Sale R, Silvestri M, Battistini E, Defilippi A-C, Sabatini F, Pecora S, Rossi G A
Pulmonary Division, G. Gaslini Institute, Genoa, Italy.
Allergy. 2003 Nov;58(11):1171-5. doi: 10.1034/j.1398-9995.2003.00286.x.
In atopic subjects, dysfunctions of the upper and lower airways frequently coexist and allergic rhinitis seems to constitute a risk factor for the occurrence of asthma in predisposed individuals.
To evaluate whether in atopic subjects nasal inflammation could reflect changes in respiratory functions, 11 allergic children, sensitized to house dust mites (HDM), with rhinoconjunctivitis and asthma and 10 nonatopic controls (ctrs) were studied.
All subjects underwent nasal brushing to detect percentages of nasal eosinophils (Eos %) and intercellular adhesion molecule-1 (ICAM-1) expression by nasal epithelial cells. In the same day pulmonary function tests, i.e. forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1), forced expiratory flows at 25-75% of the vital capacity (FEF25-75%) and methacholine (MCh) bronchial inhalation challenge were also evaluated.
Pulmonary function parameters were not significantly different in allergic children and in ctrs (P > 0.05), while a significant increase in bronchial reactivity to MCh, expressed as Pd20 MCh, was detected in the former population (P < 0.05). As compared with ctrs, allergic children showed elevated Eos % and ICAM-1 expression (P < 0.05). When nasal inflammation and pulmonary function parameters were compared, a significant correlation was found between nasal Eos % and bronchial reactivity to MCh (P = 0.002).
These data support the concept of significant links between upper and lower respiratory tract involvement in atopic children sensitized to HDM.
在特应性个体中，上、下呼吸道功能障碍常常并存，变应性鼻炎似乎是易感个体发生哮喘的一个危险因素。
为了评估在特应性个体中鼻炎症是否能反映呼吸功能的变化，对11名对屋尘螨（HDM）致敏、患有鼻结膜炎和哮喘的变应性儿童以及10名非特应性对照者进行了研究。
所有受试者均接受鼻拭子检查，以检测鼻嗜酸性粒细胞百分比（Eos%）和鼻上皮细胞细胞间黏附分子-1（ICAM-1）的表达。在同一天还评估了肺功能测试，即用力肺活量（FVC）、第1秒用力呼气量（FEV1）、肺活量25%-75%时的用力呼气流量（FEF25-75%）以及乙酰甲胆碱（MCh）支气管吸入激发试验。
变应性儿童和对照者的肺功能参数无显著差异（P>0.05），而在前一组人群中检测到对MCh的支气管反应性显著增加，以Pd20 MCh表示（P<0.05）。与对照者相比，变应性儿童的Eos%和ICAM-1表达升高（P<0.05）。当比较鼻炎症和肺功能参数时，发现鼻Eos%与对MCh的支气管反应性之间存在显著相关性（P=0.002）。
这些数据支持了对HDM致敏的特应性儿童上、下呼吸道受累之间存在显著联系的观点。
