Steiner Iwona, Sobieska Magdalena, Pucher Beata, Grzegorowski Michał, Samborski Włodzimierz
Klinika Otolaryngologii Dzieciecej Akademii Medycznej im. K. Marcinkowskiego, Poznań.
Ann Acad Med Stetin. 2006;52(2):33-7; discussion 37.
Allergic rhinitis is an inflammatory disorder of upper respiratory tract (about 15 per cent of the population in industrialized countries suffer from this condition), characterized by frequent sneezing and a runny or stuffy nose sometimes accompanied by watery eyes. As the most common allergic condition, allergic rhinitis affects people of all ages. Boys are twice as likely to get allergic rhinitis than girls. The median age of onset of the condition is 10 years old, meaning that equal numbers of children develop the condition before and after age 10. Symptoms usually appear in childhood first and then lessen by the age of 30 or 40. Seasonal allergic rhinitis usually results from tree, grass or weed pollen. With this type of rhinitis, symptoms will decrease with the arrival of cold weather. Perennial allergic rhinitis can cause year-round symptoms. This allergic reaction is the result of indoor irritants such as feathers, mold spores, animal dander (hair and skin shed by pets) or dust mites. It is often aggravated by a food allergy, the most common being an allergy to milk. Acute phase proteins (APP) belong to the most ancient part of the unspecific immunity and contribute markedly to the keeping of homeostasis. As much as 30 various proteins are for the moment regarded as APP. Being multifunctional regulators and effectors APP stay in multiple relations to practically all types of cells and molecules. Among APP following functional groups may be described: transport proteins (transferrin, ceruloplasmin and haptoglobin), clotting factors (fibrinogen), antiproteases (alpha1-antitrypsin, alpha1-antichymotrypsin, alpha2-macroglobulin), complement components (C3, C4) and several proteins of hardly known function, like C-reactive protein (CRP), serum amyloid A, acid alpha1-glycoprotein (AGP) and others.
From a group of 32 children, aged from 5 to 14 years, with symptoms of seasonal allergic rhinitis, and from a control group of 10 healthy children sex and age matched, blood sample was taken after written parents' consent. In all children skin tests (Stallergens) were performed at the beginning of the year. Any reaction was present in the control group. Following proteins were analyzed: CRP, AGP, alpha1-antichymotrypsin (ACT), transferrin, ceruloplasmin (Cp), alpha1-antitrypsin, haptoglobin and alpha2-macroglobulin (A2M).
C-reactive protein level was very low, what allowed us to exclude all acute conditions. As expected, AGP and ACT concentrations were not elevated, either, and even non significantly lower values were observed in allergic children in comparison to controls. It is worth noticing that transferrin concentration was statistically lower in allergic children, as well as A2M and Cp concentrations. All this suggest an on-going disturbance in cytokine network that may directly affect both the iron metabolism and the non-specific immunity.
It may be stated that allergic rhinitis causes impairment of acute phase proteins synthesis, which may affect natural defense or homeostasis in the immune system of a child.
过敏性鼻炎是上呼吸道的一种炎症性疾病（在工业化国家约15%的人口患有此病），其特征是频繁打喷嚏、流鼻涕或鼻塞，有时还伴有流泪。作为最常见的过敏病症，过敏性鼻炎影响所有年龄段的人。男孩患过敏性鼻炎的可能性是女孩的两倍。该病的中位发病年龄为10岁，这意味着10岁前后患此病的儿童数量相等。症状通常首先在儿童期出现，然后在30岁或40岁时减轻。季节性过敏性鼻炎通常由树、草或杂草花粉引起。患这种鼻炎时，症状会随着寒冷天气的到来而减轻。常年性过敏性鼻炎可导致全年症状。这种过敏反应是由室内刺激物引起的，如羽毛、霉菌孢子、动物皮屑（宠物脱落的毛发和皮肤）或尘螨。它常因食物过敏而加重，最常见的是对牛奶过敏。急性期蛋白（APP）属于非特异性免疫最古老的部分，对维持体内平衡有显著作用。目前有多达30种不同的蛋白质被视为APP。作为多功能调节因子和效应器，APP与几乎所有类型的细胞和分子都有多种关系。在APP中，可以描述以下功能组：转运蛋白（转铁蛋白、铜蓝蛋白和触珠蛋白）、凝血因子（纤维蛋白原）、抗蛋白酶（α1-抗胰蛋白酶、α1-抗糜蛋白酶、α2-巨球蛋白）、补体成分（C3、C4）以及几种功能几乎未知的蛋白质，如C反应蛋白（CRP）、血清淀粉样蛋白A、酸性α1-糖蛋白（AGP）等。
从一组32名年龄在5至14岁、有季节性过敏性鼻炎症状的儿童以及一组10名年龄和性别匹配的健康儿童对照组中，在获得家长书面同意后采集血样。在年初对所有儿童进行皮肤试验（Stallergens）。对照组未出现任何反应。分析了以下蛋白质：CRP、AGP、α1-抗糜蛋白酶（ACT）、转铁蛋白、铜蓝蛋白（Cp）、α1-抗胰蛋白酶、触珠蛋白和α2-巨球蛋白（A2M）。
C反应蛋白水平非常低，这使我们能够排除所有急性病症。正如预期的那样，AGP和ACT浓度也没有升高，与对照组相比，过敏性儿童中甚至观察到非显著更低的值。值得注意的是，过敏性儿童中转铁蛋白浓度在统计学上较低，A2M和Cp浓度也是如此。所有这些表明细胞因子网络正在受到干扰，这可能直接影响铁代谢和非特异性免疫。
可以说过敏性鼻炎会导致急性期蛋白合成受损，这可能会影响儿童免疫系统的自然防御或体内平衡。
