Passali D, Bellussi L, Gaudio E
Cattedra di Clinica ORL-Università de L'Aquilla.
Acta Otorhinolaryngol Ital. 1990;10 Suppl 28:53-62.
The histological integrity of the nasal mucosa assures full efficacy of the respiratory, conditioning and defense functions. Together with ciliated and goblet cells, the respiratory epithelium not only carries out mucociliary clearance but it is also responsible for correct assembly of secretory IgA, the foundation of the mucosal defense system. The secretory component stabilizing the immunoglobulin molecule is indeed, an epithelial glycoprotein which begins to fail when the mucous trophism is altered through inflammatory processes of various natures. The efficacy of an anti-inflammatory drug (tiaprofenic acid) can thus be proven not only because the respiratory and mucociliary transport functions are normalized but, histologically speaking, through an accumulation of IgA in the epithelial cells and nasal secretions as well. In the present experiment the effect of tiaprofenic acid on the local production of antibodies appears prompt and long lasting. On the contrary, respiratory function and mucocillary transport are more deeply affected by structural alterations of the epithelium, most likely because the histological integrity-demonstrated by the increase of IgA in the secretion and accumulation of the secretory component in the epithelium-is the starting point for a perfect coordination according to fixed biological rhythms of all nasal functions.
鼻黏膜的组织学完整性确保了呼吸、调节和防御功能的充分发挥。呼吸上皮细胞与纤毛细胞和杯状细胞一起,不仅执行黏液纤毛清除功能,还负责分泌型IgA的正确组装,而分泌型IgA是黏膜防御系统的基础。稳定免疫球蛋白分子的分泌成分实际上是一种上皮糖蛋白,当黏液营养通过各种性质的炎症过程发生改变时,它就会开始失效。因此,一种抗炎药物(噻洛芬酸)的疗效不仅可以通过呼吸和黏液纤毛运输功能恢复正常得到证明,从组织学角度来看,还可以通过上皮细胞和鼻分泌物中IgA的积累得到证明。在本实验中,噻洛芬酸对局部抗体产生的影响迅速且持久。相反,呼吸功能和黏液纤毛运输受上皮结构改变的影响更大,这很可能是因为组织学完整性(通过分泌物中IgA的增加和上皮中分泌成分的积累来证明)是所有鼻功能根据固定生物节律完美协调的起点。