过敏学科发展:机遇与挑战
doi: 10.20227/j.cnki.2096-3610.2025.02.002
孙劲旅
中国医学科学院北京协和医院变态(过敏)反应科,北京 100730
基金项目: 中央高水平医院临床科研项目(2022-PUMCH-D-002) ; 中国医学科学院医学与健康科技创新工程项目(021-I2M1-017)
Development of allergy discipline: opportunities and challenges
SUN Jinlv
Department of Allergy, Peking Union Medical College Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, Beijing 100730 , China
摘要
过敏性疾病是全球第六大疾病,影响着全球近40%的人口,已经成为我国的常见病、多发病,应该引起全社会及各部门的高度重视。在过去几十年里,过敏研究领域的国际发展以迅速的步伐推进,取得了多项重要突破。我国过敏及其相关领域的临床和科研工作者也做出了巨大贡献。目前,我国过敏学科的发展是机遇与挑战并存!
Abstract
Allergic diseases are the sixth leading cause of disease globally, affecting nearly 40% of the population, and have become prevalent and common diseases in China. This issue requires more and more attention from society and government. Over the past few decades, the field of allergy medicine has progressed rapidly in the world, with several significant breakthroughs. Clinical and basic research progress in China have also made substantial contributions to the field. Currently, the development of allergy medicine disciplines in China meets both opportunities and challenges.
过敏性疾病,又称为变态反应性疾病,被世界卫生组织列为21世纪重点防治的疾病之一,是由于生活方式变化引起的疾病[1]。世界变态反应组织白皮书报告指出过敏性疾病已经成为全球第六大疾病,影响着全球近 40% 的人口[2]。过敏性疾病包括过敏性鼻炎、过敏性哮喘、特应性皮炎、接触性皮炎、荨麻疹、食物过敏、药物过敏、严重过敏反应等,它们作为临床最常见的过敏性疾病,严重影响人民的生活质量,并且给社会带来了巨大的经济损失[3]。我国现有过敏性鼻炎患者患病率约为17.6%[4],北方草原地区的患病率高达 32.4%[5],20 岁以上成人哮喘患病率达 4.2%[6],特应性皮炎的儿童与成人患病率分别达世界人口的 15%~20% 和 6%~10%[7-8]。过敏性疾病严重影响患者生活质量和身心健康[3],譬如从个体层面来看,过敏性疾病对患者的日常生活造成了严重影响,轻者包括睡眠、工作、社交活动以及身体状况等,重者累及全身多个系统,导致多系统、多器官的损害,甚至导致死亡[9],这一问题应当引起全社会的广泛关注。
在过去几十年里,过敏研究领域的国际发展以迅速的步伐推进,取得了多项重要突破。随着结构生物学及组学技术的发展,科学家们能够深入了解过敏反应的基本机制,创新了过敏性疾病的治疗方法。例如:IgE 受体结构解析[10] 及新型组胺受体的发现[11];治疗过敏性疾病的生物制剂和小分子药物:如抗 IgE 单抗[12]、抗 IL-4/IL-13 单抗[13]、抗 IL-5 单抗[14]、抗 TSLP 单抗[15]、JAK-STAT 信号通路抑制剂[16],为过敏患者带来福音,激发了更多过敏专业及其相关专业医务人员对于过敏学科发展的信心!
我国过敏及其相关领域的临床和科研工作者也做出了巨大贡献。譬如IgE受体结构解析有望为进一步过敏性疾病的生物治疗带来理论性突破,过敏性疾病多组学研究有望发现过敏性疾病的诊断和治疗的生物标志物,过敏性疾病的流行病学调查,发现我国过敏性疾病真实的患病率,需要引起社会各界的高度重视!在生物制药行业,我国原创和仿制的生物制剂不断增多[17],临床研究表明有些原创药物疗效还优于国外药物[18]。北京协和医院、北京世纪坛医院、北京儿童医院作为我国最早开展过敏专科医师培训基地已经得到北京医师协会和国家皮肤与免疫性疾病临床研究中心的联合认可,并且可以从全国遴选经过内科规培的住院医师,为我国的过敏专科医师培训起到示范作用!在国内多位专家的共同努力下,我们一起拟定了《过敏专科建设规范》(TCRHA 106―2024)和《过敏门诊建设规范》(TCRHA 107―2024),得到中国研究型医院学会批准并对外发布。在国外学术团体和杂志,我国学者也在多种场合发出中国声音,譬如担任国外顶级的专业期刊Allergy的副主编和编委,出版中国专刊!更加令人欣喜的是:由我国主办的英文过敏专业期刊 Allergy Medicine也成功出版发行,并且还被中国卓越期刊项目评选为高起点英文期刊,为我们在过敏及相关领域发出中国声音又创造了一个好的国际平台!
目前,我国过敏学科的发展是机遇与挑战并存!现代生物技术和AI技术的迅猛发展,为我们研究过敏性疾病的发病机制及治疗策略带来前所未有的机遇:关注和研究过敏的人越来越多,我们要积极欢迎各位有志之士积极投身过敏行业!同时,我们也面临前所未有的挑战:加强过敏原诊断和治疗制剂的研发,如何高效进行国内外合作,如何充分发挥中医药的特点,都是我们面临的巨大挑战!
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