Clinical Department of Internal Disease, Dermatology and Allergology in Zabrze, Medical University of Silesia, Katowice, Poland,
Department of Biochemistry, School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia, Katowice, Poland.
Int Arch Allergy Immunol. 2020;181(11):831-838. doi: 10.1159/000509438. Epub 2020 Aug 7.
Different endotypes of rhinitis are known, but its pathomechanism has not been conclusively established. For example, the precise difference between systemic allergic rhinitis (SAR) and local allergic rhinitis (LAR) is still being checked. Comparison of patients with LAR and with allergies to birch of those with intermittent allergic rhinitis, same allergy, or with non-allergic rhinitis (NAR) was the purpose of this study.
Twenty-six patients with LAR, 18 with SAR and allergy to birch, and 21 with NAR were included. Patients who met the inclusion criteria were selected to undergo the following procedures at baseline: medical examinations, nasal provocation test (NPT), detection of nasal-specific IgE to birch as well as basophil activation test (BAT). All immunological parameters were detected before and after NPT.
Concentration of nasal IgE to Bet v1 increased comparably in the LAR and SAR groups after NPT to birch as follows: in 21 (81%) patients with LAR, 14 (78%) with SAR, and in everyone in the NAR group. Serum concentration of allergen-specific IgE to Bet v1 increased significantly from a median of 20.7 (25-75% interval: 11.2-35.6) IU/mL to 29.9 (13.6-44.1) (p = 0.028) after NPT in patients with SAR. Allergen-specific IgE to Bet v1 was absent in all patients with LAR and NAR before and after NPT. BAT with Bet v1 was positive in 22 (85%) patients with LAR, in 14 (78%) with SAR, and 2 (9.5%) with NAR.
These obtained data suggest there are no potential mechanisms that could explain LAR compared to SAR.
鼻炎有不同的表型，但其发病机制尚未明确。例如，全身性过敏性鼻炎（SAR）和局部过敏性鼻炎（LAR）之间的确切区别仍在研究中。本研究旨在比较 LAR 患者与对桦树过敏的患者、间歇性过敏性鼻炎患者、同种过敏患者和非过敏性鼻炎（NAR）患者之间的差异。
共纳入 26 例 LAR 患者、18 例对桦树过敏的 SAR 患者和 21 例 NAR 患者。符合纳入标准的患者在基线时接受以下检查：体格检查、鼻激发试验（NPT）、桦树特异性 IgE 检测和嗜碱性粒细胞活化试验（BAT）。所有免疫参数均在 NPT 前后进行检测。
NPT 后，LAR 组和 SAR 组的鼻 IgE 对 Bet v1 的浓度均有类似增加：21 例（81%）LAR 患者、14 例（78%）SAR 患者和 NAR 组的所有患者均如此。NPT 后，SAR 患者血清特异性 IgE 对 Bet v1 的浓度从中位数 20.7（25-75%区间：11.2-35.6）IU/ml 显著增加至 29.9（13.6-44.1）IU/ml（p = 0.028）。NPT 前后，所有 LAR 和 NAR 患者的特异性 IgE 对 Bet v1 均为阴性。LAR 患者的 BAT 阳性率为 85%（22/26），SAR 患者为 78%（14/18），NAR 患者为 9.5%（2/21）。
这些数据表明，与 SAR 相比，LAR 没有潜在的机制可以解释。
