlled trial showed that standardized The artemisia annua sublingual desensitization treatment can improve the patient’s immunological indicators.
After the drug is stopped, it can continue to improve the patient’s symptoms and reduce the probability of new allergens in the patient.
It shows that the artemisia annua sublingual desensitization treatment has Long-term curative effect and preventive effect.

Professor Zhang Luo on the cover of the China Special Issue of "Allergy" pointed out that China’s clinical academic research on allergy has made considerable progress and has participated in many international English version of the diagnosis and treatment guidelines.
It is worth mentioning that in February 2021, the international The high-impact journal Allergy has launched a special China issue, which includes important articles recently published by many Chinese scholars in Allergy, which also shows that China's clinical research is internationally recognized.

At the same time, Professor Zhang Luo also pointed out that China’s allergic diseases still have to be solved by themselves.

Chinese scholars published in Allergy in 2019, Allergy.
2021;76:422–424.
The editorial issued by Allergy pointed out that in the field of allergy, Artemisia was first reported as the most important allergic in northern China in the early 1950s.
Source of pollen.

Since then, the prevalence of allergic diseases and the consequent socio-economic burden has increased greatly.

This has led to many studies evaluating the epidemiology, pathogenesis, diagnosis and treatment strategies of allergic diseases, which has made significant progress in this field.

In the past 70 years, Chinese scientists have made great contributions to the global understanding of allergies.

On the other hand, my country has also made breakthroughs in the commercialization of drug treatments for allergic diseases.
The development of this drug for allergic diseases has been selected as a major national new drug creation project and has been given priority review by the Center for Drug Evaluation (CDE) of the National Medical Products Administration.
qualifications.

The launch of the new drug may bring significant clinical benefits to many domestic patients suffering from Artemisia pollen allergies, and effectively improve the prognosis of patients and enhance the quality of life.

  References: 1.
Sensitization patterns and minimum screening panels for aeroallergens in self-reported allergic rhinitis in China, 2017.
2.
Lou H, et al.
Artemisia Annua sublingual immunotherapy for seasonal allergic rhinitis: A multicenter, randomized trial.
World Allergy Organ J.
2020, 13(9): 100458.
3.
Lou H, Huang Y, Ouyang Y, et al.
Artemisia annua-sublingual immunotherapy for seasonal allergic rhinitis: A randomized controlled trial.
Allergy, 2020, 75(86).
Written by JACKZHAO Editor| Jessica authorized reprinting, submission and breaking news, please contact Metz Medical Administrator MedSci (WeChat ID: medsci_m)