{"id":155585,"date":"2026-03-16T12:04:55","date_gmt":"2026-03-16T05:04:55","guid":{"rendered":"https:\/\/vnras.com\/drug\/?p=155585"},"modified":"2026-04-01T14:58:41","modified_gmt":"2026-04-01T07:58:41","slug":"tu-di-ung-autoallergy-va-nhung-dieu-bac-si-di-ung-can-biet","status":"publish","type":"post","link":"https:\/\/vnras.com\/drug\/tu-di-ung-autoallergy-va-nhung-dieu-bac-si-di-ung-can-biet\/","title":{"rendered":"T\u1ef0 D\u1eca \u1ee8NG (AUTOALLERGY) V\u00c0 NH\u1eeeNG \u0110I\u1ec0U B\u00c1C S\u0128 D\u1eca \u1ee8NG C\u1ea6N BI\u1ebeT"},"content":{"rendered":"<p style=\"text-align: justify;\">L\u01b0\u1ee3t d\u1ecbch: NT \u0397\u039d<\/p>\n<h2 style=\"text-align: justify;\">T\u1ed4NG QUAN<\/h2>\n<p style=\"text-align: justify;\">Hen suy\u1ec5n, vi\u00eam da c\u01a1 \u0111\u1ecba (AD), m\u00e0y \u0111ay m\u1ea1n t\u00ednh (CU) v\u00e0 d\u1ecb \u1ee9ng th\u1ee9c \u0103n l\u00e0 nh\u1eefng r\u1ed1i lo\u1ea1n mi\u1ec5n d\u1ecbch th\u01b0\u1eddng g\u1eb7p nh\u1ea5t \u0111\u01b0\u1ee3c c\u00e1c b\u00e1c s\u0129 chuy\u00ean khoa d\u1ecb \u1ee9ng \u0111i\u1ec1u tr\u1ecb. Hen suy\u1ec5n l\u00e0 b\u1ec7nh \u0111\u01b0\u1eddng h\u00f4 h\u1ea5p d\u01b0\u1edbi, \u0111\u1eb7c tr\u01b0ng v\u1edbi c\u00e1c tri\u1ec7u ch\u1ee9ng nh\u01b0 ho, kh\u00f2 kh\u00e8, kh\u00f3 th\u1edf v\u00e0 t\u0103ng ph\u1ea3n \u1ee9ng ph\u1ebf qu\u1ea3n. Nhi\u1ec1u ki\u1ec3u h\u00ecnh n\u1ed9i t\u1ea1i (endotype) c\u1ee7a hen suy\u1ec5n \u0111\u00e3 \u0111\u01b0\u1ee3c m\u00f4 t\u1ea3, bao g\u1ed3m hen suy\u1ec5n Th2-cao, \u0111\u1eb7c tr\u01b0ng n\u1ed3ng \u0111\u1ed9 cao c\u00e1c cytokine type 2 v\u00e0 t\u00ecnh tr\u1ea1ng vi\u00eam \u0111\u01b0\u1eddng th\u1edf do b\u1ea1ch c\u1ea7u \u00e1i toan, v\u00e0 hen suy\u1ec5n Th2-th\u1ea5p li\u00ean quan \u0111\u1ebfn vi\u00eam do b\u1ea1ch c\u1ea7u trung t\u00ednh ho\u1eb7c t\u00ecnh tr\u1ea1ng vi\u00eam \u00edt b\u1ea1ch c\u1ea7u h\u1ea1t. Vi\u00eam da c\u01a1 \u0111\u1ecba (AD) l\u00e0 m\u1ed9t b\u00eanh vi\u00eam da m\u1ea1n t\u00ednh th\u01b0\u1eddng g\u1eb7p, \u0111\u1eb7c tr\u01b0ng v\u1edbi ng\u1ee9a, \u0111\u1ecf v\u00e0 kh\u00f4 da. Nguy\u00ean nh\u00e2n c\u1ee7a AD mang t\u00ednh \u0111a y\u1ebfu t\u1ed1, bao g\u1ed3m c\u00e1c y\u1ebfu t\u1ed1 k\u00edch th\u00edch t\u1eeb m\u00f4i tr\u01b0\u1eddng, khuynh h\u01b0\u1edbng di truy\u1ec1n, h\u00e0ng r\u00e0o b\u1ea3o v\u1ec7 da b\u1ecb suy y\u1ebfu v\u00e0 s\u1ef1 r\u1ed1i lo\u1ea1n \u0111i\u1ec1u h\u00f2a c\u1ee7a h\u1ec7 mi\u1ec5n d\u1ecbch. T\u01b0\u01a1ng t\u1ef1 nh\u01b0 hen suy\u1ec5n, AD c\u0169ng c\u00f3 c\u00e1c c\u01a1 ch\u1ebf sinh l\u00fd b\u1ec7nh kh\u00e1c nhau; tuy nhi\u00ean, vi\u1ec7c x\u00e1c \u0111\u1ecbnh c\u00e1c endotype c\u00f3 t\u00ednh t\u00e1i l\u1eadp \u1ed5n \u0111\u1ecbnh v\u1eabn c\u00f2n nhi\u1ec1u th\u00e1ch th\u1ee9c. M\u00e0y \u0111ay m\u1ea1n t\u00ednh, m\u1ed9t r\u1ed1i lo\u1ea1n vi\u00eam da do t\u1ebf b\u00e0o mast chi ph\u1ed1i, \u0111\u1eb7c tr\u01b0ng v\u1edbi s\u1ea9n ng\u1ee9a, ph\u00f9 m\u1ea1ch ho\u1eb7c c\u1ea3 hai, t\u00e1i ph\u00e1t k\u00e9o d\u00e0i h\u01a1n 6 tu\u1ea7n. CSU c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c ph\u00e2n lo\u1ea1i th\u00e0nh m\u00e0y \u0111ay m\u1ea1n t\u00ednh t\u1ef1 ph\u00e1t v\u00e0 m\u00e0y \u0111ay m\u1ea1n t\u00ednh c\u00f3 y\u1ebfu t\u1ed1 th\u00fac \u0111\u1ea9y (ClndU), trong \u0111\u00f3 CSU x\u1ea3y ra khi kh\u00f4ng x\u00e1c \u0111\u1ecbnh \u0111\u01b0\u1ee3c c\u00e1c k\u00edch th\u00edch v\u1eadt l\u00fd ho\u1eb7c m\u00f4i tr\u01b0\u1eddng c\u1ee5 th\u1ec3. Trong nh\u1eefng n\u0103m g\u1ea7n \u0111\u00e2y, c\u00e1c ti\u1ebfn b\u1ed9 trong nghi\u00ean c\u1ee9u mi\u1ec5n d\u1ecbch h\u1ecdc \u0111\u00e3 cho th\u1ea5y t\u1ef1 mi\u1ec5n \u0111\u00f3ng vai tr\u00f2 trung t\u00e2m trong c\u01a1 ch\u1ebf b\u1ec7nh sinh c\u1ee7a CSU. D\u1ecb \u1ee9ng th\u1ee9c \u0103n l\u00e0 c\u00e1c ph\u1ea3n \u1ee9ng mi\u1ec5n d\u1ecbch b\u1ea5t th\u01b0\u1eddng \u0111\u01b0\u1ee3c k\u00edch ho\u1ea1t khi ti\u1ebfp x\u00fac v\u1edbi nh\u1eefng lo\u1ea1i th\u1ef1c ph\u1ea9m nh\u1ea5t \u0111\u1ecbnh v\u00e0 theo \u0111\u1ecbnh ngh\u0129a c\u1ed5 \u0111i\u1ec3n l\u00e0 c\u00e1c ph\u1ea3n \u1ee9ng qu\u00e1 m\u1eabn qua trung gian IgE. Tuy nhi\u00ean, nh\u1eefng ti\u1ebfn b\u1ed9 g\u1ea7n \u0111\u00e2y, v\u00edd\u1ee5 nh\u01b0 trong c\u00e1c c\u00f4ng c\u1ee5 ch\u1ea9n \u0111o\u00e1n, \u0111\u00e3 \u0111\u01b0a ra c\u00e1c \u0111\u1ec1 xu\u1ea5t v\u1ec1 endotype d\u1ecb \u1ee9ng th\u1ef1c ph\u1ea9m kh\u00e1c nhau.<\/p>\n<p style=\"text-align: justify;\">\u1ea2nh h\u01b0\u1edfng \u0111\u1ebfn kho\u1ea3ng 30-40% d\u00e2n s\u1ed1 to\u00e0n c\u1ea7u, c\u00e1c b\u1ec7nh l\u00fd n\u00e0y \u0111ang ng\u00e0y c\u00e0ng tr\u1edf n\u00ean ph\u1ed5 bi\u1ebfn v\u00e0 ph\u1ee9c t\u1ea1p h\u01a1n, th\u01b0\u1eddng li\u00ean quan \u0111\u1ebfn nhi\u1ec1u y\u1ebfu t\u1ed1 kh\u1edfi ph\u00e1t v\u00e0 c\u00e1c ki\u1ec3u h\u00ecnh b\u1ec7nh ch\u1ed3ng l\u1ea5p. Trong khi tr\u01b0\u1edbc \u0111\u00e2y ch\u00fang th\u01b0\u1eddng \u0111\u01b0\u1ee3c xem l\u00e0 c\u00e1c r\u1ed1i lo\u1ea1n qu\u00e1 m\u1eabn v\u1edbi kh\u00e1ng nguy\u00ean ngo\u1ea1i sinh (d\u1ecb \u1ee9ng), c\u00e1c nghi\u00ean c\u1ee9u g\u1ea7n \u0111\u00e2y cho th\u1ea5y m\u1ed9t s\u1ed1 b\u1ec7nh c\u0169ng c\u00f3 th\u1ec3 li\u00ean quan \u0111\u1ebfn \u0111\u00e1p \u1ee9ng mi\u1ec5n d\u1ecbch ch\u1ed1ng l\u1ea1i ch\u00ednh kh\u00e1ng nguy\u00ean c\u1ee7a c\u01a1 th\u1ec3, hi\u1ec7n t\u01b0\u1ee3ng \u0111\u01b0\u1ee3c g\u1ecdi l\u00e0 t\u1ef1 d\u1ecb \u1ee9ng (autoallergy). Kh\u00e1i ni\u1ec7m n\u00e0y n\u1eb1m \u1edf giao \u0111i\u1ec3m gi\u1eefa d\u1ecb \u1ee9ng v\u00e0 t\u1ef1 mi\u1ec5n, nh\u01b0ng v\u1eabn ch\u01b0a \u0111\u01b0\u1ee3c nh\u1eadn bi\u1ebft \u0111\u1ea7y \u0111\u1ee7 trong th\u1ef1c h\u00e0nh l\u00e2m s\u00e0ng h\u00e0ng ng\u00e0y. Trong b\u00e0i vi\u1ebft n\u00e0y, ch\u00fang t\u00f4i cung c\u1ea5p cho b\u00e1c s\u0129 d\u1ecb \u1ee9ng m\u1ed9t g\u00f3c nh\u00ecn t\u1ed5ng quan ng\u1eafn g\u1ecdn v\u00e0 c\u00f3 gi\u00e1 tr\u1ecb l\u00e2m s\u00e0ng v\u1ec1 t\u1ef1 d\u1ecb \u1ee9ng th\u00f4ng qua vi\u1ec7c tr\u1ea3 l\u1eddi 5 c\u00e2u h\u1ecfi ch\u00ednh trong b\u1ea3ng 1: (1) T\u1ef1 d\u1ecb \u1ee9ng l\u00e0 g\u00ec v\u00e0 kh\u00e1c g\u00ec so v\u1edbi d\u1ecb \u1ee9ng c\u1ed5 \u0111i\u1ec3n? (2) T\u1ef1 d\u1ecb \u1ee9ng ph\u1ed5 bi\u1ebfn \u0111\u1ebfn m\u1ee9c n\u00e0o? (3) T\u1ef1 d\u1ecb \u1ee9ng c\u00f3 \u00fd ngh\u0129a l\u00e2m s\u00e0ng hay kh\u00f4ng? (4) L\u00e0m th\u1ebf n\u00e0o \u0111\u1ec3 ch\u1ea9n \u0111o\u00e1n t\u1ef1 d\u1ecb \u1ee9ng? (5) T\u1ef1 d\u1ecb \u1ee9ng \u0111\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb nh\u01b0 th\u1ebf n\u00e0o? Trong b\u00e0i vi\u1ebft n\u00e0y ch\u00fang t\u00f4i t\u1eadp trung v\u00e0o hen, vi\u00eam da c\u01a1 \u0111\u1ecba, m\u00e0y \u0111ay m\u1ea1n t\u00ednh v\u00e0 d\u1ecb \u1ee9ng th\u1ee9c \u0103n.