Department of Otolaryngology, Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing, China.
Department of Otolaryngology, Eye and ENT Hospital, Fudan University, Shanghai, China.
Int Arch Allergy Immunol. 2023;184(6):587-597. doi: 10.1159/000529436. Epub 2023 Mar 7.
Macrophages play a central role in balancing the immune response by switching phenotypes between the M1 and M2 profiles according to a delicate equilibrium. Based on a previous clinical trial (NCT03649139), this study aimed to evaluate the change in M2 macrophages during pollen exposure in seasonal allergic rhinitis (SAR).
Nasal symptom scores were recorded. Peripheral M2 macrophages were investigated according to cell surface markers, and M2-associated cytokine/chemokine release in serum and nasal secretion were assessed. In vitro pollen stimulation tests were performed, and polarized macrophage subsets were analyzed by flow cytometry.
Compared to baseline, the percentage of peripheral CD163+ M2 macrophages in CD14+ monocytes increased during the pollen season (p < 0.001) and at the end of treatment (p = 0.004) in the SLIT group. The percentage of CD206+CD86- M2 cells in M2 macrophages during the pollen season was higher than that at baseline and at the end of SLIT. On the other hand, the percentage of CD206-CD86+ M2 cells in M2 macrophages significantly increased at the end of treatment in the SLIT group compared to baseline (p = 0.049), the peak pollen period (p = 0.017), and the placebo group (p = 0.0023). M2-associated chemokines CCL26 and YKL-40 were significantly increased during the pollen season in the SLIT group and remained higher at the end of SLIT than at baseline. Correspondingly, in vitro study demonstrated that Artemisia annua promoted M2 macrophage polarization in pollen-induced AR patients.
Significant M2 macrophage polarization was promoted when patients with SAR were exposed to the allergen, either naturally exposed in pollen seasons or subjectively continuously exposed during the course of SLIT.
巨噬细胞根据微妙的平衡，在 M1 和 M2 表型之间切换表型，从而在平衡免疫反应中发挥核心作用。基于先前的临床试验（NCT03649139），本研究旨在评估季节性变应性鼻炎（SAR）患者暴露于花粉时 M2 巨噬细胞的变化。
记录鼻部症状评分。根据细胞表面标志物研究外周 M2 巨噬细胞，并评估血清和鼻分泌物中 M2 相关细胞因子/趋化因子的释放。进行体外花粉刺激试验，并通过流式细胞术分析极化的巨噬细胞亚群。
与基线相比，SLIT 组在花粉季节（p < 0.001）和治疗结束时（p = 0.004）外周血 CD14+单核细胞中 CD163+M2 巨噬细胞的百分比增加。M2 巨噬细胞中 CD206+CD86-M2 细胞的百分比在花粉季节高于基线和 SLIT 治疗结束时。另一方面，与基线相比，SLIT 组在治疗结束时 M2 巨噬细胞中 CD206-CD86+M2 细胞的百分比明显增加（p = 0.049），花粉高峰期（p = 0.017）和安慰剂组（p = 0.0023）。在 SLIT 组中，M2 相关趋化因子 CCL26 和 YKL-40 在花粉季节明显增加，并且在 SLIT 治疗结束时仍高于基线。相应地，体外研究表明，青蒿素可促进花粉诱导的 AR 患者 M2 巨噬细胞极化。
SAR 患者暴露于过敏原时，无论是在花粉季节自然暴露还是在 SLIT 过程中主观持续暴露，都会明显促进 M2 巨噬细胞极化。
