抗免疫球蛋白E对季节性变应性鼻结膜炎患者鼻炎症的影响。

Effect of anti-immunoglobulin E on nasal inflammation in patients with seasonal allergic rhinoconjunctivitis.

作者信息

Bez C, Schubert R, Kopp M, Ersfeld Y, Rosewich M, Kuehr J, Kamin W, Berg A V, Wahu U, Zielen S

机构信息

University Children's Hospital, Frankfurt, Germany.

出版信息

Clin Exp Allergy. 2004 Jul;34(7):1079-85. doi: 10.1111/j.1365-2222.2004.01998.x.

DOI:10.1111/j.1365-2222.2004.01998.x

PMID:15248853

Abstract

BACKGROUND

Binding of allergens to IgE on mast cells and basophils causes release of inflammatory mediators in nasal secretions.

OBJECTIVE

The combined effect of specific immunotherapy (SIT) and omalizumab, a humanized monoclonal anti-IgE antibody, on release of eosinophilic cationic protein (ECP), tryptase, IL-6, and IL-8 in nasal secretion was evaluated.

METHODS

Two hundred and twenty five children (aged 6-17 years) with a history of seasonal allergic rhinoconjunctivitis induced by birch and grass pollen were randomized into four groups: either birch- or grass-pollen SIT in combination with either anti-IgE or placebo. Complete sets of nasal secretion samples before treatment Visit 1 (V1), during birch- (V2) and grass (V3)-pollen season and after the pollen season (V4) were collected from 53 patients.

RESULTS

A significant reduction in tryptase only was seen in the anti-IgE-treated group at V2 (P<0.05) and V4 (P<0.05) compared with the placebo group. During the pollen season, patients with placebo showed an increase of ECP compared with baseline (V2: +30.3 microg/L; V3: +134.2 microg/L, P< 0.005; V4: +79.0 microg/L, P< 0.05), and stable levels of tryptase, IL-6 and IL-8. Treatment with anti-IgE resulted in stable ECP values and a significant decrease of tryptase compared with V1 (baseline): V2: -80.0 microg/L (P< 0.05); V3: -56.3 microg/L, which persisted after the pollen season with V4: -71.6 microg/L (P< 0.05). After the pollen season, a decrease of IL-6 was observed in both groups (V4 placebo group: -37.5 ng/L; V4 anti-IgE group: -42.9 ng/L, P< 0.01).

CONCLUSION

The combination of SIT and anti-IgE is associated with prevention of nasal ECP increase and decreased tryptase levels in nasal secretions.

摘要

背景

变应原与肥大细胞和嗜碱性粒细胞上的IgE结合会导致鼻分泌物中炎症介质的释放。

目的

评估特异性免疫疗法（SIT）与奥马珠单抗（一种人源化抗IgE单克隆抗体）联合应用对鼻分泌物中嗜酸性粒细胞阳离子蛋白（ECP）、类胰蛋白酶、白细胞介素-6（IL-6）和白细胞介素-8（IL-8）释放的影响。

方法

225名有桦树和草花粉引起的季节性变应性鼻结膜炎病史的儿童（6-17岁）被随机分为四组：桦树或草花粉SIT联合抗IgE或安慰剂。从53名患者中收集了治疗前第1次就诊（V1）、桦树花粉季节（V2）和草花粉季节（V3）以及花粉季节后（V4）的全套鼻分泌物样本。

结果

与安慰剂组相比，抗IgE治疗组在V2（P<0.05）和V4（P<0.05）时仅类胰蛋白酶有显著降低。在花粉季节，安慰剂组患者的ECP较基线水平升高（V2：+30.3μg/L；V3：+134.2μg/L，P<0.005；V4：+79.0μg/L，P<0.05），类胰蛋白酶、IL-6和IL-8水平稳定。与V1（基线）相比，抗IgE治疗使ECP值稳定，类胰蛋白酶显著降低：V2：-80.0μg/L（P<0.05）；V3：-56.3μg/L，花粉季节后V4时仍为-71.6μg/L（P<0.05）。花粉季节后，两组均观察到IL-6降低（V4安慰剂组：-37.5ng/L；V4抗IgE组：-42.9ng/L，P<0.01）。