Castelli Sveva, Arasi Stefania, Pawankar Ruby, Matricardi Paolo M
Department of Paediatric Pneumology & Immunology, Charité - Universitätsmedizin Berlin, Berlin, Germany.
Department of Pediatrics-Allergy Unit, University of Messina, Messina, Italy.
Curr Opin Allergy Clin Immunol. 2018 Feb;18(1):1-9. doi: 10.1097/ACI.0000000000000412.
The identification of immunological markers in nasal secretions and tears is becoming essential in the study of allergic diseases. The collection procedure of nasal and ocular secretions directly influences the results, thus it is of paramount importance to validate and standardize the sampling process.
Current techniques for nasal secretions sampling are mainly based on three principles: collection of spontaneous secretions, nasal washings, and absorption. Collection of spontaneous secretions is appropriate in subjects with nasal hypersecretion, whereas in healthy individuals the collected volume is frequently insufficient. Nasal washings are associated with an unpredictable, high dilution and concentrations of markers often fall below detection limits of immunological assays. Absorption seem to provide the best compromise between sufficient sample amounts and detectability of inflammatory mediators and immunoglobulin E. Tear samples can be obtained by glass capillary tubes, filter paper strips and ophthalmic sponges. Volumes are however small or highly diluted through reflex tearing.
Secretions reflect the local inflammatory activity and provide valuable information about the immunological reaction to allergens at the target organ. There is increasing evidence of the potential clinical role of their analysis, for diagnosis, and monitoring of allergic rhino-conjunctivitis. Appropriate collection and processing is very important and requires special attention.
在变应性疾病研究中，鉴定鼻分泌物和泪液中的免疫标志物变得至关重要。鼻分泌物和眼分泌物的采集程序直接影响结果，因此验证和规范采样过程至关重要。
目前鼻分泌物采样技术主要基于三个原则：自发性分泌物采集、鼻腔冲洗和吸收法。自发性分泌物采集适用于鼻分泌物过多的受试者，而在健康个体中，采集到的量往往不足。鼻腔冲洗会导致不可预测的高稀释度，标志物浓度常常低于免疫测定的检测限。吸收法似乎在足够的样本量与炎症介质和免疫球蛋白E的可检测性之间提供了最佳折衷方案。泪液样本可通过玻璃毛细管、滤纸和眼科海绵获取。然而，由于反射性流泪，样本量小或高度稀释。
分泌物反映局部炎症活动，并提供有关靶器官对变应原免疫反应的有价值信息。越来越多的证据表明其分析在变应性鼻结膜炎的诊断和监测中具有潜在临床作用。适当的采集和处理非常重要，需要特别关注。
