Fernández Rivas M, Puyana J, Quirce S, de la Hoz B, Cuesta J, Losada E
Servicio de Alergia, Hospital Ramón y Cajal, Madrid, Spain.
Allergol Immunopathol (Madr). 1990 Mar-Apr;18(2):79-82.
The immediate skin test due to interaction between allergen and mast cell bound IgE is one of the cornerstones in the clinical allergy workup. The release of histamine and other mediators from basophils and mast cells depends on the influx of Ca2+ into these cells when stimulated. The aim of this study was to evaluate the effect of common therapeutic doses of nifedipine (NFD), one of the calcium channel blockers, on the allergen skin tests. We prick tested 23 grass sensitive individuals with 7 different grass pollens at three times: at basal conditions (T0), 30 min. after having taken 20 mg of NFD s. l. (T1), and 17 of them after a week of receiving twice a day 20 mg of a NFD retard form (T2). The wheal surface obtained for each substance (allergen, histamine) at T0 was considered as basal value and compared with the one obtained at T1 and T2 for the same substance by the Wilcoxon's test. We found a significant increase in the wheal surfaces, both with allergen and histamine, at T1 and T2. In contrast to what could be expected, common therapeutic doses of NFD produce a discrete but statistically significant increase of the PT. Factors such as arteriolar vasodilation could be implicated. The increase of the allergen prick test and the increase of the histamine prick test both at T1 and T2 were not statistically different. Therefore, we do not think it necessary to stop NFD before allergen skin testing.
由于变应原与肥大细胞结合的IgE之间相互作用而进行的即时皮肤试验是临床过敏检查的基石之一。当受到刺激时,嗜碱性粒细胞和肥大细胞释放组胺及其他介质取决于Ca2+流入这些细胞。本研究的目的是评估钙通道阻滞剂之一硝苯地平(NFD)的常用治疗剂量对变应原皮肤试验的影响。我们对23名对草过敏的个体用7种不同的草花粉进行点刺试验,共三次:在基础状态下(T0)、口服20mg NFD后30分钟(T1),其中17人在每天两次服用20mg缓释型NFD一周后(T2)。将T0时每种物质(变应原、组胺)获得的风团面积视为基础值,并通过Wilcoxon检验将其与T1和T2时相同物质获得的风团面积进行比较。我们发现在T1和T2时,变应原和组胺引起的风团面积均显著增加。与预期相反,NFD的常用治疗剂量使点刺试验结果有离散但具有统计学意义的增加。诸如小动脉血管舒张等因素可能与之有关。T1和T2时变应原点刺试验的增加和组胺点刺试验的增加在统计学上无差异。因此,我们认为在变应原皮肤试验前没有必要停用NFD。