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鼻黏膜嗜酸性粒细胞计数比ICAM-1阳性鼻上皮细胞数量更适合评估屋尘螨敏感型过敏性鼻炎的严重程度:一项临床相关性研究。

Eosinophil count in nasal mucosa is more suitable than the number of ICAM-1-positive nasal epithelial cells to evaluate the severity of house dust mite-sensitive allergic rhinitis: a clinical correlation study.

作者信息

Klaewsongkram Jettanong, Ruxrungtham Kiat, Wannakrairot Pongsak, Ruangvejvorachai Preecha, Phanupak Praphan

机构信息

Division of Allergy and Clinical Immunology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.

出版信息

Int Arch Allergy Immunol. 2003 Sep;132(1):68-75. doi: 10.1159/000073266.

Abstract

BACKGROUND

House dust mite (HDM)-sensitive allergic rhinitis is a perennial rhinitis with persistent nasal inflammation. Currently, there are no reliable parameters to monitor the severity of perennial allergic rhinitis. The purpose of this study was to evaluate correlations between clinical and laboratory parameters in patients with HDM-sensitive allergic rhinitis.

METHODS

We measured nasal symptoms, did the Dermatophagoides pteronyssinus (Der P) skin prick test (SPT), evaluated the Der P allergen nasal challenge threshold, and laboratory parameters [(1) inflammatory cell count from nasal mucosal scraping specimens: eosinophils and neutrophils and (2) immunocytochemistry: ICAM-1 expression on nasal epithelial cells] in 20 cases of HDM-sensitive allergic rhinitis and performed correlation tests between all parameters.

RESULTS

The wheal diameter induced by Der P SPT was significantly correlated with the Der P allergen nasal challenge threshold (p = 0.001). The number of eosinophils from nasal mucosal scrapping specimens was correlated with the ICAM-1 expression on nasal epithelial cells (p = 0.039), the number of neutrophils from nasal mucosal scrapping specimens (p = 0.001), and nasal stuffiness (p = 0.037) but did not correlate with total nasal symptom scores.

CONCLUSION

Clinical symptoms of HDM-sensitive allergic rhinitis showed a poor correlation with inflammatory parameters. The eosinophil count in nasal mucosa is correlated with ICAM-1 expression and more suitable than ICAM-1 levels to evaluate the severity of HDM-sensitive allergic rhinitis. This study also supports the role of the SPT in the diagnosis of nasal allergy to HDM.

摘要

背景

屋尘螨(HDM)敏感型过敏性鼻炎是一种伴有持续性鼻腔炎症的常年性鼻炎。目前,尚无可靠参数来监测常年性过敏性鼻炎的严重程度。本研究旨在评估HDM敏感型过敏性鼻炎患者临床参数与实验室参数之间的相关性。

方法

我们对20例HDM敏感型过敏性鼻炎患者测量了鼻部症状,进行了尘螨(Der P)皮肤点刺试验(SPT),评估了Der P变应原鼻激发阈值,并检测了实验室参数[(1)鼻黏膜刮片标本中的炎症细胞计数:嗜酸性粒细胞和中性粒细胞,以及(2)免疫细胞化学:鼻上皮细胞上细胞间黏附分子-1(ICAM-1)的表达],并对所有参数进行了相关性测试。

结果

Der P SPT诱导的风团直径与Der P变应原鼻激发阈值显著相关(p = 0.001)。鼻黏膜刮片标本中的嗜酸性粒细胞数量与鼻上皮细胞上ICAM-1的表达(p = 0.039)、鼻黏膜刮片标本中的中性粒细胞数量(p = 0.001)以及鼻塞(p = 0.037)相关,但与鼻部症状总评分无关。

结论

HDM敏感型过敏性鼻炎的临床症状与炎症参数的相关性较差。鼻黏膜中的嗜酸性粒细胞计数与ICAM-1表达相关,并且比ICAM-1水平更适合评估HDM敏感型过敏性鼻炎的严重程度。本研究还支持SPT在HDM鼻过敏诊断中的作用。

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