<\/p>\n<h2 style=\"text-align: justify;\">T\u1ef0 D\u1eca \u1ee8NG L\u00c0 G\u00cc V\u00c0 KH\u00c1C G\u00cc SO V\u1edaI D\u1eca \u1ee8NG C\u1ed4 \u0110I\u1ec2N?<\/h2>\n<p style=\"text-align: justify;\">IgE \u0111\u01b0\u1ee3c bi\u1ebft l\u00e0 m\u1ed9t y\u1ebfu t\u1ed1 quan tr\u1ecdng trong ph\u1ea3n \u1ee9ng qu\u00e1 m\u1eabn type 1. D\u1ecb \u1ee9ng c\u1ed5 \u0111i\u1ec3n qua trung gian IgE li\u00ean quan \u0111\u1ebfn ph\u1ea3n \u1ee9ng qu\u00e1 m\u1eabn v\u1edbi c\u00e1c kh\u00e1ng nguy\u00ean m\u00f4i tr\u01b0\u1eddng (ngo\u1ea1i sinh) (v\u00ed d\u1ee5: ph\u1ea5n hoa v\u00e0 protein th\u1ef1c ph\u1ea9m), trong \u0111\u00f3 c\u00e1c t\u1ebf b\u00e0o tr\u00ecnh di\u1ec7n kh\u00e1ng nguy\u00ean tr\u00ecnh di\u1ec7n d\u1ecb nguy\u00ean cho t\u1ebf b\u00e0o T ch\u01b0a bi\u1ec7t h\u00f3a. C\u00e1c t\u1ebf b\u00e0o Th2 \u0111\u00e3 bi\u1ec7t h\u00f3a sau \u0111\u00f3 ho\u1ea1t h\u00f3a t\u1ebf b\u00e0o B, kh\u1edfi ph\u00e1t qu\u00e1 tr\u00ecnh chuy\u1ec3n l\u1edbp kh\u00e1ng th\u1ec3 v\u00e0 s\u1ea3n xu\u1ea5t IgE. IgE c\u00f3 th\u1ec3 g\u1eafn l\u00ean c\u00e1c t\u1ebf b\u00e0o hi\u1ec7u \u1ee9ng nh\u01b0 basophil v\u00e0 mast cell th\u00f4ng qua th\u1ee5 th\u1ec3 \u00e1i l\u1ef1c cao FcERI. Khi c\u01a1 th\u1ec3 ti\u1ebfp x\u00fac l\u1ea1i v\u1edbi d\u1ecb nguy\u00ean, d\u1ecb nguy\u00ean s\u1ebd li\u00ean k\u1ebft ch\u00e9o c\u00e1c ph\u00e2n t\u1eed IgE tr\u00ean b\u1ec1 m\u1eb7t mast cell v\u00e0 basophil, g\u00e2y gi\u1ea3i ph\u00f3ng c\u00e1c h\u1ea1t v\u00e0 histamine, leukotriene v\u00e0 c\u00e1c cytokine.<\/p>\n<p style=\"text-align: justify;\">C\u00e1c b\u1eb1ng ch\u1ee9ng ng\u00e0y c\u00e0ng cho th\u1ea5y IgE ngo\u00e0i vi\u1ec7c nh\u1eadn di\u1ec7n kh\u00e1ng nguy\u00ean ngo\u1ea1i sinh, c\u00f2n c\u00f3 th\u1ec3 nh\u1eafm v\u00e0o c\u00e1c kh\u00e1ng nguy\u00ean c\u1ee7a ch\u00ednh c\u01a1 th\u1ec3, g\u00e2y ph\u1ea3n \u1ee9ng t\u1ef1 mi\u1ec5n \u0111\u01b0\u1ee3c g\u1ecdi l\u00e0 t\u1ef1 d\u1ecb \u1ee9ng ho\u1eb7c t\u1ef1 mi\u1ec5n type 1. Trong t\u1ef1 d\u1ecb \u1ee9ng, h\u1ec7 mi\u1ec5n d\u1ecbch t\u1ea1o ra t\u1ef1 kh\u00e1ng th\u1ec3 IgE ch\u1ed1ng l\u1ea1i kh\u00e1ng nguy\u00ean n\u1ed9i sinh (c\u00f2n g\u1ecdi l\u00e0 t\u1ef1 kh\u00e1ng nguy\u00ean hay autoantigen) ho\u1eb7c t\u1ef1 d\u1ecb nguy\u00ean (autoallergens), bao g\u1ed3m thyroid peroxidase (TPO), interleukin-24 (IL-24), MnSOD, c\u00f9ng v\u1edbi nhi\u1ec1u kh\u00e1ng nguy\u00ean kh\u00e1c. T\u01b0\u01a1ng t\u1ef1 nh\u01b0 trong d\u1ecb \u1ee9ng c\u1ed5 \u0111i\u1ec3n, d\u1ea1ng t\u1ef1 mi\u1ec5n n\u00e0y d\u1eabn \u0111\u1ebfn s\u1ef1 ho\u1ea1t h\u00f3a c\u1ee7a t\u1ebf b\u00e0o mast cell v\u00e0 basophils th\u00f4ng qua s\u1ef1 li\u00ean k\u1ebft ch\u00e9o c\u1ee7a IgE g\u1eafn v\u1edbi th\u1ee5 th\u1ec3 FcERI, t\u1eeb \u0111\u00f3 g\u00e2y ph\u1ea3n \u1ee9ng vi\u00eam v\u00e0 c\u00e1c bi\u1ec3u hi\u1ec7n l\u00e2m s\u00e0ng nh\u01b0 m\u00e0y \u0111ay.<\/p>\n<p style=\"text-align: justify;\">B\u1ea3ng 1: T\u00f3m t\u1eaft c\u00e2u h\u1ecfi v\u00e0 c\u00e2u tr\u1ea3 l\u1eddi<\/p>\n<table style=\"border-collapse: collapse; width: 100%; height: 126px;\">\n<tbody>\n<tr style=\"height: 21px;\">\n<td style=\"width: 50%; height: 21px; text-align: center;\"><strong>C\u00e2u h\u1ecfi<\/strong><\/td>\n<td style=\"width: 50%; height: 21px; text-align: center;\"><strong>C\u00e2u tr\u1ea3 l\u1eddi<\/strong><\/td>\n<\/tr>\n<tr style=\"height: 21px;\">\n<td style=\"width: 50%; height: 21px;\">T\u1ef1 d\u1ecb \u1ee9ng l\u00e0 g\u00ec v\u00e0 kh\u00e1c g\u00ec so v\u1edbi d\u1ecb \u1ee9ng c\u1ed5 \u0111i\u1ec3n?<\/td>\n<td style=\"width: 50%; height: 21px; text-align: justify;\">Trong t\u1ef1 d\u1ecb \u1ee9ng, c\u00e1c kh\u00e1ng th\u1ec3 IgE \u0111\u01b0\u1ee3c t\u1ea1o ra ch\u1ed1ng l\u1ea1i c\u00e1c protein n\u1ed9i sinh c\u1ee7a c\u01a1 th\u1ec3 (t\u1ef1 kh\u00e1ng nguy\u00ean &#8211; autoantigens). C\u00e1c kh\u00e1ng th\u1ec3 n\u00e0y g\u1eafn l\u00ean th\u1ee5 th\u1ec3 tr\u00ean b\u1ec1 m\u1eb7t t\u1ebf b\u00e0o mast v\u00e0 basophils, ho\u1ea1t h\u00f3a ch\u00fang v\u00e0 g\u00e2y ra c\u00e1c tri\u1ec7u ch\u1ee9ng b\u1ec7nh. Ng\u01b0\u1ee3c l\u1ea1i, d\u1ecb \u1ee9ng c\u1ed5 \u0111i\u1ec3n li\u00ean quan \u0111\u1ebfn \u0111\u00e1p \u1ee9ng IgE \u0111\u1ed1i v\u1edbi c\u00e1c d\u1ecb nguy\u00ean ngo\u1ea1i sinh, nh\u01b0 ph\u1ea5n hoa ho\u1eb7c protein th\u1ef1c ph\u1ea9m, m\u1eb7c d\u00f9 ki\u1ec3u bi\u1ec3u hi\u1ec7n tri\u1ec7u ch\u1ee9ng c\u00f3 th\u1ec3 nh\u01b0 nhau.<\/td>\n<\/tr>\n<tr style=\"height: 21px;\">\n<td style=\"width: 50%; height: 21px;\">T\u1ef1 d\u1ecb \u1ee9ng ph\u1ed5 bi\u1ebfn \u0111\u1ebfn m\u1ee9c n\u00e0o?<\/td>\n<td style=\"width: 50%; height: 21px; text-align: justify;\">T\u1ef1 d\u1ecb \u1ee9ng \u0111\u01b0\u1ee3c cho l\u00e0 kh\u00e1 th\u01b0\u1eddng g\u1eb7p, tuy nhi\u00ean t\u1ef7 l\u1ec7 m\u1eafc c\u00f3 th\u1ec3 kh\u00e1c nhau \u0111\u00e1ng k\u1ec3 gi\u1eefa c\u00e1c b\u1ec7nh l\u00fd, c\u00e1c nh\u00f3m nghi\u00ean c\u1ee9u v\u00e0 ph\u01b0\u01a1ng ph\u00e1p ph\u00e1t hi\u1ec7n.<\/td>\n<\/tr>\n<tr style=\"height: 21px;\">\n<td style=\"width: 50%; height: 21px;\">T\u1ef1 d\u1ecb \u1ee9ng c\u00f3 \u00fd ngh\u0129a l\u00e2m s\u00e0ng kh\u00f4ng?<\/td>\n<td style=\"width: 50%; height: 21px; text-align: justify;\">Trong m\u1ed9t s\u1ed1 b\u1ec7nh nh\u01b0 vi\u00eam da c\u01a1 \u0111\u1ecba (AD) v\u00e0 m\u00e0y \u0111ay m\u1ea1n t\u00ednh t\u1ef1 ph\u00e1t (CSU), s\u1ef1 hi\u1ec7n di\u1ec7n c\u1ee7a t\u1ef1 kh\u00e1ng th\u1ec3 IgE c\u00f3 li\u00ean quan \u0111\u1ebfn m\u1ee9c \u0111\u1ed9 ho\u1ea1t \u0111\u1ed9ng b\u1ec7nh cao h\u01a1n v\u00e0 nhi\u1ec1u b\u1ec7nh \u0111i k\u00e8m h\u01a1n. Tuy nhi\u00ean, c\u00e1c b\u1eb1ng ch\u1ee9ng hi\u1ec7n nay ch\u01b0a ho\u00e0n to\u00e0n nh\u1ea5t qu\u00e1n, v\u00e0 c\u1ea7n th\u00eam nhi\u1ec1u nghi\u00ean c\u1ee9u \u0111\u1ec3 l\u00e0m r\u00f5 v\u1ea5n \u0111\u1ec1 n\u00e0y.