Koskela H, Di Sciascio M B, Anderson S D, Andersson M, Chan H K, Gadalla S, Katelaris C
Department of Respiratory Medicine, Kuopio University Hospital, 70211 Kuopio, Finland.
Clin Exp Allergy. 2000 Nov;30(11):1627-36. doi: 10.1046/j.1365-2222.2000.00923.x.
The responses to airway hyperosmolar challenges probably involve various inflammatory mediators. However, it is not fully understood which cell type/types are the source of these mediators. Potential cell types include mast cell, epithelial cell and the sensory c-fibre nerve cell.
To clarify which cell types are involved with the mediator response to hyperosmolarity in the human airway.
Ten healthy subjects, 11 patients with nonactive allergic rhinitis, and nine with active allergic rhinitis were challenged intranasally with mannitol powder, and with sham provocation, on separate days. Symptoms were assessed by visual analogue scales and nasal patency by measuring the nasal peak inspiratory flow (nPIF). Nasal lavage fluid levels of alpha(2)-macroglobulin (an index of plasma extravasation), substance P (an index of sensory nerve cell activation), tryptase (an index of mast cell activation) and 15-hydroxyeicosatetraenoic acid (15-HETE, an index of epithelial cell activation) were analysed.
Immediate, although transient burning was the most prominent symptom in all groups whereas only the patients with active rhinitis experienced a fall in nPIF. Mannitol significantly increased the nasal lavage fluid 15-HETE levels in the allergic patients (P < 0.01 vs the sham challenge), but not in the healthy subjects. The increase in 15-HETE correlated with nasal symptoms for itching (r(s) = 0.65, P = 0.019) and burning (r(s) = 0.72, P = 0.009). Detectable levels of tryptase was found only in five allergic subjects. Lavage levels of substance P and alpha(2)-macroglobulin did not not change.
Epithelial cell seems to be involved with the mediator response to airway hyperosmolar challenge. The roles of sensory c-fibre nerve cell and mast cell remained less clear.
气道高渗刺激的反应可能涉及多种炎症介质。然而，这些介质的来源是哪种或哪些细胞类型尚未完全明确。潜在的细胞类型包括肥大细胞、上皮细胞和感觉C纤维神经细胞。
阐明在人类气道中哪些细胞类型参与了对高渗刺激的介质反应。
10名健康受试者、11名非活动性变应性鼻炎患者和9名活动性变应性鼻炎患者在不同日期分别接受甘露醇粉末鼻腔激发试验和假激发试验。通过视觉模拟量表评估症状，并通过测量鼻吸气峰流量（nPIF）评估鼻腔通畅情况。分析鼻灌洗液中α2-巨球蛋白（血浆外渗指标）、P物质（感觉神经细胞激活指标）、类胰蛋白酶（肥大细胞激活指标）和15-羟基二十碳四烯酸（15-HETE，上皮细胞激活指标）的水平。
即刻出现的短暂烧灼感是所有组中最突出的症状，而只有活动性鼻炎患者的nPIF下降。甘露醇显著增加了变应性患者鼻灌洗液中15-HETE的水平（与假激发试验相比，P<0.01），但在健康受试者中未增加。15-HETE的增加与瘙痒（rs=0.65，P=0.019）和烧灼感（rs=0.72，P=0.009）的鼻部症状相关。仅在5名变应性受试者中检测到可检测水平的类胰蛋白酶。P物质和α2-巨球蛋白的灌洗液水平没有变化。
上皮细胞似乎参与了对气道高渗刺激的介质反应。感觉C纤维神经细胞和肥大细胞的作用仍不太清楚。
