[持续性变应性鼻炎患者鼻分泌物及血浆中白三烯D4的变化及抗组胺药的作用]

[Changes of leukotriene D4 in nasal discharge and plasma of patients with persistent allergic rhinitis and the effects of antihistamine].

作者信息

Luo Hong, Yu Ye, Shen Ying, Zeng Ligang, Yan Nengbing, Ke Feng, Fu Xuanxiang, Wang Pengju, Kong Weijia

机构信息

Department of Otorhinolaryngology, Xiangyang Hospital, Tongji Medical College, Huazhong University of Science and Technology, the Central Hospital of Xiangyang, 441021, China.

出版信息

Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2011 Apr;25(8):342-6.

PMID:21761705

Abstract

OBJECTIVE

To investigate the changes of leukotriene D4 (LTD4) in nasal discharge and plasma of patients with persistent allergic rhinitis (AR) and the effects of antihistamine.

METHOD

The investigation was a prospective, randomized controlled trial. Forty AR patients (group C) were divided randomly into two subgroup. One group received oral antihistamine 10 mg everyday for one week (group CA) and another group received no loratadine tablets 10 mg everyday for one week (group CB). Fifteen age matched healthy (group D) people were enrolled as control. The level of LTD4 and interleukin-5 (IL-5) in both nasal discharge and plasma by using enzyme linked immunosorbent assay (ELISA) and enzyme immunoassay (EIA), cell counts and cell differentials in nasal discharge, were measured before and after three month. The clinical symptom and life quality scores of group C were also investigated.

RESULT

The concentrations of LTD4 in nasal discharge [(794 +/- 305) pg] and plasma [(5219 +/- those in group D [(347 +/- 169) pg, (2283 +/- 489) ng/L, all P 1185) ng/L] in group C were significantly higher than those in group D [(347 +/- 169) pg, (2283 +/- 489) ng/L, all P < 0.05]. The level of LTD4 in nasal discharge was positively correlated with the percentage of neutrophil (r = 0.453, P < 0.05) and IL-5 (r = 0.364, P < 0.05). The pre- and post-therapy concentrations of nasal discharge and plasma in group CA were (812 +/- 1592) pg, (657 +/- 495) pg and (5422 +/- 935) ng/L, (4589 +/- 1057) ng/L respectively; While in group CB the concentrations were (776 +/- 227) pg, (860 +/- 194) pg and (5074 +/- 1850) ng/L, (6063 +/- 450) ng/L, respectively. There were no significant difference either in the level of LTD4 in nasal discharge or in plasma in both groups (all P > 0.05).

CONCLUSION

The results suggested that LTD4 was involved in airway inflammation in AR. Antihistamine was not effective enough in decreasing the levels of LTD4 in both nasal discharge and plasma of AR patients.

摘要

目的

探讨持续性变应性鼻炎（AR）患者鼻分泌物和血浆中白三烯D4（LTD4）的变化及抗组胺药的作用。

方法

本研究为前瞻性随机对照试验。40例AR患者（C组）随机分为两个亚组。一组每天口服10mg抗组胺药，共1周（CA组）；另一组每天不服用10mg氯雷他定片，共1周（CB组）。纳入15例年龄匹配的健康人（D组）作为对照。采用酶联免疫吸附测定（ELISA）和酶免疫测定（EIA）法分别检测治疗前和治疗3个月后鼻分泌物和血浆中LTD4和白细胞介素-5（IL-5）的水平，同时检测鼻分泌物中的细胞计数和细胞分类。对C组患者的临床症状和生活质量评分进行调查。

结果

C组鼻分泌物中LTD4浓度[（794±305）pg]和血浆中LTD4浓度[（5219±1185）ng/L]显著高于D组[（347±169）pg，（2283±489）ng/L，均P<0.05]。鼻分泌物中LTD4水平与中性粒细胞百分比（r=0.453，P<0.05）和IL-5水平（r=0.364，P<0.05）呈正相关。CA组治疗前后鼻分泌物和血浆中LTD4浓度分别为（812±1592）pg、（657±495）pg和（5422±935）ng/L、（4589±1057）ng/L；而CB组分别为（776±227）pg、（860±194）pg和（5074±185）ng/L、（6063±450）ng/L。两组鼻分泌物和血浆中LTD4水平均无显著差异（均P>0.05）。