Ciprandi Giorgio, Tosca Maria Angela, Marseglia Gian Luigi, Klersy Catherine
Ospedale San Martino, Genoa, Italy.
Ann Allergy Asthma Immunol. 2005 Feb;94(2):258-61. doi: 10.1016/S1081-1206(10)61305-1.
Allergic rhinitis is characterized by a T(H)2-dependent inflammation. Nasal obstruction is a typical symptom of allergic rhinitis.
To evaluate the possible relationships among nasal symptoms, allergic inflammation, including inflammatory cells and cytokine pattern, and nasal airflow in children with seasonal allergic rhinitis.
Children with seasonal allergic rhinitis and moderate-severe nasal obstruction were evaluated during the pollen season. Total symptom score, rhinomanometry, nasal lavage, and nasal scraping were evaluated in all patients. Inflammatory cells were counted by conventional staining; interleukin 5 (IL-5) and IL-8 levels were measured by immunoassay on fluids recovered from nasal lavage.
Twenty children (11 boys and 9 girls; mean +/- SD age, 12.9 +/- 1.7 years) participated in this study. Eosinophil levels were significantly associated with total symptom score (r = 90.6%, P < .001), IL-5 (r = 94.9%, P < .001), and nasal flow (r = -93.6%, P < .001). No association was elicited with IL-8 (r = 9.4%, P = .69). In a multivariate analysis that included eosinophils, neutrophils, and IL-5, eosinophil levels were shown to be the only independent predictor of nasal flow.
This study demonstrates the close connection between T(H)2 cytokines and eosinophil infiltration. In addition, there is clear evidence concerning the relationship among nasal symptoms, eosinophil infiltration, and nasal airflow. These findings constitute evidence of the relationship between nasal airflow impairment and eosinophilic inflammation in children with seasonal allergic rhinitis.
变应性鼻炎的特征为2型辅助性T细胞（Th2）介导的炎症。鼻塞是变应性鼻炎的典型症状。
评估季节性变应性鼻炎患儿的鼻部症状、变应性炎症（包括炎症细胞和细胞因子模式）与鼻气流之间的可能关系。
在花粉季节对患有季节性变应性鼻炎且有中重度鼻塞的患儿进行评估。对所有患者评估总症状评分、鼻阻力测量、鼻腔灌洗和鼻刮片检查。通过传统染色对炎症细胞进行计数；采用免疫分析法测定从鼻腔灌洗液中回收的液体中的白细胞介素5（IL-5）和IL-8水平。
20名儿童（11名男孩和9名女孩；平均±标准差年龄为12.9±1.7岁）参与了本研究。嗜酸性粒细胞水平与总症状评分（r = 90.6%，P < 0.001）、IL-5（r = 94.9%，P < 0.001）和鼻气流（r = -93.6%，P < 0.001）显著相关。与IL-8无相关性（r = 9.4%，P = 0.69）。在一项纳入嗜酸性粒细胞、中性粒细胞和IL-5的多变量分析中，嗜酸性粒细胞水平被证明是鼻气流的唯一独立预测因素。
本研究证明了Th2细胞因子与嗜酸性粒细胞浸润之间的密切联系。此外，有明确证据表明鼻部症状、嗜酸性粒细胞浸润和鼻气流之间存在关系。这些发现构成了季节性变应性鼻炎患儿鼻气流受损与嗜酸性粒细胞炎症之间关系的证据。