<\/td>\n<\/tr>\n<tr style=\"height: 21px;\">\n<td style=\"width: 50%; height: 21px;\">L\u00e0m th\u1ebf n\u00e0o \u0111\u1ec3 ch\u1ea9n \u0111o\u00e1n t\u1ef1 d\u1ecb \u1ee9ng?<\/td>\n<td style=\"width: 50%; height: 21px; text-align: justify;\">T\u1ef1 d\u1ecb \u1ee9ng c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c \u0111\u00e1nh gi\u00e1 b\u1eb1ng nhi\u1ec1u ph\u01b0\u01a1ng ph\u00e1p nh\u1eb1m ph\u00e1t hi\u1ec7n t\u1ef1 kh\u00e1ng th\u1ec3 IgE v\u00e0\/ho\u1eb7c t\u1ef1 kh\u00e1ng nguy\u00ean, v\u00ed d\u1ee5: c\u00e1c x\u00e9t nghi\u1ec7m mi\u1ec5n d\u1ecbch, protein microarrays, x\u00e9t nghi\u1ec7m ch\u1ee9c n\u0103ng (v\u00edd\u1ee5: test ho\u1ea1t h\u00f3a basophil), test da. Tuy nhi\u00ean ch\u01b0a c\u00f3 ph\u01b0\u01a1ng ph\u00e1p n\u00e0o hi\u1ec7n \u0111\u01b0\u1ee3c thi\u1ebft l\u1eadp trong th\u1ef1c h\u00e0nh l\u00e2m s\u00e0ng th\u01b0\u1eddng quy \u0111\u1ec3 ph\u00e1t hi\u1ec7n t\u1ef1 d\u1ecb \u1ee9ng. V\u00ec v\u1eady, vi\u1ec7c ph\u00e1t tri\u1ec3n c\u00e1c c\u00f4ng c\u1ee5 ch\u1ea9n \u0111o\u00e1n ti\u00eau chu\u1ea9n v\u00e0 \u0111\u01b0\u1ee3c x\u00e1c nh\u1eadn l\u00e2m s\u00e0ng v\u1eabn l\u00e0 m\u1ed9t nhu c\u1ea7u c\u1ea5p thi\u1ebft.<\/td>\n<\/tr>\n<tr style=\"height: 21px;\">\n<td style=\"width: 50%; height: 21px;\">T\u1ef1 d\u1ecb \u1ee9ng \u0111\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb nh\u01b0 th\u1ebf n\u00e0o?<\/td>\n<td style=\"width: 50%; height: 21px; text-align: justify;\">Omalizumab, m\u1ed9t kh\u00e1ng th\u1ec3 \u0111\u01a1n d\u00f2ng kh\u00e1ng IgE \u0111\u00e3 \u0111\u01b0\u1ee3c ph\u00ea duy\u1ec7t \u0111\u1ec3 \u0111i\u1ec1u tr\u1ecb hen, m\u00e0y \u0111ay t\u1ef1 ph\u00e1t m\u1ea1n t\u00ednh v\u00e0 d\u1ecb \u1ee9ng th\u1ee9c \u0103n. C\u00e1c l\u1ef1a ch\u1ecdn \u0111i\u1ec1u tr\u1ecb kh\u00e1c t\u1eadp trung v\u00e0o \u1ee9c ch\u1ebf c\u00e1c cytokine quan tr\u1ecdng trong qu\u00e1 tr\u00ecnh s\u1ea3n xu\u1ea5t IgE v\u00e0 ho\u1ea1t h\u00f3a mast cell, bao g\u1ed3m thu\u1ed1c ch\u1eb9n IL-4\/IL-13 (dupilumab), thu\u1ed1c \u1ee9c ch\u1ebf BTK (remibrutinib), kh\u00e1ng th\u1ec3 kh\u00e1ng KIT l\u00e0m gi\u1ea3m s\u1ed1 l\u01b0\u1ee3ng t\u1ebf b\u00e0o mast (barzolvolimab).<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<p style=\"text-align: justify;\">\u0110\u00e1p \u1ee9ng IgE ch\u1ed1ng l\u1ea1i c\u00e1c kh\u00e1ng nguy\u00ean n\u1ed9i sinh c\u00f3 th\u1ec3 ph\u00e1t sinh th\u00f4ng qua nhi\u1ec1u c\u01a1 ch\u1ebf mi\u1ec5n d\u1ecbch kh\u00e1c nhau, ng\u00e0y c\u00e0ng \u0111\u01b0\u1ee3c ghi nh\u1eadn trong c\u00e1c b\u1ec7nh vi\u00eam m\u1ea1n t\u00ednh v\u00e0 b\u1ec7nh t\u1ef1 mi\u1ec5n. M\u1ed9t trong nh\u1eefng c\u01a1 ch\u1ebf n\u00e0y l\u00e0 molecular mimicry, trong \u0111\u00f3 c\u00e1c kh\u00e1ng nguy\u00ean ngo\u1ea1i sinh (nh\u01b0 protein c\u1ee7a vi sinh v\u1eadt ho\u1eb7c k\u00fd sinh tr\u00f9ng) c\u00f3 s\u1ef1 t\u01b0\u01a1ng \u0111\u1ed3ng v\u1ec1 c\u1ea5u tr\u00fac ho\u1eb7c tr\u00ecnh t\u1ef1 v\u1edbi c\u00e1c protein \u0111\u1eb7c hi\u1ec7u c\u1ee7a m\u00f4 ng\u01b0\u1eddi ho\u1eb7c c\u00e1c d\u1ecb nguy\u00ean b\u00ean ngo\u00e0i, t\u1eeb \u0111\u00f3 g\u00e2y \u0111\u00e1p \u1ee9ng IgE ph\u1ea3n \u1ee9ng ch\u00e9o. Sanchez v\u00e0 c\u1ed9ng s\u1ef1 \u0111\u1ec1 xu\u1ea5t r\u1eb1ng thyroid peroxidase (TPO) c\u00f3 th\u1ec3 t\u01b0\u01a1ng \u0111\u1ed3ng v\u1edbi c\u00e1c protein n\u1ed9i sinh c\u1ee7a b\u1ea1ch c\u1ea7u \u00e1i toan, nh\u01b0 eosinophil peroxidase, t\u1eeb \u0111\u00f3 c\u00f3 kh\u1ea3 n\u0103ng k\u00edch ho\u1ea1t \u0111\u00e1p \u1ee9ng IgE t\u1ef1 ph\u1ea3n \u1ee9ng. Ngo\u00e0i ra, ph\u1ea3n \u1ee9ng IgE v\u1edbi profilin c\u1ee7a ng\u01b0\u1eddi, v\u1ed1n l\u00e0 t\u1ef1 kh\u00e1ng nguy\u00ean IgE \u0111\u1ea7u ti\u00ean \u0111\u01b0\u1ee3c x\u00e1c \u0111\u1ecbnh, \u0111\u00e3 \u0111\u01b0\u1ee3c ph\u00e1t hi\u1ec7n \u1edf nh\u1eefng ng\u01b0\u1eddi d\u1ecb \u1ee9ng ph\u1ea5n hoa, g\u1ee3i \u00fd v\u1ec1 hi\u1ec7n t\u01b0\u1ee3ng molecular mimicry.<\/p>\n<p style=\"text-align: justify;\">M\u1ed9t c\u01a1 ch\u1ebf g\u00f3p ph\u1ea7n kh\u00e1c l\u00e0 s\u1ef1 lan r\u1ed9ng epitope, trong \u0111\u00f3 ph\u1ea3n \u1ee9ng mi\u1ec5n d\u1ecbch ban \u0111\u1ea7u ch\u1ed1ng l\u1ea1i m\u1ed9t epitope d\u1ea7n d\u1ea7n m\u1edf r\u1ed9ng sang c\u00e1c epitope kh\u00e1c tr\u00ean c\u00f9ng m\u1ed9t ho\u1eb7c c\u00e1c t\u1ef1 kh\u00e1ng nguy\u00ean li\u00ean quan, t\u1eeb \u0111\u00f3 l\u00e0m t\u0103ng c\u01b0\u1eddng qu\u00e1 tr\u00ecnh t\u1ef1 mi\u1ec5n v\u00e0 t\u1ef1 d\u1ecb \u1ee9ng. Ngo\u00e0i ra, t\u00e1i t\u1ed5 h\u1ee3p chuy\u1ec3n l\u1edbp kh\u00e1ng th\u1ec3 sang IgE t\u1ea1i ch\u1ed7 c\u00f3 th\u1ec3 x\u1ea3y ra trong c\u00e1c c\u1ea5u tr\u00fac lympho b\u1eadc ba h\u00ecnh th\u00e0nh trong c\u00e1c m\u00f4 b\u1ecb vi\u00eam m\u1ea1n t\u00ednh nh\u01b0 da. Nh\u1eefng c\u1ea5u tr\u00fac lympho n\u00e0y t\u1ea1o ra vi m\u00f4i tr\u01b0\u1eddng chuy\u00ean bi\u1ec7t h\u1ed7 tr\u1ee3 s\u1ef1 ho\u1ea1t h\u00f3a li\u00ean t\u1ee5c c\u1ee7a t\u1ebf b\u00e0o B v\u00e0 qu\u00e1 tr\u00ecnh chuy\u1ec3n l\u1edbp kh\u00e1ng th\u1ec3 ngay t\u1ea1i m\u00f4, cho ph\u00e9p s\u1ea3n xu\u1ea5t IgE ch\u1ed1ng l\u1ea1i c\u00e1c kh\u00e1ng nguy\u00ean c\u1ee7a m\u00f4 t\u1ea1i ch\u1ed7 m\u00e0 kh\u00f4ng ph\u1ee5 thu\u1ed9c v\u00e0o c\u01a1 quan mi\u1ec5n d\u1ecbch trung \u01b0\u01a1ng. S\u1ef1 s\u1ea3n xu\u1ea5t IgE t\u1ea1i ch\u1ed7 nh\u01b0 v\u1eady c\u0169ng \u0111\u00e3 \u0111\u01b0\u1ee3c \u0111\u1ec1 xu\u1ea5t x\u1ea3y ra \u1edf c\u00e1c c\u01a1 quan h\u00e0ng r\u00e0o nh\u01b0 bi\u1ec3u m\u00f4 \u0111\u01b0\u1eddng h\u00f4 h\u1ea5p v\u00e0 ni\u00eam m\u1ea1c m\u0169i, \u0111\u1eb7c bi\u1ec7t trong b\u1ec7nh hen v\u00e0 vi\u00eam m\u0169i d\u1ecb \u1ee9ng. M\u1ed9t m\u00f4 h\u00ecnh \u0111\u01b0\u1ee3c \u0111\u1ec1 xu\u1ea5t c\u1ee7a t\u1ef1 d\u1ecb \u1ee9ng (H\u00ecnh 1) ph\u1ea3n \u00e1nh chu\u1ed7i ph\u1ea3n \u1ee9ng qu\u00e1 m\u1eabn typ 1 c\u1ed5 \u0111i\u1ec3n, g\u1ed3m giai \u0111o\u1ea1n m\u1eabn c\u1ea3m ti\u1ebfp theo l\u00e0 giai \u0111o\u1ea1n hi\u1ec7u \u1ee9ng, nh\u01b0ng c\u00f3 nh\u1eefng kh\u00e1c bi\u1ec7t quan tr\u1ecdng v\u1ec1 ngu\u1ed3n g\u1ed1c c\u1ee7a kh\u00e1ng nguy\u00ean.