Department of Physical Medicine, Rehabilitation and Occupational Medicine, Medical University of Vienna, Austria.
Center for Public Health, Department of Environmental Health, Medical University of Vienna, Austria.
Clin Immunol. 2020 Jun;215:108422. doi: 10.1016/j.clim.2020.108422. Epub 2020 Apr 15.
IgE-mediated inflammatory responses upon allergen contact in allergic rhinitis (AR) are associated with rapid alterations of circulating blood cell numbers detectable in a complete blood count (CBC). Aim of this study was to evaluate whether intake of antihistamines may modulate allergen-induced CBC dynamics in male and female patients. A total of N = 112 specific allergen challenges were performed in otherwise healthy AR subjects. Seventy-two (n = 72) subjects received placebo and forty (n = 40) received cetirizine (H1-receptor antagonist) per os prior to allergen exposure in a randomized, double-blind trial at the Vienna Challenge Chamber (VCC); a subgroup of twenty-five (n = 25) subjects received cetirizine and placebo on different study days (parallel group). Blood samples and symptom scores were taken at baseline and immediately after 6 h of airway challenge simulating ambient allergen contact. Female sex was associated with a pronounced circulating monocyte increase (p < .01) and male sex with an eosinophil decrease (p < .05) in the placebo group, but not in cetirizine treated subjects. The significant increase in segmented neutrophils (p < .001) and decrease in circulating erythrocytes (p < .01) upon allergen challenge was less prominent after cetirizine intake in both sexes. A more prominent thrombocyte increase in female subjects (p < .05) was noted upon allergen exposure, regardless of prior cetirizine intake. Cetirizine inhibited the mobilization of neutrophils, lymphocytes and decline in erythrocyte numbers, but did not affect thrombocyte increase upon allergen challenge. It further diminished gender-specific blood cell dynamics. Overall, as reflected in a simple CBC, cetirizine critically diminished immediate and late innate immune responses subsequent to allergen exposure.
变应性鼻炎（AR）患者接触过敏原后 IgE 介导的炎症反应与循环血细胞数量的快速变化有关，这些变化在全血细胞计数（CBC）中可检测到。本研究旨在评估抗组胺药是否可调节男性和女性患者过敏原诱导的 CBC 动力学。在维也纳挑战舱（VCC）中进行了一项随机、双盲试验，共有 112 名特应性过敏原挑战的健康 AR 患者接受了研究。72 名患者（n=72）接受安慰剂，40 名患者（n=40）在过敏原暴露前口服西替利嗪（H1 受体拮抗剂）。其中 25 名患者（n=25）接受西替利嗪和安慰剂在不同的研究日（平行组）。在模拟环境过敏原接触的气道挑战后 6 小时，采集基线和即刻的血液样本和症状评分。在安慰剂组中，女性与循环单核细胞明显增加（p<.01）和男性与嗜酸性粒细胞减少（p<.05）相关，但在西替利嗪治疗的患者中没有。在两性中，过敏原挑战后明显增加的分叶核中性粒细胞（p<.001）和循环红细胞减少（p<.01）在西替利嗪摄入后不那么明显。在女性中，无论之前是否摄入西替利嗪，都注意到血小板明显增加（p<.05）。西替利嗪抑制中性粒细胞、淋巴细胞的动员和红细胞数量的下降，但不影响过敏原挑战后的血小板增加。它进一步减少了性别特异性的血细胞动力学。总体而言，正如简单的 CBC 所反映的那样，西替利嗪严重抑制了过敏原暴露后即刻和晚期的固有免疫反应。
