Rak S, Björnson A, Håkanson L, Sörenson S, Venge P
Department of Lung Medicine, Central Hospital, Västerås, Sweden.
J Allergy Clin Immunol. 1991 Dec;88(6):878-88. doi: 10.1016/0091-6749(91)90244-i.
Two groups of birch pollen--allergic patients with seasonal rhinoconjunctivitis and asthma were followed during two consecutive birch-pollen seasons, one group, N = 10, during a season with high pollen load, and one group, N = 15, during a season of low pollen load. Half the patients were treated with immunotherapy (IT) for 3 and 4 years, respectively. The other half of the patients served as control group (non-IT). Bronchoalveolar lavage (BAL) was performed once before each season and once during the pollen season. Eosinophil (EOS) numbers in BAL were increased (p less than 0.01) during the season with high pollen load but not in the season with a low pollen load, and this increment was absent in the IT-treated group. Also, the EOS cationic protein levels were raised in the non-IT-treated group during the season with a high pollen load. The levels of EOS and neutrophil chemotactic activity were raised in BAL in both seasons in the non-IT-treated group compared with the IT-treated group (p less than 0.02, p less than 0.003, p less than 0.04, and p less than 0.005 in high- and low-load pollen season, respectively). Serum and BAL eosinophil chemotactic activity (ECA) were positively correlated (p less than 0.001). We conclude that there is an influx of active EOSs into the lung of pollen-allergic patients with asthma during a pollen season, which may be abrogated by IT. Furthermore, the generation of ECA appears to be an extremely sensitive marker of antigenic exposure, and the potent inhibition of the generation of ECA by IT may provide a clue as to the mechanism of this treatment.
两组桦树花粉过敏且患有季节性鼻结膜炎和哮喘的患者在连续两个桦树花粉季节接受随访，一组（N = 10）处于花粉负荷高的季节，另一组（N = 15）处于花粉负荷低的季节。一半患者分别接受了3年和4年的免疫疗法（IT）治疗。另一半患者作为对照组（非IT组）。在每个季节前和花粉季节期间各进行一次支气管肺泡灌洗（BAL）。花粉负荷高的季节BAL中的嗜酸性粒细胞（EOS）数量增加（p < 0.01），而花粉负荷低的季节则没有增加，并且IT治疗组没有这种增加。此外，在花粉负荷高的季节，非IT治疗组的EOS阳离子蛋白水平升高。与IT治疗组相比，非IT治疗组在两个季节的BAL中EOS和中性粒细胞趋化活性水平均升高（花粉高负荷和低负荷季节分别为p < 0.02、p < 0.003、p < 0.04和p < 0.005）。血清和BAL嗜酸性粒细胞趋化活性（ECA）呈正相关（p < 0.001）。我们得出结论，在花粉季节，患有哮喘的花粉过敏患者的肺部有活性EOS流入，IT可能会消除这种情况。此外，ECA的产生似乎是抗原暴露的一个极其敏感的标志物，IT对ECA产生的有效抑制可能为这种治疗的机制提供线索。
