Liu Yue-Hui, Tao Ze-Zhang
Department of Otorhinolaryngology Head and Neck Surgery, Renmin Hospital of Wuhan University, Wuhan 440060, China.
Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2009 Nov;44(11):935-40.
To investigate the influence of inhaled glucocorticoid on the pathological change of the nasal mucosa in allergic rhinitis.
One hundred and eighty Sprague-Dawley (SD) rats were selected. According to the random number table, these animals were randomly divided into two groups: the control Group A and the experimental group. There were 60 rats in Group A and 120 rats in experimental group. First of all, the rats in experimental group were sensitized by intra-peritoneal injection with ovalbumin (OVA), enhanced and local stimulated. Next, the rats in the experimental group were randomly divided into B and C groups. The number of rats in each group was 60. Group B still had the intranasal dropping on each side with OVA in the same volume and concentration twice a week. The rats in Group C also had the intranasal dropping on each side with OVA in the same volume and concentration twice a week. But, at the same time, these animals had fluticasone propionate (FP) nasal spray each side 50 microl/per day. While doing intra-peritoneal injection with physiological saline in the same volume and intranasal dropping on the rats in normal Group A. Ten rats from each group were randomly selected to be killed at the end of first, second, fourth, eighth, twelfth and sixteenth weeks after treatment. One from the ten rats in each group was used for micro-vascular casting of nasal mucosa, and the remaining nine were used for pathological examination.
The model of the rats in experimental group was established successfully. After allergen stimulation, the nasal mucosa showed metaplasia of the goblet cells, epithelial denudation, inflammatory cells infiltration especially eosinophils, hyperplasia of the number of gland and density of micro-blood vessels. The capillary became netted. Cilia of epithelial shed to different extent and were uneven, and the layers of reticular formation of basal membrane became thick, and collagen deposition and fabric hyperplasia were seen under the electron microscope. In Group B, due to continuously contact with allergen, the mucosa remodeling enhanced. In Group C, glucocorticoid controlled the symptoms of allergic rhinitis better, but the cilia of epithelial shed, metaplasia of the goblet cells, inflammatory cells infiltration, hyperplasia of gland and micro-blood vessels, collagen deposition and fabric hyperplasia also could be seen in rat nasal mucosa.
The pathological change of the nasal mucosa was found in allergic rhinitis. If the allergen was continuously contacted, the pathological change aggravated. Glucocorticoid could control the symptoms of allergic rhinitis better and reverse the mucosa pathological change to some extent, but it could not retro-converse or repair the nasal mucosa while the irreversibile change had occurred.
探讨吸入糖皮质激素对变应性鼻炎鼻黏膜病理改变的影响。
选取180只Sprague-Dawley（SD）大鼠。根据随机数字表，将这些动物随机分为两组：对照组A和实验组。A组60只大鼠，实验组120只大鼠。首先，实验组大鼠通过腹腔注射卵清蛋白（OVA）进行致敏、强化及局部刺激。接下来，实验组大鼠随机分为B组和C组。每组大鼠60只。B组仍每周两次以相同体积和浓度的OVA滴鼻双侧。C组同样每周两次以相同体积和浓度的OVA滴鼻双侧。但同时，这些动物每天每侧给予50微升丙酸氟替卡松（FP）鼻喷雾剂。正常A组大鼠腹腔注射相同体积的生理盐水并滴鼻。治疗后第1、2、4、8、12和16周结束时，每组随机选取10只大鼠处死。每组10只大鼠中的1只用于鼻黏膜微血管铸型，其余9只用于病理检查。
实验组大鼠模型成功建立。变应原刺激后，鼻黏膜出现杯状细胞化生、上皮剥脱、炎性细胞浸润尤其是嗜酸性粒细胞、腺体数量增生及微血管密度增加。毛细血管呈网状。上皮纤毛不同程度脱落且不均匀，基底膜网状结构层数增厚，电镜下可见胶原沉积及纤维增生。B组因持续接触变应原，黏膜重塑增强。C组中，糖皮质激素能更好地控制变应性鼻炎症状，但大鼠鼻黏膜仍可见上皮纤毛脱落、杯状细胞化生、炎性细胞浸润、腺体及微血管增生、胶原沉积及纤维增生。
变应性鼻炎存在鼻黏膜病理改变。若持续接触变应原，病理改变加重。糖皮质激素能较好地控制变应性鼻炎症状并在一定程度上逆转黏膜病理改变，但当不可逆改变发生时，不能使其逆转为正常或修复鼻黏膜。
