Kramer M F, Jordan T R, Pfrogner E, Rasp G
Klinik und Poliklinik für Hals-, Nasen-, und Ohrenheilkunde am Klinikum Grosshadern, Ludwig-Maximilians-Universität München. Matthias.
Laryngorhinootologie. 2005 Jul;84(7):503-10. doi: 10.1055/s-2005-861402.
Mucosa-immunologic aspects are gaining an increasing awareness in the pathophysiology of type I allergies. Humoral mucosal immune responses are dominated by secretory IgA, but there is evidence for a relevant role of IgG in nasal mucosa-associated lymphoid tissue.
was to measure allergen-specific immunoglobulins (IgA and IgG) in nasal secretions as an expression of a humoral mucosal immune response in allergic rhinitis. For tissue eosinophilia we studied nasal Eosinophilic Cationic Protein (ECP) and for mast cell activation nasal tryptase.
Nasal secretions of 40 patients suffering from allergic rhinitis were analyzed for allergen-specific IgA, IgG, and IgE, and for ECP and tryptase. Patients were highly sensitized against the major allergens of house dust mites, timothy, and birch pollen. 43 non-atopic individuals served as controls. In order to study possible effects of the actual pollen season on the studied parameter we secondly compared patients allergic to seasonal allergens co- (n = 28) and extra-seasonally (n = 41). In order to determine a possible influence of allergen-specific IgA in eosinophilic degranulation we additionally studied 5 patients after nasal allergen challenge.
In allergic rhinitis we found significantly increased levels of allergen-specific immunoglobulins of all studied subclasses and allergens in nasal secretions. Comparison of nasal ECP and tryptase showed significantly increased concentrations in allergic individuals as well. Co-seasonally we found elevated allergen-specific IgE, ECP, and tryptase but lower concentrations of allergen-specific IgA and IgG. There was no association between late phase eosinophilia and IgA concentrations after local allergen challenge.
The occurrence of allergen-specific immunoglobulins in nasal secretions is interpreted as a local humoral mucosal immune response. The physiologic role of local allergen-specific immunoglobulins is not clear to date. Involvement in degranulation of eosinophils or mast cells, like suggested before, seems unlikely.
黏膜免疫方面在I型过敏的病理生理学中日益受到关注。体液黏膜免疫反应以分泌型IgA为主，但有证据表明IgG在鼻黏膜相关淋巴组织中发挥相关作用。
测量鼻分泌物中变应原特异性免疫球蛋白（IgA和IgG），作为变应性鼻炎中体液黏膜免疫反应的一种表现。对于组织嗜酸性粒细胞增多，我们研究了鼻嗜酸性粒细胞阳离子蛋白（ECP），对于肥大细胞活化，研究了鼻类胰蛋白酶。
分析40例变应性鼻炎患者的鼻分泌物中的变应原特异性IgA、IgG和IgE，以及ECP和类胰蛋白酶。患者对屋尘螨、梯牧草和桦树花粉的主要变应原高度敏感。43名非特应性个体作为对照。为了研究实际花粉季节对研究参数的可能影响，我们其次比较了对季节性变应原过敏的患者，其中同时期过敏的患者有28例，非同时期过敏的患者有41例。为了确定变应原特异性IgA在嗜酸性粒细胞脱颗粒中的可能影响，我们另外研究了5例鼻变应原激发后的患者。
在变应性鼻炎患者中，我们发现鼻分泌物中所有研究亚类和变应原的变应原特异性免疫球蛋白水平显著升高。鼻ECP和类胰蛋白酶的比较显示，变应性个体中的浓度也显著升高。在同时期过敏患者中，我们发现变应原特异性IgE、ECP和类胰蛋白酶升高，但变应原特异性IgA和IgG浓度较低。局部变应原激发后，晚期嗜酸性粒细胞增多与IgA浓度之间无关联。
鼻分泌物中变应原特异性免疫球蛋白的出现被解释为局部体液黏膜免疫反应。目前尚不清楚局部变应原特异性免疫球蛋白的生理作用。如之前所提示的，参与嗜酸性粒细胞或肥大细胞的脱颗粒似乎不太可能。