<\/p>\n<p style=\"text-align: justify;\">C\u00e1c x\u00e9t nghi\u1ec7m ch\u1ee9c n\u0103ng nh\u01b0 test ho\u1ea1t h\u00f3a basophil (BAT &#8211; Basophil activation test), c\u00f9ng v\u1edbi c\u00e1c th\u1eed nghi\u1ec7m nh\u01b0 test l\u1ea5y da (skin prick test) v\u00e0 passive transfer \u0111\u00e3 l\u00e0m n\u1ed5i b\u1eadt vai tr\u00f2 c\u1ee7a IgE t\u1ef1 ph\u1ea3n \u1ee9ng trong c\u01a1 ch\u1ebf b\u1ec7nh sinh c\u1ee7a hen suy\u1ec5n, vi\u00eam da c\u01a1 \u0111\u1ecba, m\u00e0y \u0111ay t\u1ef1 ph\u00e1t m\u1ea1n t\u00ednh v\u00e0 d\u1ecb \u1ee9ng th\u1ee9c \u0103n. \u0110\u00e1ng ch\u00fa \u00fd, th\u00ed nghi\u1ec7m chuy\u1ec3n th\u1ee5 \u0111\u1ed9ng IgE kh\u00e1ng TPO t\u1eeb b\u1ec7nh nh\u00e2n CSU \u0111\u00e3 \u0111\u01b0\u1ee3c ch\u1ee9ng minh c\u00f3 th\u1ec3 g\u00e2y ph\u1ea3n \u1ee9ng s\u00e2n ph\u1ee7 ban \u0111\u1ecf tr\u00ean da ng\u01b0\u1eddi kh\u1ecfe m\u1ea1nh. K\u1ebft qu\u1ea3 n\u00e0y \u0111\u01b0\u1ee3c minh h\u1ecda trong nghi\u00ean c\u1ee9u c\u1ee7a Sanchez v\u00e0 c\u1ed9ng s\u1ef1, qua \u0111\u00f3 c\u00e0ng c\u00f9ng c\u1ed1 vai tr\u00f2 g\u00e2y b\u1ec7nh c\u1ee7a IgE t\u1ef1 ph\u1ea3n \u1ee9ng trong CSU. V\u00ed d\u1ee5, basophil t\u1eeb c\u00e1c b\u1ec7nh nh\u00e2n hen d\u01b0\u01a1ng t\u00ednh v\u1edbi IgE kh\u00e1ng eosinophil cationic protein (ECP) v\u00e0 IgE kh\u00e1ng eosinophil peroxidase (EXP) cho th\u1ea5y m\u1ee9c \u0111\u1ed9 ho\u1ea1t h\u00f3a ph\u1ee5 thu\u1ed9c li\u1ec1u l\u01b0\u1ee3ng khi \u0111\u01b0\u1ee3c k\u00edch th\u00edch b\u1eb1ng t\u1ef1 kh\u00e1ng nguy\u00ean t\u01b0\u01a1ng \u1ee9ng. T\u01b0\u01a1ng t\u1ef1, c\u00e1c x\u00e9t nghi\u1ec7m s\u1eed d\u1ee5ng t\u1ebf b\u00e0o leukemia b\u1ea1ch c\u1ea7u \u00e1i ki\u1ec1m c\u1ee7a chu\u1ed9t cho th\u1ea5y a-lactalbumin c\u1ee7a ng\u01b0\u1eddi c\u00f3 th\u1ec3 k\u00edch th\u00edch gi\u1ea3i ph\u00f3ng c\u00e1c ch\u1ea5t trung gian g\u00e2y d\u1ecb \u1ee9ng \u1edf ng\u01b0\u1eddi b\u1ecb d\u1ecb \u1ee9ng s\u1eefa \u0111\u00e3 \u0111\u01b0\u1ee3c m\u1eabn c\u1ea3m tr\u01b0\u1edbc \u0111\u00f3.<\/p>\n<h2 style=\"text-align: justify;\">T\u1ef0 D\u1eca \u1ee8NG PH\u1ed4 BI\u1ebeN \u0110\u1ebeN M\u1ee8C N\u00c0O?<\/h2>\n<p style=\"text-align: justify;\">Hi\u1ec7n t\u01b0\u1ee3ng t\u1ef1 d\u1ecb \u1ee9ng \u0111\u00e3 \u0111\u01b0\u1ee3c ph\u00e1t hi\u1ec7n trong nhi\u1ec1u r\u1ed1i lo\u1ea1n qua trung gian mi\u1ec5n d\u1ecbch kh\u00e1c nhau. Tuy nhi\u00ean, t\u1ef7 l\u1ec7 hi\u1ec7n di\u1ec7n c\u1ee7a IgE t\u1ef1 ph\u1ea3n \u1ee9ng thay \u0111\u1ed5i \u0111\u00e1ng k\u1ec3 t\u00f9y thu\u1ed9c v\u00e0o b\u1ec7nh l\u00fd n\u1ec1n, t\u1ef1 d\u1ecb nguy\u00ean c\u1ee5 th\u1ec3, \u0111\u1eb7c \u0111i\u1ec3m c\u1ee7a qu\u1ea7n th\u1ec3 nghi\u00ean c\u1ee9u, c\u0169ng nh\u01b0 c\u00e1c ph\u01b0\u01a1ng ph\u00e1p ph\u00e1t hi\u1ec7n \u0111\u01b0\u1ee3c s\u1eedd\u1ee5ng. B\u1ea3ng 2 cung c\u1ea5p t\u1ed5ng quan v\u1ec1 t\u00ednh t\u1ef1 ph\u1ea3n \u1ee9ng c\u1ee7a IgE trong c\u00e1c b\u1ec7nh \u0111\u00e3 \u0111\u01b0\u1ee3c b\u00e1o c\u00e1o, bao g\u1ed3m th\u00f4ng tin v\u1ec1 c\u00e1c t\u1ef1 kh\u00e1ng nguy\u00ean \u0111\u00e3 \u0111\u01b0\u1ee3c x\u00e1c \u0111\u1ecbnh, t\u1ef7 l\u1ec7 hi\u1ec7n m\u1eafc v\u00e0 c\u00e1c k\u1ef9 thu\u1eadt ph\u00e1t hi\u1ec7n.<\/p>\n<p style=\"text-align: justify;\">C\u00e1c nghi\u00ean c\u1ee9u v\u1ec1 hen suy\u1ec5n \u0111\u00e3 x\u00e1c \u0111\u1ecbnh s\u1ef1 hi\u1ec7n di\u1ec7n c\u1ee7a t\u1ef1 kh\u00e1ng th\u1ec3 IgE nh\u1eafm v\u00e0o nhi\u1ec1u t\u1ef1 kh\u00e1ng nguy\u00ean kh\u00e1c nhau, bao g\u1ed3m DFS70, periplakin, y\u1ebfu t\u1ed1 th\u1ea5p, kh\u00e1ng nguy\u00ean ti\u1ec3u c\u1ea7u, EXP v\u00e0 ECP, v\u1edbi t\u1ef7 l\u1ec7 m\u1eafc \u0111\u01b0\u1ee3c b\u00e1o c\u00e1o dao \u0111\u1ed9ng t\u1eeb 8.7% \u0111\u1ebfn 70%. Trong b\u1ed1i c\u1ea3nh d\u1ecb \u1ee9ng th\u1ee9c \u0103n, c\u00e1c b\u00e1o c\u00e1o hi\u1ec7n c\u00f3 v\u1ec1 t\u1ef1 kh\u00e1ng th\u1ec3 IgE c\u00f2n kh\u00e1 h\u1ea1n ch\u1ebf v\u00e0 ch\u1ee7 y\u1ebfu t\u1eadp trung v\u00e0o d\u1ecb \u1ee9ng s\u1eefa b\u00f2, trong \u0111\u00f3 IgE t\u1ef1 ph\u1ea3n \u1ee9ng \u0111\u00e3 \u0111\u01b0\u1ee3c ph\u00e1t hi\u1ec7n ch\u1ed1ng l\u1ea1i c\u00e1c protein t\u01b0\u01a1ng \u0111\u1ed3ng \u1edf ng\u01b0\u1eddi c\u1ee7a a-lactalbumin, \u1e9e-casein v\u00e0 x-casein (xem B\u1ea3ng 2). \u0110\u00e1ng ch\u00fa \u00fd, t\u1ef7 l\u1ec7 IgE t\u1ef1 ph\u1ea3n \u1ee9ng trong d\u1ecb \u1ee9ng s\u1eefa d\u01b0\u1eddng nh\u01b0 kh\u00e1 cao, dao \u0111\u1ed9ng t\u1eeb 35% \u0111\u1ebfn 100%.<\/p>\n<p style=\"text-align: justify;\">Trong m\u00e0y \u0111ay t\u1ef1 ph\u00e1t m\u1ea1n t\u00ednh (CSU), nhi\u1ec1u \u0111\u00edch c\u1ee7a t\u1ef1 kh\u00e1ng th\u1ec3 IgE \u0111\u00e3 \u0111\u01b0\u1ee3c x\u00e1c \u0111\u1ecbnh, bao g\u1ed3m IL-24, TPO, TG, DNA s\u1ee3i k\u00e9p, ECP, EXP, th\u1ee5 th\u1ec3 FcERI, tissue factor v\u00e0 tissue-transglutaminase 2. T\u1ef7 l\u1ec7 IgE t\u1ef1 ph\u1ea3n \u1ee9ng \u0111\u01b0\u1ee3c b\u00e1o c\u00e1o trong CSU dao \u0111\u1ed9ng r\u1ea5t l\u1edbn, t\u1eeb 0-100%. Tuy nhi\u00ean, ph\u1ea7n l\u1edbn c\u00e1c nghi\u00ean c\u1ee9u ghi nh\u1eadn t\u1ef7 l\u1ec7 kho\u1ea3ng 30-60%. M\u1ed9t nghi\u00ean c\u1ee9u g\u1ea7n \u0111\u00e2y tr\u00ean 111 b\u1ec7nh nh\u00e2n CSU cho th\u1ea5y h\u01a1n m\u1ed9t n\u1eeda s\u1ed1 b\u1ec7nh nh\u00e2n (58%) bi\u1ec3u hi\u1ec7n ki\u1ec3u h\u00ecnh t\u1ef1 d\u1ecb \u1ee9ng, cho th\u1ea5y t\u1ef1 d\u1ecb \u1ee9ng l\u00e0 m\u1ed9t \u0111\u1eb7c \u0111i\u1ec3m kh\u00e1 ph\u1ed5 bi\u1ebfn c\u1ee7a CSU.