Kojima T, Asakura K
Department of Otolaryngology, Sapporo Medical College.
Nihon Jibiinkoka Gakkai Kaiho. 1991 Mar;94(3):366-76. doi: 10.3950/jibiinkoka.94.366.
In order to clarify the details of a late phase response (LPR) in allergic rhinitis, serial changes of nasal symptoms and concentration of chemical mediators (histamine, leukotriene (LT) C4 and kinins) in nasal lavage fluid were investigated after the nasal antigen challenge in ten patients with perennial allergic rhinitis with a positive intradermal skin reaction to mite extract. Samples were collected periodically for 8 hours following the challenge. Nasal airway resistance (NAR) and clinical symptoms were also recorded serially. Three out of ten patients showed only early phase response (EPR) and the other seven patients showed both early and late phase response after the challenge. The chief nasal symptom in LPR was nasal obstruction. In EPR, concentrations of chemical mediators in the nasal lavage fluid always increased. In dual (early and late) phase responders, increases of chemical mediators in nasal lavage fluids were notable during both early and late phase responses. In EPR, there was a significant correlation between severity of sneezing attack and concentration of histamine. In LPR, increase of LTC4 level was significantly correlated with the increase of NAR. RAST score and daily nasal symptoms tended to be higher and more sever in dual phase responders compared with early phase responders. We suggest that the amounts of released chemical mediators during allergic reaction denoted the LPR in allergic rhinitis patients.
为了阐明变应性鼻炎迟发相反应（LPR）的详细情况，我们对10例对螨提取物皮内皮肤反应阳性的常年性变应性鼻炎患者进行鼻内抗原激发试验后，研究了鼻症状的连续变化以及鼻灌洗液中化学介质（组胺、白三烯（LT）C4和激肽）的浓度。激发试验后8小时定期采集样本。还连续记录鼻气道阻力（NAR）和临床症状。10例患者中有3例仅表现为早发相反应（EPR），另外7例患者在激发试验后表现为早发相和迟发相反应。LPR中主要的鼻部症状是鼻塞。在EPR中，鼻灌洗液中化学介质的浓度总是升高的。在双相（早发和迟发）反应者中，鼻灌洗液中化学介质在早发相和迟发相反应期间均显著升高。在EPR中，喷嚏发作的严重程度与组胺浓度之间存在显著相关性。在LPR中，LTC4水平的升高与NAR的升高显著相关。与早发相反应者相比，双相反应者的RAST评分和每日鼻部症状往往更高且更严重。我们认为变应性反应期间释放的化学介质的量表明了变应性鼻炎患者的LPR。
