Winther L, Moseholm L, Reimert C M, Stahl Skov P, Kaergaard Poulsen L
Allergy Unit, National University Hospital, Copenhagen, Denmark.
Allergy. 1999 May;54(5):436-45. doi: 10.1034/j.1398-9995.1999.00910.x.
Serum specific IgE, basophil histamine release, and blood eosinophil parameters are associated with allergic rhinitis, but investigations of the relationship to the severity of allergic symptoms are few and conflicting. Our study aimed to investigate the seasonal changes in the following laboratory tests: specific IgE, basophil histamine release, eosinophil counts, and serum and plasma eosinophil cationic protein (ECP) and eosinophil protein X (EPX), and to analyze, in detail, the relationship of each individual test to the severity of symptoms in rhinitis patients allergic to both birch and grass pollen.
The above tests were performed on blood samples obtained from 49 allergic rhinitis patients during the birch-pollen season, during the grass-pollen season, and after the seasons. Symptom-medication diaries were filled in during both pollen seasons. We used partial least square (PLS) analysis to establish an optimal statistical link between the symptom score and medication and the laboratory tests, in an investigator-independent way.
Increases in specific IgE, basophil histamine release, eosinophil counts, serum ECP and EPX, and plasma EPX were observed from the birch-pollen season to the grass-pollen season, followed by a decrease from the grass-pollen season to after the pollen seasons, except for the specific IgE. No seasonal changes in plasma ECP and total IgE were seen. The PLS analysis found a relationship between symptom score and medication and the aggregate laboratory tests (F-test value 40.2, correlation 0.34 for the cumulative relation). However, the variation in laboratory tests could explain only half of the total variation in symptoms and less than a quarter of the total variation in medication. The symptom score and, to a minor degree, medication were especially correlated with the basophil histamine-release results, with a decreasing relevance of specific IgE, eosinophil counts, total IgE, serum and plasma EPX, and serum ECP. Plasma ECP was not related to the symptom score and medication.
A significant relationship between the severity of allergic rhinitis and various allergic inflammatory markers was found but could account for only a minor part of the variation in the patients' evaluation of their disease.
血清特异性IgE、嗜碱性粒细胞组胺释放及血液嗜酸性粒细胞参数与过敏性鼻炎相关,但关于其与过敏症状严重程度关系的研究较少且结果相互矛盾。我们的研究旨在调查以下实验室检测指标的季节性变化:特异性IgE、嗜碱性粒细胞组胺释放、嗜酸性粒细胞计数、血清和血浆嗜酸性粒细胞阳离子蛋白(ECP)及嗜酸性粒细胞蛋白X(EPX),并详细分析每项检测指标与对桦树和草花粉均过敏的鼻炎患者症状严重程度之间的关系。
对49例过敏性鼻炎患者在桦树花粉季、草花粉季及花粉季过后采集的血样进行上述检测。在两个花粉季期间填写症状 - 用药日记。我们采用偏最小二乘法(PLS)分析,以一种独立于研究者的方式在症状评分和用药情况与实验室检测之间建立最佳统计关联。
从桦树花粉季到草花粉季,特异性IgE、嗜碱性粒细胞组胺释放、嗜酸性粒细胞计数、血清ECP和EPX以及血浆EPX均升高,随后从草花粉季到花粉季过后下降,但特异性IgE除外。血浆ECP和总IgE未见季节性变化。PLS分析发现症状评分和用药情况与综合实验室检测之间存在关联(F检验值40.2,累积关系的相关性为0.34)。然而,实验室检测的变化仅能解释症状总变化的一半以及用药总变化的不到四分之一。症状评分以及在较小程度上用药情况与嗜碱性粒细胞组胺释放结果尤其相关,特异性IgE、嗜酸性粒细胞计数、总IgE、血清和血浆EPX以及血清ECP的相关性逐渐降低。血浆ECP与症状评分和用药情况无关。
发现过敏性鼻炎严重程度与多种过敏炎症标志物之间存在显著关联,但仅能解释患者对自身疾病评估中变异的一小部分。