<\/p>\n<p style=\"text-align: justify;\">IgE t\u1ef1 ph\u1ea3n \u1ee9ng c\u0169ng c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c ph\u00e1t hi\u1ec7n \u1edf m\u1ed9t s\u1ed1 ng\u01b0\u1eddi kh\u1ecfe m\u1ea1nh, v\u1edbi t\u1ef7 l\u1ec7 \u0111\u01b0\u1ee3c b\u00e1o c\u00e1o dao \u0111\u1ed9ng t\u1eeb 0 \u0111\u1ebfn kho\u1ea3ng 30%. Tuy nhi\u00ean, trong nh\u1eefng tr\u01b0\u1eddng h\u1ee3p n\u00e0y, c\u00e1c kh\u00e1ng th\u1ec3 nh\u01b0 v\u1eady th\u01b0\u1eddng \u0111\u01b0\u1ee3c xem l\u00e0 kh\u00f4ng c\u00f3 t\u00ednh g\u00e2y b\u1ec7nh. Sanchez v\u00e0 c\u1ed9ng s\u1ef1 \u0111\u00e3 ch\u1ee9ng minh r\u1eb1ng nh\u1eefng ng\u01b0\u1eddi kh\u1ecfe m\u1ea1nh c\u00f3 IgE ch\u1ed1ng l\u1ea1i ECP v\u00e0 EXP v\u1eabn cho th\u1ea5y r\u1ea5t \u00edt ho\u1eb7c h\u1ea7u nh\u01b0 kh\u00f4ng c\u00f3 s\u1ef1 ho\u1ea1t h\u00f3a b\u1ea1ch c\u1ea7u \u00e1i ki\u1ec3m khi \u0111\u01b0\u1ee3c k\u00edch th\u00edch b\u1eb1ng c\u00e1c t\u1ef1 kh\u00e1ng nguy\u00ean n\u00e0y.<\/p>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"aligncenter size-full wp-image-155587\" src=\"https:\/\/vnras.com\/drug\/wp-content\/uploads\/2026\/03\/tu-di-ung-autoallergy-va-nhung-dieu-bac-si-di-ung-can-biet.jpg\" alt=\"T\u1ef0 D\u1eca \u1ee8NG (AUTOALLERGY) V\u00c0 NH\u1eeeNG \u0110I\u1ec0U B\u00c1C S\u0128 D\u1eca \u1ee8NG C\u1ea6N BI\u1ebeT\" width=\"1200\" height=\"900\" title=\"\" srcset=\"https:\/\/vnras.com\/drug\/wp-content\/uploads\/2026\/03\/tu-di-ung-autoallergy-va-nhung-dieu-bac-si-di-ung-can-biet.jpg 1200w, https:\/\/vnras.com\/drug\/wp-content\/uploads\/2026\/03\/tu-di-ung-autoallergy-va-nhung-dieu-bac-si-di-ung-can-biet-533x400.jpg 533w, https:\/\/vnras.com\/drug\/wp-content\/uploads\/2026\/03\/tu-di-ung-autoallergy-va-nhung-dieu-bac-si-di-ung-can-biet-1067x800.jpg 1067w, https:\/\/vnras.com\/drug\/wp-content\/uploads\/2026\/03\/tu-di-ung-autoallergy-va-nhung-dieu-bac-si-di-ung-can-biet-768x576.jpg 768w, https:\/\/vnras.com\/drug\/wp-content\/uploads\/2026\/03\/tu-di-ung-autoallergy-va-nhung-dieu-bac-si-di-ung-can-biet-350x263.jpg 350w\" sizes=\"auto, (max-width: 1200px) 100vw, 1200px\" \/><\/p>\n<p style=\"text-align: justify;\">H\u00ecnh 1. C\u01a1 ch\u1ebf b\u1ec7nh sinh c\u1ee7a t\u1ef1 d\u1ecb \u1ee9ng trong hen, m\u00e0y \u0111ay m\u1ea1n t\u00ednh t\u1ef1 ph\u00e1t, vi\u00eam da c\u01a1 \u0111\u1ecba v\u00e0 d\u1ecb \u1ee9ng th\u1ee9c \u0103n. T\u01b0\u01a1ng t\u1ef1 nh\u01b0 ph\u1ea3n \u1ee9ng qu\u00e1 m\u1eabn type 1, t\u1ef1 d\u1ecb \u1ee9ng c\u0169ng \u0111\u1eb7c tr\u01b0ng b\u1edfi hai giai \u0111o\u1ea1n, g\u1ed3m giai \u0111o\u1ea1n m\u1eabn c\u1ea3m v\u00e0 giai \u0111o\u1ea1n hi\u1ec7u \u1ee9ng. Tuy nhi\u00ean, c\u00e1c c\u01a1 ch\u1ebf ch\u00ednh x\u00e1c d\u1eabn \u0111\u1ebfn qu\u00e1 tr\u00ecnh m\u1eabn c\u1ea3m trong t\u1ef1 d\u1ecb \u1ee9ng v\u1eabn ch\u01b0a \u0111\u01b0\u1ee3c hi\u1ec3u r\u00f5. M\u1ed9t s\u1ed1 gi\u1ea3 thuy\u1ebft \u0111\u00e3 \u0111\u01b0\u1ee3c \u0111\u1ec1 xu\u1ea5t \u0111\u1ec3 gi\u1ea3i th\u00edch s\u1ef1 h\u00ecnh th\u00e0nh IgE t\u1ef1 ph\u1ea3n \u1ee9ng. M\u1ed9t gi\u1ea3 thuy\u1ebft cho r\u1eb1ng khi c\u00f3 s\u1ef1 hi\u1ec7n di\u1ec7n c\u1ee7a c\u00e1c t\u00edn hi\u1ec7u c\u1ea3nh b\u00e1o t\u1eeb m\u00f4 t\u1ed5n th\u01b0\u01a1ng, t\u1ef1 kh\u00e1ng nguy\u00ean c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c t\u1ebf b\u00e0o tr\u00ecnh di\u1ec7n kh\u00e1ng nguy\u00ean thu nh\u1eadn, t\u1eeb \u0111\u00f3 g\u00e2y ho\u1ea1t h\u00f3a t\u1ebf b\u00e0o Th2. C\u00e1c t\u1ebf b\u00e0o Th2 n\u00e0y sau \u0111\u00f3 th\u00fac \u0111\u1ea9y t\u1ebf b\u00e0o plasma s\u1ea3n xu\u1ea5t kh\u00e1ng th\u1ec3 IgE t\u1ef1 ph\u1ea3n \u1ee9ng. M\u1ed9t c\u01a1 ch\u1ebf kh\u00e1c \u0111\u01b0\u1ee3c \u0111\u1ec1 xu\u1ea5t l\u00e0 molecular mimicry, trong \u0111\u00f3 s\u1ef1 t\u01b0\u01a1ng \u0111\u1ed3ng c\u1ea5u tr\u00fac gi\u1eefa c\u00e1c kh\u00e1ng nguy\u00ean m\u00f4i tr\u01b0\u1eddng ho\u1eb7c vi sinh v\u1eadt v\u1edbi protein c\u1ee7a c\u01a1 th\u1ec3 d\u1eabn \u0111\u1ebfn s\u1ef1 h\u00ecnh th\u00e0nh c\u00e1c t\u1ef1 kh\u00e1ng th\u1ec3 IgE. C\u00e1c t\u1ef1 kh\u00e1ng th\u1ec3 IgE c\u00f3 th\u1ec3 g\u1eafn l\u00ean c\u00e1c t\u1ebf b\u00e0o mast c\u01b0 tr\u00fa trong m\u00f4, nh\u01b0 \u1edf ph\u1ed5i trong hen, \u1edf da trong vi\u00eam da c\u01a1 \u0111\u1ecba, \u1edf ph\u1ed1i, ru\u1ed9t v\u00e0 da trong d\u1ecb \u1ee9ng th\u1ee9c \u0103n. S\u1ef1 ho\u1ea1t h\u00f3a t\u1ebf b\u00e0o mast v\u00e0 qu\u00e1 tr\u00ecnh ph\u00f3ng h\u1ea1t sau \u0111\u00f3 c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c k\u00edch ho\u1ea1t b\u1edfi t\u1ef1 d\u1ecb nguy\u00ean c\u00f3 ph\u1ea3n \u1ee9ng ch\u00e9o v\u1edbi d\u1ecb nguy\u00ean ngo\u1ea1i sinh (v\u00ed d\u1ee5: MnSOD), s\u1ef1 t\u00e1i ti\u1ebfp x\u00fac v\u1edbi t\u1ef1 d\u1ecb nguy\u00ean \u0111\u01b0\u1ee3c t\u1ea1o ra t\u1ea1i ch\u1ed7 (v\u00ed d\u1ee5: IL-24), ho\u1eb7c d\u1ecb nguy\u00ean t\u1ea1i ch\u1ed7 c\u00f3 ph\u1ea3n \u1ee9ng ch\u00e9o v\u1edbi c\u00e1c protein kh\u00e1c c\u1ee7a ng\u01b0\u1eddi (v\u00edd\u1ee5: TPO v\u00e0 EXP).<\/p>\n<h2 style=\"text-align: justify;\">T\u1ef0 D\u1eca \u1ee8NG C\u00d3 \u00dd NGH\u0128A L\u00c2M S\u00c0NG HAY KH\u00d4NG?<\/h2>\n<p style=\"text-align: justify;\">\u00dd ngh\u0129a l\u00e2m s\u00e0ng c\u1ee7a t\u1ef1 d\u1ecb \u1ee9ng d\u1ef1a tr\u00ean c\u00e1c b\u1eb1ng ch\u1ee9ng cho th\u1ea5y IgE t\u1ef1 ph\u1ea3n \u1ee9ng c\u00f3 li\u00ean quan \u0111\u1ebfn m\u1ee9c \u0111\u1ed9 n\u1eb7ng c\u1ee7a b\u1ec7nh v\u00e0 c\u00e1c \u0111\u1eb7c \u0111i\u1ec3m l\u00e2m s\u00e0ng kh\u00e1c. Trong vi\u00eam da c\u01a1 \u0111\u1ecba, t\u1ef1 kh\u00e1ng th\u1ec3 IgE c\u0169ng li\u00ean quan v\u1edbi da kh\u00f4, ch\u00e0m t\u1ed5 \u0111\u1ecba, nhi\u1ec5m tr\u00f9ng v\u00e0 ng\u1ee9a. Trong hen, nh\u1eefng b\u1ec7nh nh\u00e2n c\u00f3 IgE kh\u00e1ng periplakin c\u00f3 t\u1ea7n su\u1ea5t xu\u1ea5t hi\u1ec7n polyp m\u0169i cao h\u01a1n so v\u1edbi c\u00e1c b\u1ec7nh nh\u00e2n kh\u00f4ng c\u00f3 t\u1ef1 kh\u00e1ng th\u1ec3 n\u00e0y. Trong m\u00e0y \u0111ay m\u1ea1n t\u00ednh t\u1ef1 ph\u00e1t, IgE kh\u00e1ng TPO c\u00f3 li\u00ean quan \u0111\u1ebfn t\u1ea7n su\u1ea5t cao h\u01a1n c\u1ee7a c\u01a1 \u0111\u1ecba d\u1ecb \u1ee9ng v\u00e0 hen suy\u1ec5n. Ngo\u00e0i ra, n\u1ed3ng \u0111\u1ed9 IgE kh\u00e1ng TPO c\u00f2n t\u01b0\u01a1ng quan v\u1edbi n\u1ed3ng \u0111\u1ed9 IgG kh\u00e1ng TPO, c\u00f9ng c\u1ed1 gi\u1ea3 thuy\u1ebft r\u1eb1ng b\u1ec7nh nh\u00e2n CSU c\u00f3 nguy c\u01a1 m\u1eafc c\u00e1c b\u1ec7nh l\u00fd tuy\u1ebfn gi\u00e1p t\u1ef1 mi\u1ec5n v\u00e0 r\u1ed1i lo\u1ea1n ch\u1ee9c n\u0103ng tuy\u1ebfn gi\u00e1p. Ph\u1ea3n \u1ee9ng ch\u00e9o gi\u1eefa protein c\u1ee7a b\u00f2 v\u00e0 c\u1ee7a ng\u01b0\u1eddi \u0111\u1eb7c bi\u1ec7t c\u00f3 \u00fd ngh\u0129a l\u00e2m s\u00e0ng trong tr\u01b0\u1eddng h\u1ee3p tr\u1ebb s\u01a1 sinh b\u1ecb d\u1ecb \u1ee9ng s\u1eefa b\u00f2 v\u1eabn c\u00f2n tri\u1ec7u ch\u1ee9ng, m\u1eb7c d\u00f9 ng\u01b0\u1eddi m\u1eb9 \u0111\u00e3 tr\u00e1nh ho\u00e0n to\u00e0n c\u00e1c s\u1ea3n ph\u1ea9m t\u1eeb s\u1eefa.