Rondón Carmen, Romero José J, López Soledad, Antúnez Cristina, Martín-Casañez Enrique, Torres Maria J, Mayorga Cristobalina, R-Pena Rebeca, Blanca Miguel
Allergy Service Carlos Haya Hospital, Málaga, Spain.
J Allergy Clin Immunol. 2007 Apr;119(4):899-905. doi: 10.1016/j.jaci.2007.01.006. Epub 2007 Mar 2.
Allergic rhinitis is an IgE-mediated inflammatory disease of the nasal mucosa, which is usually diagnosed by typical symptoms, positive skin tests, and/or serum specific IgE antibodies to allergens. Despite suggestive symptoms of allergic rhinitis, some patients have a negative diagnostic test for atopy.
To evaluate in the nose the inflammatory response, specific IgE to Dermatophagoides pteronyssinus (DP), and the response to a nasal allergen provocation test with DP (NAPT-DP), in patients with persistent nonallergic rhinitis (PNAR) compared with patients with persistent allergic rhinitis (PAR) and healthy controls.
Fifty patients with PNAR, 30 with PAR to DP, and 30 healthy controls were studied by determining the nasal leukocyte-lymphocyte phenotype by flow cytometry (CD16, CD8, CD4, CD33, CD3, and CD45), nasal eosinophil cationic protein (ECP), albumin, total and specific IgE to DP, and NAPT-DP.
The PNAR patients showed a similar leukocyte-lymphocyte phenotype in nasal lavage to the PAR patients and was different to the healthy controls. Within the PNAR group, 54% showed a positive NAPT-DP, with 22% of these having nasal specific IgE to DP.
These data support the hypothesis that in persistent nonallergic rhinitis some patients may have local inflammation, nasal IgE production, and a positive response to a nasal allergen provocation test despite no evidence of systemic atopy. Further research is needed to evaluate the influence of other perennial allergens and/or immunologic mechanisms.
The local production of IgE antibodies without systemic detection is a condition that should be considered in patients with PNAR.
变应性鼻炎是一种由IgE介导的鼻黏膜炎症性疾病，通常通过典型症状、皮肤试验阳性和/或针对变应原的血清特异性IgE抗体来诊断。尽管有变应性鼻炎的提示性症状，但一些患者的特应性诊断试验结果为阴性。
评估持续性非变应性鼻炎（PNAR）患者与持续性变应性鼻炎（PAR）患者及健康对照相比，鼻内的炎症反应、针对屋尘螨（DP）的特异性IgE以及对DP鼻变应原激发试验（NAPT-DP）的反应。
通过流式细胞术测定鼻灌洗中的白细胞-淋巴细胞表型（CD16、CD8、CD4、CD33、CD3和CD45）、鼻嗜酸性粒细胞阳离子蛋白（ECP）、白蛋白、针对DP的总IgE和特异性IgE以及NAPT-DP，对50例PNAR患者、30例对DP过敏的PAR患者和30例健康对照进行研究。
PNAR患者鼻灌洗中的白细胞-淋巴细胞表型与PAR患者相似，与健康对照不同。在PNAR组中，54%的患者NAPT-DP呈阳性，其中22%的患者鼻内有针对DP的特异性IgE。
这些数据支持以下假设，即持续性非变应性鼻炎患者中，一些患者可能存在局部炎症、鼻内IgE产生以及对鼻变应原激发试验呈阳性反应，尽管没有系统性特应性的证据。需要进一步研究以评估其他常年性变应原和/或免疫机制的影响。
在PNAR患者中应考虑未被系统性检测到的IgE抗体的局部产生情况。
