Ferreira M Branco, Santos A Spinola, Santos M C Pereira, Carlos M L Palma, Barbosa M A Pereira, Carlos A G Palma
Immunoallergology Unit, Hospital de Santa Maria CHIUL, Faculty of Medicine, University of Lisbon, Portugal.
Eur Ann Allergy Clin Immunol. 2005 Mar;37(3):96-102.
Specific immunotherapy (SIT) is an effective treatment in allergic rhinitis and it has been shown to decrease nasal ECP rise after allergen challenge.
To evaluate if the kynetics of nasal ECP release after specific nasal challenge could be changed by SIT and if these changes were related to the dose of allergen administered.
75 allergic rhinitis patients, monosensitized to house dust mites were included: 25 controls and 50 SIT-treated patients. These patients were divided in two groups: one receiving a high dose of the allergenic extract (Group 2) and other receiving a lower dose (Group 1). Nasal challenges were performed at the beginning of the study (T0), after 6 (T1) and after 12 months (T2). Nasal ECP values were measured in nasal lavages before challenge and one and four hours after obtaining a positive reaction. Patients were also asked in every visit to evaluate on a visual analog scale the intensity of their disease in the previous month.
SIT was effective in improving subjective (visual analog scale) and objective parameters (nasal allergenic reactivity). Both SIT groups had significant differences between T0 and T2 values and comparing with control patients. SIT reduced significantly mean post-provocation ECP values in both groups and reduced the number of patients that showed increase in nasal ECP > 100% of basal values in each of the SIT-treated groups. The changes in nasal ECP values and particularly in nasal ECP patterns were more pronounced in Group 2 than in Group 1 but the differences did not reach statistical significance.
SIT can inhibit nasal ECP increase after allergen challenge, frequently present in non SIT-treated patients. This effect is more pronounced and reaches statistical significance earlier in patients receiving higher doses of the allergenic extract used in SIT.
特异性免疫疗法（SIT）是治疗变应性鼻炎的一种有效方法，已证实其可降低变应原激发后鼻内嗜酸性粒细胞阳离子蛋白（ECP）水平的升高。
评估特异性鼻激发后鼻ECP释放的动力学是否会因SIT而改变，以及这些改变是否与变应原的给药剂量有关。
纳入75名单一尘螨致敏的变应性鼻炎患者，其中25名作为对照，50名接受SIT治疗。这些患者分为两组：一组接受高剂量变应原提取物（第2组），另一组接受低剂量变应原提取物（第1组）。在研究开始时（T0）、6个月后（T1）和12个月后（T2）进行鼻激发试验。在激发前以及出现阳性反应后1小时和4小时测量鼻灌洗液中的鼻ECP值。每次就诊时还要求患者使用视觉模拟量表评估前一个月疾病的严重程度。
SIT可有效改善主观（视觉模拟量表）和客观参数（鼻变应性反应性）。两个SIT组在T0和T2值之间以及与对照患者相比均有显著差异。SIT显著降低了两组激发后ECP的平均水平，并减少了每个SIT治疗组中鼻ECP升高超过基础值100%的患者数量。第2组鼻ECP值的变化，尤其是鼻ECP模式的变化比第1组更明显，但差异未达到统计学意义。
SIT可抑制变应原激发后鼻ECP水平的升高，这在未接受SIT治疗的患者中较为常见。在接受SIT中使用的高剂量变应原提取物的患者中，这种作用更明显，且在更早时间达到统计学意义。
