Greiff L, Petersen H, Mattsson E, Andersson M, Erjefält J S, Linden M, Svensson C, Persson C G
Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital, Lund, Sweden.
Clin Exp Allergy. 2001 Aug;31(8):1321-7. doi: 10.1046/j.1365-2222.2001.01029.x.
Eotaxin is a chemokine that attracts and activates eosinophils. The present study examines the occurrence of eotaxin in nasal mucosal surface liquids in patients with seasonal allergic rhinitis without allergen exposure and during repeat allergen challenge with and without topical glucocorticosteroid treatment. The number of subepithelial eosinophils and mucosal outputs of bulk plasma (alpha2-macroglobulin) and eosinophil cationic protein (ECP) are also examined.
Twelve patients underwent daily allergen challenges for 6 days. Separately, 14 patients, who were receiving budesonide and placebo in a parallel group design, also underwent allergen challenge for 6 days. Nasal biopsies were obtained before and 24 h after the allergen challenge series, and lavages were carried out before and 15 min after selected allergen challenges.
At baseline nasal lavage fluid levels of eotaxin correlated to levels of alpha2-macroglobulin and ECP. After the first allergen challenge there was a correlation between nasal lavage fluid levels of eotaxin and ECP. Repeat allergen exposure increased the mucosal output of eotaxin (P <0.05) and ECP (P <0.01) as well as eosinophil numbers (P <0.01), but no correlation was found between increased eosinophil numbers and eotaxin. Budesonide reduced eotaxin levels during repeat allergen challenge (P <0.05).
Repeat allergen exposure in allergic rhinitis is associated with increased mucosal output of eotaxin. Topical budesonide attenuates this effect, suggesting the possibility that inhibitory effects on mucosal eotaxin may contribute to anti-eosinophilic actions of topical glucocorticosteroids.
嗜酸性粒细胞趋化因子是一种可吸引并激活嗜酸性粒细胞的趋化因子。本研究检测了季节性变应性鼻炎患者在无变应原暴露时以及在重复变应原激发试验（有无局部糖皮质激素治疗）期间鼻黏膜表面液体中嗜酸性粒细胞趋化因子的出现情况。同时还检测了上皮下嗜酸性粒细胞的数量以及血浆（α2-巨球蛋白）和嗜酸性粒细胞阳离子蛋白（ECP）的黏膜分泌量。
12例患者每日进行变应原激发试验，共6天。另外，14例采用平行组设计接受布地奈德和安慰剂治疗的患者也进行了6天的变应原激发试验。在变应原激发试验系列前及试验后24小时获取鼻活检组织，并在选定的变应原激发试验前及激发后15分钟进行灌洗。
在基线时，鼻灌洗液中嗜酸性粒细胞趋化因子水平与α2-巨球蛋白和ECP水平相关。首次变应原激发后，鼻灌洗液中嗜酸性粒细胞趋化因子水平与ECP之间存在相关性。重复变应原暴露增加了嗜酸性粒细胞趋化因子（P<0.05）和ECP（P<0.01）的黏膜分泌量以及嗜酸性粒细胞数量（P<0.01），但嗜酸性粒细胞数量增加与嗜酸性粒细胞趋化因子之间未发现相关性。布地奈德在重复变应原激发试验期间降低了嗜酸性粒细胞趋化因子水平（P<0.05）。
变应性鼻炎患者重复变应原暴露与嗜酸性粒细胞趋化因子黏膜分泌量增加有关。局部布地奈德可减轻这种效应，提示对鼻黏膜嗜酸性粒细胞趋化因子的抑制作用可能有助于局部糖皮质激素的抗嗜酸性粒细胞作用。
