Marcucci F, Sensi L G, Migali E, Coniglio G
Institute of Pediatrics, University of Perugia, Italy.
Allergy. 2001 Mar;56(3):231-6. doi: 10.1034/j.1398-9995.2001.056003231.x.
After allergen exposure, IgE-bearing mast cells surface in respiratory mucosa. Eosinophils are also recruited locally by chemotactic mediators; they are the main cell directly involved in the late phase of allergic inflammation. IgE antibody and eosinophil cationic protein (ECP) are routinely determined mainly in serum although they exert their pathogenetic role more directly on mucosal surfaces.
We performed a comparative study of IgE antibody to grass and ECP on nasal mucosa and blood samples in order to evaluate the relevance of monitoring allergic inflammation in the target organ. Thirty-one patients and 10 nonatopic controls were enrolled in the protocol. Twenty-six subjects allergic to grass, 11 with rhinitis (group 1) and 15 with asthma and rhinitis (group 2), completed the study. Five patients dropped out. Specific IgE to grass and ECP was determined in nasal mucosa by our method based on in situ incubation.
Serum IgE to grass did not increase during the pollen peak, as did nasal IgE, in group 1 from before the pollen peak, from 2.3 to 3.2 kU/l (P=0.02), and in group 2 at the pollen peak, from 4.8 to 12.2 kU/l (P=0.01). Serum ECP did not show any significant variation in group 1, but it increased at pollen peak from 6 to 11.2 microg/l (P=0.01) in group 2. Nasal ECP increased significantly in both groups even before the pollen peak. In group 1, ECP values rose from 15 to 39.9 microg/l (P=0.01). In group 2, ECP increase was much higher than in group 1, from 9 to 213 microg/l (P=0.001). Serum eosinophils, like nasal ECP, showed a significant increase of values from before the pollen peak in both groups, without correlation with serum ECP in rhinitic patients.
Both specific IgE and ECP in the nasal mucosa showed a better correlation with allergen exposure than serum evaluations. With an appropriate method, allergic inflammation may be best monitored in the nasal mucosa.
接触变应原后，呼吸道黏膜表面出现携带IgE的肥大细胞。嗜酸性粒细胞也由趋化介质局部募集；它们是直接参与过敏性炎症晚期的主要细胞。IgE抗体和嗜酸性粒细胞阳离子蛋白（ECP）通常主要在血清中检测，尽管它们在黏膜表面发挥致病作用更为直接。
我们对鼻黏膜和血液样本中的草IgE抗体和ECP进行了一项比较研究，以评估监测靶器官过敏性炎症的相关性。31例患者和10例非特应性对照纳入该方案。26例对草过敏的受试者，11例患有鼻炎（第1组），15例患有哮喘和鼻炎（第2组），完成了研究。5例患者退出。采用我们基于原位孵育的方法测定鼻黏膜中草特异性IgE和ECP。
在花粉高峰期，第1组从花粉高峰前血清草IgE未增加，而鼻IgE增加，从2.3升至3.2 kU/l（P = 0.02）；第2组在花粉高峰期血清草IgE从4.8升至12.2 kU/l（P = 0.01）。第1组血清ECP无显著变化，但第2组在花粉高峰期从6升至11.2 μg/l（P = 0.01）。两组在花粉高峰前鼻ECP均显著增加。第1组，ECP值从15升至39.9 μg/l（P = 0.01）。第2组，ECP增加远高于第1组，从9升至213 μg/l（P = 0.001）。血清嗜酸性粒细胞与鼻ECP一样，两组在花粉高峰前值均显著增加，在鼻炎患者中与血清ECP无相关性。
鼻黏膜中的特异性IgE和ECP与变应原暴露的相关性均优于血清评估。采用适当方法，鼻黏膜过敏性炎症可能得到最佳监测。
Zotero 插件