Undem B J, Kajekar R, Hunter D D, Myers A C
Department of Medicine, Johns Hopkins Asthma and Allergy Center, Baltimore, MD 21224, USA.
J Allergy Clin Immunol. 2000 Nov;106(5 Suppl):S213-20. doi: 10.1067/mai.2000.110153.
Changes in neural activity play a key role in many symptoms of allergic disease, including sneezing, coughing, itching, and ocular irritation, among others. The mechanisms underlying allergen-induced changes in neural activity (reflexes) are largely unknown and under active investigation. Allergic inflammation can affect neural activity on a variety of levels, including at the primary afferent sensory nerve, integrative centers of the central nervous system, autonomic ganglia, and autonomic neuroeffector junction. At the level of the afferent sensory nerve, mediators released after allergen exposure either directly or indirectly increase neuronal firing. At the level of sensory ganglia, which contain cell bodies that innervate a variety of organs, changes in neuronal excitability may lead to a generalization of allergic symptoms. In the central nervous system, where afferent inputs from throughout the body converge, allergic inflammation may be associated with central sensitization, leading to the modulation of the neural reflexes. Finally, at the autonomic ganglia and neuroeffector junction, allergic inflammation appears to be associated with enhanced ganglionic transmission and neurotransmitter release, respectively. Mechanisms by which allergen challenge affects neuronal activity at various levels of the nervous system are reviewed, with a primary emphasis on studies of airway physiologic factors.
神经活动的变化在过敏性疾病的许多症状中起着关键作用，包括打喷嚏、咳嗽、瘙痒和眼部刺激等。变应原诱导的神经活动变化（反射）的潜在机制在很大程度上尚不清楚，目前正在积极研究中。过敏性炎症可在多种水平上影响神经活动，包括初级传入感觉神经、中枢神经系统的整合中枢、自主神经节和自主神经效应器接头。在传入感觉神经水平，变应原暴露后释放的介质直接或间接增加神经元放电。在感觉神经节水平，其包含支配各种器官的细胞体，神经元兴奋性的变化可能导致过敏症状的泛化。在中枢神经系统中，来自全身的传入输入在此汇聚，过敏性炎症可能与中枢敏化有关，从而导致神经反射的调节。最后，在自主神经节和神经效应器接头处，过敏性炎症似乎分别与神经节传递增强和神经递质释放增加有关。本文综述了变应原激发影响神经系统不同水平神经元活动的机制，主要侧重于气道生理因素的研究。