<\/p>\n<p style=\"text-align: justify;\">Trong m\u00e0y \u0111ay m\u1ea1n t\u00ednh t\u1ef1 ph\u00e1t, m\u1ee9c \u0111\u1ed9 t\u1ef1 kh\u00e1ng th\u1ec3 IgE \u0111\u01b0\u1ee3c ghi nh\u1eadn c\u00f3 li\u00ean quan \u0111\u1ebfn m\u1ee9c \u0111\u1ed9 ho\u1ea1t \u0111\u1ed9ng c\u1ee7a b\u1ec7nh trong m\u1ed9t s\u1ed1 nghi\u00ean c\u1ee9u, nh\u01b0ng kh\u00f4ng \u0111\u01b0\u1ee3c ghi nh\u1eadn trong c\u00e1c nghi\u00ean c\u1ee9u kh\u00e1c. V\u00ed d\u1ee5, n\u1ed3ng \u0111\u1ed9 IgE kh\u00e1ng IL-24 c\u00f3 t\u01b0\u01a1ng quan v\u1edbi \u0111i\u1ec3m ho\u1ea1t \u0111\u1ed9ng m\u00e0y \u0111ay trong 7 ng\u00e0y (UAS7). Ngo\u00e0i ra, c\u0169ng \u0111\u00e3 \u0111\u01b0\u1ee3c ch\u1ee9ng minh r\u1eb1ng m\u1ee9c \u0111\u1ed9 t\u1ef1 kh\u00e1ng th\u1ec3 t\u0103ng l\u00ean trong c\u00e1c giai \u0111o\u1ea1n b\u00f9ng ph\u00e1t c\u1ee7a b\u1ec7nh. T\u01b0\u01a1ng t\u1ef1, trong vi\u00eam da c\u01a1 \u0111\u1ecba, IgE t\u1ef1 ph\u1ea3n \u1ee9ng c\u0169ng c\u00f3 t\u01b0\u01a1ng quan v\u1edbi m\u1ee9c \u0111\u1ed9 n\u1eb7ng c\u1ee7a b\u1ec7nh trong m\u1ed9t s\u1ed1 nghi\u00ean c\u1ee9u, m\u1eb7c d\u00f9 m\u1ed9t s\u1ed1 nghi\u00ean c\u1ee9u kh\u00e1c kh\u00f4ng t\u00ecm th\u1ea5y m\u1ed1i li\u00ean h\u1ec7 n\u00e0y. V\u00ed d\u1ee5, b\u1ec7nh nh\u00e2n AD c\u00f3 IgE t\u1ef1 ph\u1ea3n \u1ee9ng ch\u1ed1ng l\u1ea1i c\u00e1c protein c\u1ee7a bi\u1ec3u b\u00ec c\u00f3 \u0111i\u1ec3m IGA v\u00e0 EASI cao h\u01a1n so v\u1edbi nh\u1eefng b\u1ec7nh nh\u00e2n AD kh\u00f4ng c\u00f3 t\u1ef1 ph\u1ea3n \u1ee9ng. Ngo\u00e0i ra, \u0111a s\u1ed1 b\u1ec7nh nh\u00e2n hen suy\u1ec5n c\u00f3 t\u1ef1 kh\u00e1ng th\u1ec3 ch\u1ed1ng EXP v\u00e0\/ho\u1eb7c ECP \u0111\u1ec1u m\u1eafc hen suy\u1ec5n n\u1eb7ng.<\/p>\n<h2 style=\"text-align: justify;\">L\u00c0M SAO \u0110\u1ec2 CH\u1ea8N \u0110O\u00c1N T\u1ef0 D\u1eca \u1ee8NG?<\/h2>\n<p style=\"text-align: justify;\">Trong d\u1ecb \u1ee9ng c\u1ed5 \u0111i\u1ec3n, c\u00f3 nhi\u1ec1u x\u00e9t nghi\u1ec7m \u0111\u00e3 \u0111\u01b0\u1ee3c ch\u1ee9ng nh\u1eadn v\u00e0 ph\u00ea duy\u1ec7t \u0111\u1ec3 ph\u00e1t hi\u1ec7n IgE \u0111\u1eb7c hi\u1ec7u v\u1edbi d\u1ecb nguy\u00ean. Ng\u01b0\u1ee3c l\u1ea1i, hi\u1ec7n nay ch\u01b0a c\u00f3 x\u00e9t nghi\u1ec7m n\u00e0o \u0111\u01b0\u1ee3c ph\u00ea duy\u1ec7t \u0111\u1ec3 x\u00e1c \u0111\u1ecbnh t\u1ef1 kh\u00e1ng th\u1ec3 IgE trong th\u1ef1c h\u00e0nh l\u00e2m s\u00e0ng th\u01b0\u1eddng quy. Cho \u0111\u1ebfn nay, t\u1ea5t c\u1ea3 x\u00e9t nghi\u1ec7m d\u00f9ng \u0111\u1ec3 \u0111\u00e1nh gi\u00e1 n\u1ed3ng \u0111\u1ed9 t\u1ef1 kh\u00e1ng th\u1ec3 IgE trong huy\u1ebft thanh, nh\u01b0 ELISA ho\u1eb7c Western Blot ch\u1ec9 \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng cho m\u1ee5c \u0111\u00edch nghi\u00ean c\u1ee9u. T\u1ef7 l\u1ec7 m\u1eafc \u0111\u01b0\u1ee3c b\u00e1o c\u00e1o dao \u0111\u1ed9ng r\u1ea5t l\u1edbn, v\u00ed d\u1ee5 0-100% \u0111\u1ed1i v\u1edbi IgE kh\u00e1ng TPO trong CSU, do thi\u1ebfu s\u1ef1 chu\u1ea9n h\u00f3a, sai l\u1ec7ch trong l\u1ef1a ch\u1ecdn m\u1eabu, c\u1ee1 m\u1eabu nh\u1ecf, v\u00e0 nh\u1eefng h\u1ea1n ch\u1ebf v\u1ec1 ph\u01b0\u01a1ng ph\u00e1p nghi\u00ean c\u1ee9u. Trong m\u1ed9t s\u1ed1 tr\u01b0\u1eddng h\u1ee3p hi\u1ebfm, test l\u1ea5y da c\u0169ng \u0111\u00e3 \u0111\u01b0\u1ee3c s\u1eedd\u1ee5ng \u0111\u1ec3 ph\u00e1t hi\u1ec7n s\u1ef1 hi\u1ec7n di\u1ec7n c\u1ee7a IgE t\u1ef1 ph\u1ea3n \u1ee9ng. \u0110\u00e1ng ch\u00fa \u00fd, g\u1ea7n \u0111\u00e2y vi\u1ec7c s\u1eed d\u1ee5ng microarray IgE \u0111\u1eb7c hi\u1ec7u d\u1ecb nguy\u00ean \u0111\u00e3 \u0111\u01b0\u1ee3c \u0111\u1ec1 xu\u1ea5t cho vi\u00eam da c\u01a1 \u0111\u1ecba v\u00e0 c\u00e1c b\u1ec7nh t\u1ef1 d\u1ecb \u1ee9ng kh\u00e1c. \u0110\u1eb7c bi\u1ec7t, vi\u1ec7c \u0111o IgE ch\u1ed1ng l\u1ea1i c\u00e1c d\u1ecb nguy\u00ean ph\u00e2n t\u1eed ngo\u1ea1i sinh c\u00f3 t\u01b0\u01a1ng \u0111\u1ed3ng v\u1edbi protein c\u1ee7a ng\u01b0\u1eddi c\u00f3 th\u1ec3 tr\u1edf th\u00e0nh m\u1ed9t d\u1ea5u \u1ea5n sinh h\u1ecdc ti\u1ec1m n\u0103ng cho t\u1ef1 d\u1ecb \u1ee9ng.<\/p>\n<p style=\"text-align: justify;\">Test ho\u1ea1t h\u00f3a b\u1ea1ch c\u1ea7u \u00e1i ki\u1ec1m (BAT) v\u00e0 x\u00e9t nghi\u1ec7m gi\u1ea3i ph\u00f3ng histamine t\u1eeb b\u1ea1ch c\u1ea7u \u00e1i ki\u1ec1m (BHRA) \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng \u0111\u1ec3 ch\u1ee9ng minh \u00fd ngh\u0129a ch\u1ee9ng minh c\u1ee7a c\u00e1c t\u1ef1 kh\u00e1ng nguy\u00ean v\u00e0\/ho\u1eb7c l\u00e0m c\u00f4ng c\u1ee5 ch\u1ea9n \u0111o\u00e1n, v\u00ed d\u1ee5 trong d\u1ecb \u1ee9ng th\u1ee9c \u0103n. C\u00f3 nhi\u1ec1u quy tr\u00ecnh BAT kh\u00e1c nhau, nh\u01b0ng nh\u00ecn chung \u0111\u01b0\u1ee3c chia th\u00e0nh hai ph\u01b0\u01a1ng ph\u00e1p ch\u00ednh: tr\u1ef1c ti\u1ebfp v\u00e0 gi\u00e1n ti\u1ebfp. Ph\u01b0\u01a1ng ph\u00e1p tr\u1ef1c ti\u1ebfp s\u1eedd\u1ee5ng m\u00e1u to\u00e0n ph\u1ea7n c\u1ee7a b\u1ec7nh nh\u00e2n. Ph\u01b0\u01a1ng ph\u00e1p gi\u00e1n ti\u1ebfp: b\u1ea1ch c\u1ea7u \u00e1i ki\u1ec1m c\u1ee7a ng\u01b0\u1eddi cho \u0111\u01b0\u1ee3c m\u1eabn c\u1ea3m v\u1edbi huy\u1ebft thah c\u1ee7a b\u1ec7nh nh\u00e2n, t\u1eeb \u0111\u00f3 chuy\u1ec3n c\u00e1c kh\u00e1ng th\u1ec3 IgE li\u00ean quan sang c\u00e1c t\u1ebf b\u00e0o n\u00e0y. Sau khi k\u00edch th\u00edch b\u1eb1ng kh\u00e1ng nguy\u00ean, c\u00e1c d\u1ea5u \u1ea5n ho\u1ea1t h\u00f3a nh\u01b0 CD203c v\u00e0 CD63 th\u01b0\u1eddng \u0111\u01b0\u1ee3c \u0111o b\u1eb1ng k\u1ef9 thu\u1eadt flow cytometry \u0111\u1ec3 \u0111\u1ecbnh l\u01b0\u1ee3ng m\u1ee9c \u0111\u1ed9 ho\u1ea1t h\u00f3a c\u1ee7a b\u1ea1ch c\u1ea7u \u00e1i ki\u1ec3m. BHRA l\u00e0 m\u1ed9t k\u1ef9 thu\u1eadt t\u01b0\u01a1ng t\u1ef1, nh\u01b0ng thay v\u00ec \u0111o c\u00e1c d\u1ea5u \u1ea5n ho\u1ea1t h\u00f3a tr\u00ean b\u1ec1 m\u1eb7t t\u1ebf b\u00e0o, ph\u01b0\u01a1ng ph\u00e1p n\u00e0y \u0111o l\u01b0\u1ee3ng histamine \u0111\u01b0\u1ee3c gi\u1ea3i ph\u00f3ng.