Millqvist E, Johansson A, Bende M
Asthma and Allergy Research Group, Sahlgrenska University Hospital, Gothenburg, Sweden.
Clin Exp Allergy. 2004 Apr;34(4):619-23. doi: 10.1111/j.1365-2222.2004.1937.x.
It is well known that some patients with allergy complain of airway symptoms from chemicals (ASCs) and strong odours. However, the importance of such information for the treatment of allergic disease is not known. Such symptoms in non-allergic patients have previously been shown to be related to increased sensory nerve reactivity, which is expressed as increased cough sensitivity to inhaled capsaicin.
The aim of this study was to examine ASC in atopic patients and relate it to cough reaction to capsaicin inhalation.
Fifty-seven consecutively chosen, skin prick-positive patients with symptoms of the upper and/or lower airways completed a questionnaire concerning ASC. The patients were then divided into two groups, those with and those without such symptoms. Both groups were provoked with inhaled capsaicin in three increments and compared with 73 healthy control subjects.
Out of 57 atopic patients, 34 reported ASC agents and 23 did not. The patients with ASC were older (P<0.01) and coughed significantly more on capsaicin provocation (P<0.001), but did not differ from them with respect to the allergic disease or its treatment or to smoking habits. Patients with atopy but without ASC did not differ from healthy controls with regard to sensitivity to capsaicin inhalation. The scored degree of ASC was directly related to the number of coughs during the capsaicin provocation.
ASC in atopic patients are related to increased airway sensory nerve reactivity. There is still no explanation for this in certain patients with atopy, but age may be a confounding factor.
众所周知，一些过敏患者会抱怨因接触化学物质（ASC）和强烈气味而出现气道症状。然而，此类信息对过敏性疾病治疗的重要性尚不清楚。此前已表明，非过敏患者的此类症状与感觉神经反应性增加有关，这表现为对吸入辣椒素的咳嗽敏感性增加。
本研究旨在检查特应性患者中的ASC，并将其与吸入辣椒素后的咳嗽反应相关联。
连续选取57名皮肤点刺试验阳性且有上呼吸道和/或下呼吸道症状的患者，完成一份关于ASC的问卷。然后将患者分为两组，有此类症状的和没有此类症状的。两组患者均以三种递增剂量吸入辣椒素进行激发试验，并与73名健康对照者进行比较。
在57名特应性患者中，34名报告有ASC诱因，23名没有。有ASC的患者年龄较大（P<0.01），在辣椒素激发试验时咳嗽明显更多（P<0.001），但在过敏性疾病及其治疗或吸烟习惯方面与无ASC的患者无差异。有特应性但无ASC的患者在吸入辣椒素的敏感性方面与健康对照者无差异。ASC的评分程度与辣椒素激发试验期间的咳嗽次数直接相关。
特应性患者中的ASC与气道感觉神经反应性增加有关。对于某些特应性患者，对此仍无法解释，但年龄可能是一个混杂因素。
