University Hospital Leuven, Division of Otorhinolaryngology, Kapucijnevoer 33, 3000 Leuven, Belgium.
Am J Respir Cell Mol Biol. 2011 Apr;44(4):517-23. doi: 10.1165/rcmb.2009-0425OC. Epub 2010 Jun 10.
Although the concept of "global airway allergy" has become widely accepted during recent years, nasobronchial interaction and its mechanisms remain incompletely understood. The experimental study of the effect of nasal allergen deposition on lower airway pathology is hampered by the difficulty of avoiding lower airway penetration of the allergens. In ovalbumin-sensitized mice with experimental airway allergy, nasal allergen provocations were performed after complete anatomical separation of upper and lower airways by means of a tracheotomy. A canula was inserted in the trachea, and the trachea was ligated, thus inhibiting any passage of allergens from upper to lower airways. Mice showed bronchial hyperresponsiveness to methacholine as early as 4 hours after nasal allergen provocation in the absence of recruitment of inflammatory cells. An increased substance P (SP) concentration in the bronchial lumen was found, as well as an increased number of SP-positive pulmonary nerves. Treatment with a neurokinin (NK) 1 receptor antagonist abolished the allergen-induced bronchial hyperresponsiveness. Moreover, endobronchial administration of SP caused NK1 receptor-dependent bronchial hyperresponsiveness in mice with airway allergy. Nasal allergen provocation rapidly induces bronchial hyperresponsiveness via pulmonary up-regulation of SP and activation of NK1 receptors.
尽管近年来“全球气道过敏”的概念已被广泛接受,但鼻支气管相互作用及其机制仍不完全清楚。由于难以避免过敏原穿透下呼吸道,因此对鼻过敏原沉积对上呼吸道病理学影响的实验研究受到阻碍。在通过气管切开术完全分离上、下呼吸道的实验性气道过敏的卵清蛋白致敏小鼠中,进行鼻过敏原激发。将插管插入气管并结扎气管,从而抑制过敏原从上呼吸道到下呼吸道的任何穿透。在鼻过敏原激发后 4 小时,即使没有炎症细胞募集,小鼠也表现出对乙酰甲胆碱的支气管高反应性。发现支气管腔中的 P 物质(SP)浓度增加,并且 SP 阳性肺神经的数量增加。用神经激肽(NK)1 受体拮抗剂治疗可消除过敏原引起的支气管高反应性。此外,在气道过敏的小鼠中,支气管内给予 SP 可引起 NK1 受体依赖性支气管高反应性。鼻过敏原激发通过肺内 SP 的上调和 NK1 受体的激活迅速诱导支气管高反应性。