<\/p>\n<p style=\"text-align: justify;\">C\u1ea7n c\u00f3 th\u00eam nhi\u1ec1u n\u1ed7 l\u1ef1c \u0111\u1ec3 ph\u00e1t tri\u1ec3n c\u00e1c c\u00f4ng c\u1ee5 \u0111\u00e3 \u0111\u01b0\u1ee3c th\u1ea9m \u0111\u1ecbnh v\u00e0 c\u00f3 kh\u1ea3 n\u0103ng t\u00e1i l\u1eadp, nh\u1eb1m ph\u00e1t hi\u1ec7n v\u00e0 \u0111\u1ecbnh l\u01b0\u1ee3ng IgE t\u1ef1 ph\u1ea3n \u1ee9ng m\u1ed9t c\u00e1ch \u0111\u00e1ng tin c\u1eady. Vi\u1ec7c thi\u1ebft l\u1eadp c\u00e1c ng\u01b0\u1ee1ng l\u00e2m s\u00e0ng v\u00e0 x\u00e1c \u0111\u1ecbnh m\u1ed1i li\u00ean h\u1ec7 gi\u1eefa IgE t\u1ef1 ph\u1ea3n \u1ee9ng v\u1edbi m\u1ee9c \u0111\u1ed9 ho\u1ea1t \u0111\u1ed9ng c\u1ee7a b\u1ec7nh c\u0169ng nh\u01b0 \u0111\u00e1p \u1ee9ng \u0111i\u1ec1u tr\u1ecb s\u1ebd l\u00e0 nh\u1eefng b\u01b0\u1edbc quan tr\u1ecdng \u0111\u1ec3 t\u00edch h\u1ee3p ch\u1ea9n \u0111o\u00e1n t\u1ef1 d\u1ecb \u1ee9ng trong th\u1ef1c h\u00e0nh l\u00e2m s\u00e0ng. Ngo\u00e0i ra, vi\u1ec7c t\u00edch h\u1ee3p c\u00e1c n\u1ec1n t\u1ea3ng c\u00f4ng ngh\u1ec7 cao nh\u01b0 proteomics \u0111a m\u1ed3i c\u0169ng c\u00f3 th\u1ec3 mang l\u1ea1i nh\u1eefng hi\u1ec3u bi\u1ebft m\u1edbi v\u00e0 h\u1ed7 tr\u1ee3 ph\u00e1t tri\u1ec3n c\u00e1c d\u1ea5u \u1ea5n sinh h\u1ecdc cho li\u1ec7u ph\u00e1p ch\u00ednh x\u00e1c trong l\u0129nh v\u1ef1c t\u1ef1 d\u1ecb \u1ee9ng.<\/p>\n<h2 style=\"text-align: justify;\">T\u1ef0 D\u1eca \u1ee8NG \u0110\u01af\u1ee2C \u0110I\u1ec0U TR\u1eca NH\u01af TH\u1ebe N\u00c0O?<\/h2>\n<p style=\"text-align: justify;\">Chi\u1ebfn l\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb ch\u00ednh trong t\u1ef1 d\u1ecb \u1ee9ng l\u00e0 trung h\u00f2a IgE l\u01b0u h\u00e0nh trong m\u00e1u, t\u1eeb \u0111\u00f3 l\u00e0m gi\u00e1n \u0111o\u1ea1n chu\u1ed7i ho\u1ea1t h\u00f3a ph\u00eda sau c\u1ee7a c\u00e1c t\u1ebf b\u00e0o hi\u1ec7u \u1ee9ng, nh\u01b0 t\u1ebf b\u00e0o mast. Omalizumab hi\u1ec7n v\u1eabn l\u00e0 kh\u00e1ng th\u1ec3 \u0111\u01a1n d\u00f2ng kh\u00e1ng IgE duy nh\u1ea5t \u0111\u00e3 \u0111\u01b0\u1ee3c ph\u00ea duy\u1ec7t \u0111\u1ec3 \u0111i\u1ec1u tr\u1ecb hen d\u1ecb \u1ee9ng, m\u00e0y \u0111ay m\u1ea1n t\u00ednh t\u1ef1 ph\u00e1t v\u00e0 d\u1ecb \u1ee9ng th\u1ef1c ph\u1ea9m. Ngo\u00e0i ra, m\u1ed9t s\u1ed1 thu\u1ed1c biosimilar c\u1ee7a omalizumab c\u0169ng \u0111\u00e3 \u0111\u01b0\u1ee3c c\u1ea5p ph\u00e9p ho\u1eb7c s\u1ebd s\u1edbm \u0111\u01b0\u1ee3c c\u1ea5p ph\u00e9p cho c\u00e1c ch\u1ec9 \u0111\u1ecbnh n\u00e0y.<\/p>\n<p style=\"text-align: justify;\">V\u1ec1 m\u1eb7t c\u01a1 ch\u1ebf, omalizumab g\u1eafn v\u00e0o m\u1ed9t epitope c\u1ea5u tr\u00fac n\u1eb1m trong mi\u1ec1n C\u20ac3 c\u1ee7a IgE, \u0111\u00e2y l\u00e0 v\u00f9ng r\u1ea5t quan tr\u1ecdng cho s\u1ef1 t\u01b0\u01a1ng t\u00e1c v\u1edbi c\u1ea3 FcCRI v\u00e0 th\u1ee5 th\u1ec3 IgE \u00e1i l\u1ef1c th\u1ea5p (CD23). B\u1eb1ng c\u00e1ch nh\u1eafm v\u00e0o mi\u1ec1n n\u00e0y, omalizumab b\u1eaft gi\u1eef IgE t\u1ef1 do v\u00e0 ng\u0103n c\u1ea3n IgE g\u1eafn v\u00e0o c\u00e1c th\u1ee5 th\u1ec3 tr\u00ean t\u1ebf b\u00e0o mast, b\u1ea1ch c\u1ea7u \u00e1i ki\u1ec1m, t\u1ebf b\u00e0o B v\u00e0 c\u00e1c t\u1ebf b\u00e0o tr\u00ecnh di\u1ec7n kh\u00e1ng nguy\u00ean. \u0110i\u1ec1u quan tr\u1ecdng l\u00e0 omalizumab kh\u00f4ng g\u1eafn v\u1edbi IgE \u0111\u00e3 g\u1eafn s\u1eb5n tr\u00ean FcERI, do \u0111\u00f3 tr\u00e1nh g\u00e2y ho\u1ea1t h\u00f3a t\u1ebf b\u00e0o ngay l\u1eadp t\u1ee9c. S\u1ef1 gi\u1ea3m n\u1ed3ng \u0111\u1ed9 IgE t\u1ef1 do trong tu\u1ea7n ho\u00e0n d\u1eabn \u0111\u1ebfn nhi\u1ec1u t\u00e1c d\u1ee5ng \u0111i\u1ec1u h\u00f2a mi\u1ec5n d\u1ecbch, bao g\u1ed3m gi\u1ea3m bi\u1ec3u hi\u1ec7n FcERI tr\u00ean t\u1ebf b\u00e0o mast, b\u1ea1ch c\u1ea7u \u00e1i ki\u1ec3m v\u00e0 t\u1ebf b\u00e0o dendritic, t\u1eeb \u0111\u00f3 l\u00e0m gi\u1ea3m \u0111\u1ed9 nh\u1ea1y v\u1edbi kh\u00e1ng nguy\u00ean v\u00e0 gi\u1ea3m s\u1ef1 ho\u1ea1t h\u00f3a t\u1ebf b\u00e0o. Ngo\u00e0i ra, omalizumab c\u00f2n l\u00e0m gi\u1ea3m qu\u00e1 tr\u00ecnh tr\u00ecnh di\u1ec7n kh\u00e1ng nguy\u00ean \u0111\u01b0\u1ee3c h\u1ed7 tr\u1ee3 b\u1edfi IgE c\u1ee7a c\u00e1c t\u1ebf b\u00e0o dendritic cell.<\/p>\n<p style=\"text-align: justify;\">S\u1ef1 \u0111\u00e1p \u1ee9ng nhanh v\u00e0 thu\u1eadn l\u1ee3i v\u1edbi omalizumab cho th\u1ea5y vai tr\u00f2 l\u00e2m s\u00e0ng c\u1ee7a autoreactive IgE trong m\u00e0y \u0111ay m\u1ea1n t\u00ednh t\u1ef1 ph\u00e1t. Omalizumab gi\u00fap \u0111\u1ea1t \u0111\u00e1p \u1ee9ng ho\u00e0n to\u00e0n \u1edf 70% b\u1ec7nh nh\u00e2n CSU c\u00f3 IgE kh\u00e1ng TPO. M\u1eb7c d\u00f9 th\u1eed nghi\u1ec7m n\u00e0y kh\u00f4ng \u0111\u00e1nh gi\u00e1 li\u1ec7u nh\u1eefng b\u1ec7nh nh\u00e2n c\u00f3 t\u1ef1 kh\u00e1ng th\u1ec3 IgE c\u00f3 \u0111\u00e1p \u1ee9ng v\u1edbi omalizumab t\u1ed1t h\u01a1n so v\u1edbi nh\u1eefng ng\u01b0\u1eddi kh\u00f4ng c\u00f3 hay kh\u00f4ng, nh\u01b0ng m\u1ed9t nghi\u00ean c\u1ee9u g\u1ea7n \u0111\u00e2y tr\u00ean b\u1ec7nh da c\u00f3 li\u00ean quan \u0111\u1ebfn t\u1ef1 kh\u00e1ng th\u1ec3 IgE \u0111\u00e3 \u1ee7ng h\u1ed9 gi\u1ea3 thuy\u1ebft n\u00e0y. C\u1ee5 th\u1ec3 75% b\u1ec7nh nh\u00e2n pemphigoid b\u1ecdng n\u01b0\u1edbc c\u00f3 n\u1ed3ng \u0111\u1ed9 IgE kh\u00e1ng BP180-NC16A huy\u1ebft thanh t\u0103ng \u1edf th\u1eddi \u0111i\u1ec3m ban \u0111\u1ea7u \u0111\u1ea1t \u0111\u00e1p \u1ee9ng ho\u00e0n to\u00e0n v\u1edbi omalizumab, so v\u1edbi 41% \u1edf nh\u1eefng b\u1ec7nh nh\u00e2n kh\u00f4ng c\u00f3 c\u00e1c t\u1ef1 kh\u00e1ng th\u1ec3 n\u00e0y (p = 0.01). C\u00e1c b\u1eb1ng ch\u1ee9ng ban \u0111\u1ea7u c\u0169ng cho th\u1ea5y \u0111i\u1ec1u tr\u1ecb b\u1eb1ng omalizumab c\u00f3 th\u1ec3 l\u00e0m gi\u1ea3m \u0111\u00e1ng k\u1ec3 n\u1ed3ng \u0111\u1ed9 t\u1ef1 kh\u00e1ng th\u1ec3 IgE trong huy\u1ebft thanh, ch\u1eb3ng h\u1ea1n IgE kh\u00e1ng TF v\u00e0 IgE kh\u00e1ng TG, \u1edf b\u1ec7nh nh\u00e2n CSU ch\u1ec9 sau m\u1ed9t tu\u1ea7n \u0111i\u1ec1u tr\u1ecb.