Bascom R, Naclerio R M, Fitzgerald T K, Kagey-Sobotka A, Proud D
Department of Medicine, University of Maryland School of Medicine, Baltimore 21201.
Am Rev Respir Dis. 1990 Sep;142(3):594-601. doi: 10.1164/ajrccm/142.3.594.
The effect of oxidant inhalation on allergic illness is of interest because allergic patients often report increased respiratory symptoms during episodes of poor air quality, and epidemiologic studies demonstrate an association between increased levels of the air pollutant ozone and exacerbations of asthma. The purpose of this study was to characterize the upper respiratory response to ozone inhalation in asymptomatic, allergic subjects and to determine whether ozone pre-exposure increased the acute response to nasal challenge with antigen in these subjects. A group of 12 asymptomatic subjects with a history of allergic rhinitis were exposed in a randomized, cross-over design, at rest, on each of 2 days, separated by 2 wk, to 4 h of clean air or 0.5 ppm ozone in an environmental chamber. Following the exposure period, subjects underwent nasal challenge with four doses of antigen (1 to 1,000 PNU ragweed or grass). Symptoms were rated and nasal lavage performed after each dose. Measurement of histamine and albumin concentration and TAME-esterase activity and determination of cell counts and differentials were performed. Exposure to ozone caused significant increases in upper and lower respiratory symptoms, a mixed inflammatory cell influx with a sevenfold increase in naval lavage neutrophils, a 20-fold increase in eosinophils, and a tenfold increase in mononuclear cells, as well as an apparent sloughing of epithelial cells. There was a significant increase in nasal lavage albumin concentration on the ozone exposure day and a small increase in nasal lavage histamine concentration on both the ozone and clean air exposure days. TAME-esterase activity showed no significant increase overall, but increased at least twofold in 5 of 12 subjects. (ABSTRACT TRUNCATED AT 250 WORDS)
吸入氧化剂对过敏性疾病的影响备受关注,因为过敏患者常在空气质量差的时段报告呼吸道症状加重,且流行病学研究表明空气污染物臭氧水平升高与哮喘发作加剧之间存在关联。本研究的目的是描述无症状过敏受试者对吸入臭氧的上呼吸道反应,并确定臭氧预暴露是否会增加这些受试者对抗原鼻腔激发的急性反应。一组12名有过敏性鼻炎病史的无症状受试者,采用随机交叉设计,在休息状态下,于相隔2周的2天中,每天在环境舱内暴露于清洁空气4小时或0.5 ppm臭氧4小时。暴露期结束后,受试者接受四剂抗原(1至1000 PNU豚草或草)的鼻腔激发。每剂后对症状进行评分并进行鼻腔灌洗。测量组胺和白蛋白浓度、TAME酯酶活性,并确定细胞计数和分类。暴露于臭氧导致上、下呼吸道症状显著增加,出现混合性炎症细胞流入,鼻腔灌洗中性粒细胞增加7倍,嗜酸性粒细胞增加20倍,单核细胞增加10倍,同时上皮细胞明显脱落。臭氧暴露当天鼻腔灌洗白蛋白浓度显著增加,臭氧和清洁空气暴露当天鼻腔灌洗组胺浓度均有小幅增加。TAME酯酶活性总体上无显著增加,但12名受试者中有5名至少增加了两倍。(摘要截短于250字)