Bachert C
HNO-Klinik, Universität Heidelberg.
Immun Infekt. 1990 Oct;18(5):164-8.
The allergic reaction of the human nasal mucosa (Type I Coombs and Gell) can be divided in an immediate- and a late-phase reaction. The degranulation of IgE-bearing mast cells is crucial for the initiation of the immediate phase (app. 30 min). Mediators of these cells - especially histamine - cause the typical allergic symptoms. Some of the patients develop a late-phase reaction after a symptom-free interval. Eosinophils migrate into the epithelial lining and release mediators. Furthermore, mast cells increase in number in the epithelium. Other cells like macrophages and T lymphocytes may be involved as well. While the released mediators cause an unspecific mucosal hyperreactivity, the increased number of IgE-bearing mast cells leads to a specific immunological augmentation of the nasal reaction ("priming effect"). The allergic pathomechanism can be reduced by drugs at different points.
人类鼻黏膜的过敏反应（I型库姆斯和盖尔反应）可分为速发相反应和迟发相反应。含IgE的肥大细胞脱颗粒对于速发相反应（约30分钟）的启动至关重要。这些细胞的介质——尤其是组胺——会引发典型的过敏症状。一些患者在无症状期后会出现迟发相反应。嗜酸性粒细胞迁移到上皮层并释放介质。此外，上皮层中的肥大细胞数量会增加。其他细胞如巨噬细胞和T淋巴细胞也可能参与其中。虽然释放的介质会导致非特异性的黏膜高反应性，但含IgE的肥大细胞数量增加会导致鼻反应的特异性免疫增强（“启动效应”）。过敏发病机制可在不同环节通过药物降低。
