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'Entopy': local allergy paradigm

机译：“熵”：局部过敏范式

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摘要

Allergy is defined as an immediate hypersensitivity type I immunological disease, which can be IgE or non-IgE driven, and in the latter case may be antibody or cell mediated. Atopy is a term used to describe individuals with a genetic predisposition for developing IgE-mediated allergic disease. But more recently, it has become evident that IgE-mediated disease can occur in non-atopic subjects. While it is now generally accepted that mucosal local IgE has a role in the expression of atopic allergic disease, the concept of'local allergy' in non-atopic subjects has been proposed, with the term 'entopy' given to this condition. Although there is increasing evidence supporting this paradigm, entopy is only applicable to a proportion of non-atopic patients, suggesting that other disease mechanisms exist to explain non-atopic disease. This review considers the evidence for local mucosal allergy in atopic and non-atopic individuals with an emphasis on diseases affecting the upper airways and eye. Furthermore, the diagnosis, treatment and relationship between local allergy and conventional (systemic) allergy are discussed, and alternative disease mechanisms predominantly involving antibodies or their sub-components (free light chain Igs) are postulated to explain the 'entopy' paradigm. This review is intended to provide an improved understanding of the mechanisms and causes of local mucosal hypersensitivity.
机译：过敏症定义为I型即刻超敏性免疫疾病，可能是IgE或非IgE驱动，在后一种情况下可能是抗体或细胞介导的。特应性是用于描述具有易患IgE介导的过敏性疾病的遗传倾向的个体的术语。但是最近，很明显，IgE介导的疾病可以发生在非特应性受试者中。尽管现在普遍认为粘膜局部IgE在特应性变态反应性疾病的表达中起作用，但是已经提出在非特应性受试者中使用“局部变态反应”的概念。尽管有越来越多的证据支持这种范例，但是对症治疗仅适用于一部分非特应性患者，这表明存在其他疾病机制来解释非特应性疾病。这篇综述考虑了特应性和非特应性个体局部黏膜过敏的证据，重点是影响上呼吸道和眼睛的疾病。此外，讨论了局部变态反应与常规（系统性）变态反应的诊断，治疗以及之间的关系，并提出了主要涉及抗体或其子成分（游离轻链Ig）的其他疾病机制来解释“熵”范式。这篇综述旨在提供对局部粘膜超敏反应的机制和原因的更好的理解。

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