Xiao Caiwen, Li Hanlin, Li Hui, Cheng Zhiying, Qin Jing, Zhou Wei, He Qingwen, Xu Xiang
Department of Otolaryngology, Affiliated Hospital, Jianghan University, Wuhan 430015, China.
Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2010 Oct;24(20):924-7.
To explore the effects of specific immunotherapy by the nasal spray and/or sublingual contain on the regulation the balance of serum Th1/Th2 cell ratio, and the expression of total IgE (tIgE) level in perennial allergic rhinitis patients.
Thirty-six cases of allergic rhinitis of perennial (PAR) patients with nasal specific immunotherapy (nasal spray group) were chosen as the object of study, 36 PAR patients with sublingual specific immunotherapy (sublingual group) were chosen for the efficacy comparison group, and 32 cases of healthy adults as control (normal control group). The levels of serum IL-2, IL-4, IL-8 and tIgE in PAR nasal spray group and sublingual group were examined by IRMA and double-antibody sandwich assay before and after the treatment of specific immunotherapy (SIT); The content of IFN-gamma was determined by enzyme-linked immunosorbent assay; The infiltration and changes of eosinophilic granulocyte were observed by the smear of nasal secretions.
In nasal spray group and sublingual group, the contents of serum Th1 cytokines IL-2 and IFN-gamma were reduced levels significantly, while the contents of Th2 cytokines IL-4, IL-8 and tIgE were significantly increased before the treatment of SIT. After the SIT to the maintenance dose, the levels of IL-2 and IFN-gamma in serum were significantly higher than that before treatment, while IL-4, IL-8 and tIgE content were significantly lower in AR patients (P < 0.01 or P < 0.05). The clinical efficacy of nasal spray group and sublingual group were 97.22% and 94.44%, while the two groups was no statistical difference in efficacy (P > 0.05).
With the presence of Th1/Th2 cell ratio and cytokine imbalance, the AR patients manifested as Th2 cell function in accentuation. Nasal mucosa and/or sublingual in the local SIT can have changed no-balance Th1/Th2 cell of by regulating the balance of serum Th1/Th2 cell ratio, the expression level of cytokine expression and the level of tIgE.
探讨鼻喷和/或舌下含服特异性免疫疗法对常年性变应性鼻炎患者血清Th1/Th2细胞比例平衡调节及总IgE（tIgE）水平表达的影响。
选取36例常年性变应性鼻炎（PAR）患者行鼻特异性免疫疗法（鼻喷组）作为研究对象，选取36例PAR患者行舌下特异性免疫疗法（舌下组）作为疗效比较组，选取32例健康成年人作为对照（正常对照组）。采用免疫放射分析（IRMA）和双抗体夹心测定法检测PAR鼻喷组和舌下组特异性免疫疗法（SIT）治疗前后血清IL-2、IL-4、IL-8及tIgE水平；采用酶联免疫吸附测定法测定IFN-γ含量；通过鼻分泌物涂片观察嗜酸性粒细胞浸润及变化情况。
鼻喷组和舌下组在SIT治疗前，血清Th1细胞因子IL-2和IFN-γ含量显著降低，而Th2细胞因子IL-4、IL-8及tIgE含量显著升高。SIT至维持剂量后，AR患者血清中IL-2和IFN-γ水平显著高于治疗前，而IL-4、IL-8及tIgE含量显著降低（P<0.01或P<0.05）。鼻喷组和舌下组的临床有效率分别为97.22%和94.44%，两组疗效差异无统计学意义（P>0.05）。
AR患者存在Th1/Th2细胞比例及细胞因子失衡，表现为Th2细胞功能亢进。鼻黏膜和/或舌下局部SIT可通过调节血清Th1/Th2细胞比例平衡、细胞因子表达水平及tIgE水平，改变失衡的Th1/Th2细胞。
