Dokic D, Trajkovska-Dokic E
University Clinic of Pulmology and Allergy, Medical Faculty Skopje, R. Macedonia.
Pril (Makedon Akad Nauk Umet Odd Med Nauki). 2013;34(1):131-41.
A double-blind randomised trail design was used to address the effect of ambient ozone on the nasal airways and to evaluate the effects of ozone on allergic mucosa. Ten grass pollen allergic rhinitics were exposed for 2 hours at rest on 2 separate occasions to 400 ppb ozone and filtered air respectively. The exposure to 400 ppb ozone and filtered air was performed prior to the grass pollen season and again during the season. Baseline nasal lavage in which histamine, eosinophil cationic protein (ECP), myeloperoxidase (MPO), total proteins, and albumin were measured and neutrophils, eosinophils and epithelial cells were counted, was made immediately prior to exposure (-120 min). After 2 h of exposure to ozone/filtered air repeated measurements were performed at 0, 30, 60, 120, 240, 360 minutes post exposure. Significant increases were observed when exposed to ozone versus filtered air during the pollen season for histamine (AUC1; p=0.05), MPO (AUC2; p=0.05), ECP (AUC2; p=0.008), total proteins (AUC, p=0.02; AUC1, p=0.007; AUC2, p=0.05), and albumin (AUC, p=0.007; AUC1, p=0.02; AUC2, p=0.005). There was also a significant increase in the total protein level (AUC, p=0.05; AUC1, p=0.02; AUC2 p=0.05) and albumin (AUC, p=0.03; AUC1, p=0.03; AUC2, p=0.04) after ozone exposure versus air out of season. Significant increase of the neutrophils (p=0.01 and p=0.007) in the nasal lavage fluid (NLF) at time points 0 min and 360 min respectively were observed, while eosinophils and epithelial cells significantly increased only at time point 360 min (p=0.02 and p=0.02 respectively) all of them after ozone exposure versus filtered air during the season. Neutrophils also significantly increased in the NLF at time point 0 min and 360 min (p=0.03 and p=0.01) while epithelial cells increased only at time point 360 min (p=0.01) after ozone exposure versus filtered air out of season. We can conclude that ozone induces neutrophil and eosinophil recruitment into the nose and this is accompanied by activation, as evidenced by release of MPO and ECP in NAL. Pre-existing allergic mucosal inflammation during the pollen season, exaggerates the response to ozone, particularly in relationship to the recruitment of eosinophils and neutrophils 6h following exposure.
采用双盲随机试验设计来研究环境臭氧对鼻气道的影响，并评估臭氧对过敏性黏膜的作用。10名草花粉过敏性鼻炎患者在两个不同时段分别静息暴露于400 ppb臭氧和过滤空气中2小时。在草花粉季节之前以及季节期间再次进行400 ppb臭氧和过滤空气的暴露。在暴露前（-120分钟）立即进行基础鼻灌洗，检测组胺、嗜酸性粒细胞阳离子蛋白（ECP）、髓过氧化物酶（MPO）、总蛋白和白蛋白，并计数中性粒细胞、嗜酸性粒细胞和上皮细胞。在暴露于臭氧/过滤空气2小时后，于暴露后0、30、60、120、240、360分钟进行重复测量。在花粉季节，与过滤空气相比，暴露于臭氧时组胺（AUC1；p=0.05）、MPO（AUC2；p=0.05）、ECP（AUC2；p=0.008）、总蛋白（AUC，p=0.02；AUC1，p=0.007；AUC2，p=0.05）和白蛋白（AUC，p=0.007；AUC1，p=0.02；AUC2，p=0.005）均有显著增加。在非花粉季节，与过滤空气相比，暴露于臭氧后总蛋白水平（AUC，p=0.05；AUC1，p=0.02；AUC2 p=0.05）和白蛋白（AUC，p=0.03；AUC1，p=0.03；AUC2，p=0.04）也有显著增加。分别在0分钟和360分钟时，观察到鼻灌洗液（NLF）中中性粒细胞显著增加（p=0.01和p=0.007），而嗜酸性粒细胞和上皮细胞仅在360分钟时显著增加（分别为p=0.02和p=0.02），所有这些均发生在花粉季节暴露于臭氧与过滤空气之后。在非花粉季节，与过滤空气相比，暴露于臭氧后，NLF中中性粒细胞在0分钟和360分钟时也显著增加（p=0.03和p=0.01），而上皮细胞仅在360分钟时增加（p=0.01）。我们可以得出结论，臭氧诱导中性粒细胞和嗜酸性粒细胞募集至鼻腔，并且伴随着活化，如NAL中MPO和ECP的释放所证明。花粉季节预先存在的过敏性黏膜炎症会夸大对臭氧的反应，尤其是在暴露后6小时嗜酸性粒细胞和中性粒细胞的募集中表现明显。
