Section of Allergology, Sahlgrenska University Hospital, Gothenburg 413 45, Sweden.
Department of Rheumatology and Inflammation Research, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
Clin Transl Allergy. 2014 May 30;4:19. doi: 10.1186/2045-7022-4-19. eCollection 2014.
Birch pollen allergic patients frequently experience gastrointestinal upset accompanied by a local allergic inflammation in the small intestine especially during the pollen season. However, it is not known if the GI pathology is connected to the subjective symptoms of the patient. The objective of this study was to evaluate the immune pathology of the duodenal mucosa and the serum IgE antibody profiles in birch pollen allergic patients in relation to their gastrointestinal symptoms, during and outside the birch pollen season.
Thirty-two patients with birch pollen allergy and sixteen healthy controls were enrolled in the study. Twenty allergic patients had gastrointestinal symptoms and twelve did not. All participants underwent an allergy investigation and gastroscopy with duodenal biopsy. The duodenal biopsies were retrieved during the pollen season (May-June) and off-season (November-March). The biopsies were immunostained for mast cells (IgE and tryptase), eosinophils, T cells (CD3), and dendritic cells (CD11c). Pollen-specific IgE antibodies were determined by ImmunoCAP and component microarray (ISAC).
Patients in both pollen allergic groups showed similar degree of intestinal allergic inflammation during the pollen season regardless of gastrointestinal symptoms. The eosinophils, mast cells and dendritic cells were increased in the mucosa. Patients with gastrointestinal symptoms had significantly elevated IgE antibodies to birch (rBet v 1), hazelnut (rCor a 1), and apple (rMal d1) during the pollen season.
Patients allergic to birch pollen have clear signs of an ongoing allergic inflammation in their intestinal mucosa, which is aggravated during the pollen season. The magnitude of the allergic intestinal inflammation is not associated with subjective gastrointestinal symptoms of the individual patient.
桦树花粉过敏患者常出现胃肠道不适，并伴有小肠局部过敏炎症，尤其是在花粉季节。然而，目前尚不清楚胃肠道病理是否与患者的主观症状有关。本研究旨在评估桦树花粉过敏患者的十二指肠黏膜免疫病理学和血清 IgE 抗体谱与胃肠道症状的关系，以及在桦树花粉季节内外的情况。
本研究纳入 32 例桦树花粉过敏患者和 16 例健康对照者。20 例过敏患者有胃肠道症状，12 例无胃肠道症状。所有参与者均接受过敏调查和胃镜检查及十二指肠活检。在花粉季节（5-6 月）和非花粉季节（11-3 月）采集十二指肠活检。对十二指肠活检进行免疫染色，以检测肥大细胞（IgE 和类胰蛋白酶）、嗜酸性粒细胞、T 细胞（CD3）和树突状细胞（CD11c）。花粉特异性 IgE 抗体通过 ImmunoCAP 和成分微阵列（ISAC）进行测定。
花粉季节两组花粉过敏患者的肠道过敏炎症程度相似，无论是否有胃肠道症状。黏膜中嗜酸性粒细胞、肥大细胞和树突状细胞增多。花粉季节有胃肠道症状的患者桦树（rBet v 1）、榛子（rCor a 1）和苹果（rMal d1）的 IgE 抗体显著升高。
对桦树花粉过敏的患者其肠道黏膜存在持续的过敏炎症迹象，且在花粉季节加重。过敏肠道炎症的严重程度与个体患者的主观胃肠道症状无关。