<\/p>\n<p style=\"text-align: justify;\">Ngo\u00e0i vi\u1ec7c t\u00e1c \u0111\u1ed9ng tr\u1ef1c ti\u1ebfp v\u00e0o IgE, b\u1ec7nh nh\u00e2n m\u1eafc c\u00e1c b\u1ec7nh t\u1ef1 d\u1ecb \u1ee9ng (autoallergic diseases) c\u0169ng c\u00f3 th\u1ec3 h\u01b0\u1edfng l\u1ee3i t\u1eeb vi\u1ec7c nh\u1eafm v\u00e0o c\u00e1c y\u1ebfu t\u1ed1 b\u1ec7nh sinh quan tr\u1ecdng kh\u00e1c, bao g\u1ed3m c\u00e1c cytokine IL-4 v\u00e0 IL-13, BTK v\u00e0 th\u1ee5 th\u1ec3 KIT. Dupilumab, m\u1ed9t ch\u1ea5t \u1ee9c ch\u1ebf IL-4Ra c\u00f3 kh\u1ea3 n\u0103ng ch\u1eb7n t\u00edn hi\u1ec7u c\u1ee7a c\u1ea3 IL-4 v\u00e0 IL-13, hi\u1ec7n \u0111\u00e3 \u0111\u01b0\u1ee3c ph\u00ea duy\u1ec7t \u0111i\u1ec1u tr\u1ecb hen ph\u1ebf qu\u1ea3n, vi\u00eam da c\u01a1 \u0111\u1ecba v\u00e0 m\u00e0y \u0111ay m\u1ea1n t\u00ednh t\u1ef1 ph\u00e1t t\u1ea1i Hoa K\u1ef3, Nh\u1eadt B\u1ea3n, Brazil v\u00e0 c\u00e1c Ti\u1ec3u v\u01b0\u01a1ng qu\u1ed1c \u1ea2 R\u1eadp v\u00e0 hi\u1ec7n \u0111ang \u0111\u01b0\u1ee3c xem x\u00e9t ph\u00ea duy\u1ec7t t\u1ea1i Li\u00ean minh ch\u00e2u \u00c2u. Dupilumab \u0111\u00e3 \u0111\u01b0\u1ee3c ch\u1ee9ng minh l\u00e0m gi\u1ea3m \u0111\u00e1ng k\u1ec3 n\u1ed3ng \u0111\u1ed9 IgE to\u00e0n ph\u1ea7n \u1edf b\u1ec7nh nh\u00e2n vi\u00eam da c\u01a1 \u0111\u1ecba, \u0111\u1ed3ng th\u1eddi gi\u1ea3m t\u1edbi 86% n\u1ed3ng \u0111\u1ed9 IgE \u0111\u1eb7c hi\u1ec7u v\u1edbi c\u00e1c d\u1ecb nguy\u00ean th\u1ee9c \u0103n sau 3 n\u0103m \u0111i\u1ec1u tr\u1ecb. BTK \u0111\u00f3ng vai tr\u00f2 quan tr\u1ecdng trong c\u1ea3 t\u00edn hi\u1ec7u th\u1ee5 th\u1ec3 t\u1ebf b\u00e0o B (BCR) v\u00e0 s\u1ef1 ho\u1ea1t h\u00f3a t\u1ebf b\u00e0o mast. Hi\u1ec7n nay, m\u1ed9t s\u1ed1 thu\u1ed1c \u1ee9c ch\u1ebf BTK nh\u01b0 remibrutinib, rilzabrutinib, atuzabrutinib, branebrutinib v\u00e0 fenebrutinib \u0111ang \u0111\u01b0\u1ee3c \u0111\u00e1nh gi\u00e1 l\u00e2m s\u00e0ng \u0111\u1ec3 s\u1eed d\u1ee5ng ti\u1ec1m n\u0103ng trong d\u1ecb \u1ee9ng th\u1ee9c \u0103n, CSU, hen v\u00e0 vi\u00eam da c\u01a1 \u0111\u1ecba. V\u00ed d\u1ee5, remibrutinib \u0111\u00e3 cho th\u1ea5y hi\u1ec7u qu\u1ea3 \u0111i\u1ec1u tr\u1ecb v\u00e0 h\u1ed3 s\u01a1 an to\u00e0n thu\u1eadn l\u1ee3i trong \u0111i\u1ec1u tr\u1ecb CSU, v\u00ec thu\u1ed1c \u1ee9c ch\u1ebf hi\u1ec7u qu\u1ea3 s\u1ef1 ho\u1ea1t h\u00f3a c\u1ee7a t\u1ebf b\u00e0o mast v\u00e0 b\u1ea1ch c\u1ea7u \u00e1i ki\u1ec1m do hi\u1ec7n t\u01b0\u1ee3ng b\u1eaft ch\u00e9o IgE ho\u1eb7c c\u00e1c y\u1ebfu t\u1ed1 ho\u1ea1t h\u00f3a c\u00f3 ngu\u1ed3n g\u1ed1c t\u1eeb huy\u1ebft thanh g\u00e2y ra.<\/p>\n<p style=\"text-align: justify;\">Do c\u00f3 kh\u1ea3 n\u0103ng ng\u0103n ch\u1eb7n s\u1ef1 ph\u00f3ng h\u1ea1t c\u1ee7a t\u1ebf b\u00e0o qua trung gian IgE, remibrutinib c\u0169ng c\u00f3 th\u1ec3 mang l\u1ea1i l\u1ee3i \u00edch trong c\u00e1c b\u1ec7nh l\u00fd t\u1ef1 d\u1ecb \u1ee9ng. Ngo\u00e0i ra, \u1ee9c ch\u1ebf BTK c\u00f3 th\u1ec3 h\u1ea1n ch\u1ebf s\u1ef1 ph\u00e1t tri\u1ec3n c\u1ee7a c\u00e1c t\u1ebf b\u00e0o autoreactive B cells v\u00e0 th\u00fac \u0111\u1ea9y self-tolerance b\u1eb1ng c\u00e1ch ng\u0103n ch\u1eb7n s\u1ef1 v\u01b0\u1ee3t qua c\u00e1c \u0111i\u1ec3m ki\u1ec3m so\u00e1t dung n\u1ea1p mi\u1ec5n d\u1ecbch ngo\u1ea1i vi. Th\u1ee5 th\u1ec3 KIT, m\u1ed9t y\u1ebfu t\u1ed1 \u0111i\u1ec1u h\u00f2a quan tr\u1ecdng \u0111\u1ed1i v\u1edbi s\u1ef1 s\u1ed1ng c\u00f2n, t\u0103ng sinh v\u00e0 ho\u1ea1t h\u00f3a c\u1ee7a t\u1ebf b\u00e0o mast, c\u00f3 th\u1ec3 b\u1ecb \u1ee9c ch\u1ebf b\u1edfi c\u00e1c kh\u00e1ng th\u1ec3 \u0111\u01a1n d\u00f2ng nh\u01b0 barzolvolimab. Trong m\u1ed9t th\u1eed nghi\u1ec7m l\u00e2m s\u00e0ng giai \u0111o\u1ea1n 1b, 43% b\u1ec7nh nh\u00e2n CSU \u0111\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb b\u1eb1ng barzolvolimab \u0111\u1ea1t \u0111\u00e1p \u1ee9ng ho\u00e0n to\u00e0n (UCT = 16) v\u00e0o tu\u1ea7n th\u1ee9 12, cho th\u1ea5y ti\u1ec1m n\u0103ng l\u00e2m s\u00e0ng c\u1ee7a c\u00e1c li\u1ec7u ph\u00e1p l\u00e0m gi\u1ea3m s\u1ed1 l\u01b0\u1ee3ng t\u1ebf b\u00e0o mast trong \u0111i\u1ec1u tr\u1ecb b\u1ec7nh t\u1ef1 d\u1ecb \u1ee9ng. Hi\u1ec7n nay, c\u00e1c th\u1eed nghi\u1ec7m l\u00e2m s\u00e0ng giai \u0111o\u1ea1n 2 v\u00e0 3 c\u1ee7a barzolvolimab trong \u0111i\u1ec1u tr\u1ecb CSU v\u1eabn \u0111ang \u0111\u01b0\u1ee3c ti\u1ebfn h\u00e0nh.<\/p>\n<h2 style=\"text-align: justify;\">T\u00c0I LI\u1ec6U THAM KH\u1ea2O<\/h2>\n<p style=\"text-align: justify;\">Steinert C, Pashuk M, Kolkhir P, Kocat\u00fcrk E, Xiang YK. T\u1ef1 d\u1ecb \u1ee9ng v\u00e0 nh\u1eefng \u0111i\u1ec1u m\u00e0 b\u00e1c s\u0129 chuy\u00ean khoa d\u1ecb \u1ee9ng c\u1ea7n bi\u1ebft. Curr Allergy Asthma Rep. 2025 ng\u00e0y 9 th\u00e1ng 8;25(1):34. doi: 10.1007\/s11882-025-01215-8. PMID: 40782271; PMCID: PMC12335397.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>L\u01b0\u1ee3t d\u1ecbch: NT \u0397\u039d T\u1ed4NG QUAN Hen suy\u1ec5n, vi\u00eam da c\u01a1 \u0111\u1ecba (AD), m\u00e0y \u0111ay m\u1ea1n t\u00ednh (CU) v\u00e0 d\u1ecb \u1ee9ng th\u1ee9c \u0103n l\u00e0 nh\u1eefng r\u1ed1i lo\u1ea1n mi\u1ec5n d\u1ecbch th\u01b0\u1eddng g\u1eb7p nh\u1ea5t \u0111\u01b0\u1ee3c c\u00e1c b\u00e1c s\u0129 chuy\u00ean khoa d\u1ecb \u1ee9ng \u0111i\u1ec1u tr\u1ecb. Hen suy\u1ec5n l\u00e0 b\u1ec7nh \u0111\u01b0\u1eddng h\u00f4 h\u1ea5p d\u01b0\u1edbi, \u0111\u1eb7c tr\u01b0ng v\u1edbi c\u00e1c tri\u1ec7u [&#8230;]\n","protected":false},"author":1,"featured_media":156124,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[1],"tags":[],"class_list":["post-155585","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-y-te-suc-khoe"],"acf":[],"_links":{"self":[{"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/posts\/155585","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/comments?post=155585"}],"version-history":[{"count":1,"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/posts\/155585\/revisions"}],"predecessor-version":[{"id":155588,"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/posts\/155585\/revisions\/155588"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/media\/156124"}],"wp:attachment":[{"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/media?parent=155585"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/categories?post=155585"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/tags?post=155585"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}