알레르기 면역요법과 생물학제제 병용요법: 알레르기 질환 관리의 새로운 패러다임

Abstract

Allergen specific immunotherapy (AIT) is a well-established, disease-modifying treatment for allergic rhinitis, asthma, and Hymenoptera venom allergy. In recent years, monoclonal antibodies targeting the key mediators of type 2 immunity, such as immunoglobulin E (IgE), interleukin (IL)-4, IL-13, and thymic stromal lymphopoietin (TSLP), have emerged as a promising strategy to enhance AIT efficacy, improved safety, and enabled earlier symptom control. Anti-IgE therapy remains most well-established and widely studied, demonstrating consistent benefits in enhancing both safety and efficacy. Anti-IL-4/IL-13 receptor antibodies may contribute to improvement in immunologic profiles, although their clinical impact appears modest in a short term. Notably, the combination of AIT with anti-TSLP therapy has shown sustained immunomodulatory effects and clinical improvement lasting up to one year posttreatment. Despite these encouraging findings, the optimal dosing regimens, treatment duration, cost-effectiveness, and criteria for appropriate patient selection have not yet been clearly established. Further studies are needed to address these gaps and to guide the development of personalized therapeutic strategies for the management of allergic diseases. (Allergy Asthma Respir Dis 2025;13:138-147)