Wang D Y, Clement P
Department of Otolaryngology, National University of Singapore, Republic of Singapore.
Am J Rhinol. 2000 Sep-Oct;14(5):325-33. doi: 10.2500/105065800781329483.
This paper reviews our previous studies on an objective evaluation of nasal symptoms, a quantitative determination of biochemical mediators, and inflammatory cells in nasal secretions of atopic patients after nasal allergen challenge (NAC) and during natural allergen exposure. The use of the microsuction technique has proved to be a useful and reliable nasal sampling method permitting quantitative analysis of important mediators in nasal secretions. This has provided accurate data on the activity of some important inflammatory cells such as mast cells, basophils, and eosinophils in allergic rhinitis. Our studies demonstrate that a significant increase in the concentrations of histamine, tryptase, and LTC4 in nasal secretions occurs within seconds or minutes after NAC, and this is accompanied by itching, sneezing, rhinorrhea, and nasal obstruction. The infiltration and activation of eosinophils are found to be the predominant condition during the late-phase reaction (LPR), which is mainly characterized by unilateral and/or bilateral nasal obstruction with little sneezing and rhinorrhea. The latter condition is found to be very much similar to the pathophysiology of patients with ongoing allergic rhinitis. In conclusion, our studies demonstrate that patients with ongoing allergic rhinitis seem to be in a continuous late phase state of eosinophilia and increased mediator release, a condition that can explain priming and nonspecific hyperreactivity of the nasal mucous membrane.
本文回顾了我们之前的研究，这些研究涉及对特应性患者在鼻过敏原激发试验（NAC）后以及自然暴露于过敏原期间的鼻症状进行客观评估、对鼻分泌物中的生化介质进行定量测定以及对炎症细胞进行分析。微吸技术已被证明是一种有用且可靠的鼻采样方法，可对鼻分泌物中的重要介质进行定量分析。这为过敏性鼻炎中一些重要炎症细胞（如肥大细胞、嗜碱性粒细胞和嗜酸性粒细胞）的活性提供了准确数据。我们的研究表明，在NAC后数秒或数分钟内，鼻分泌物中组胺、类胰蛋白酶和白三烯C4（LTC4）的浓度会显著增加，同时伴有瘙痒、打喷嚏、流涕和鼻塞。嗜酸性粒细胞的浸润和激活是迟发相反应（LPR）期间的主要情况，其主要特征是单侧和/或双侧鼻塞，打喷嚏和流涕较少。发现后一种情况与持续性过敏性鼻炎患者的病理生理学非常相似。总之，我们的研究表明，持续性过敏性鼻炎患者似乎处于嗜酸性粒细胞增多和介质释放增加的持续迟发相状态，这种情况可以解释鼻黏膜的启动和非特异性高反应性。
