Kowalczyk Agnieszka, Krogulska Aneta
Department of Paediatrics, Allergology and Gastroenterology, Ludwik Rydygier Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Torun, Poland.
Postepy Dermatol Alergol. 2023 Dec;40(6):779-789. doi: 10.5114/ada.2023.133586. Epub 2024 Jan 8.
A possible mechanism in the pathogenesis of allergic rhinitis (AR) is hypercholesterolemia, which may shift the balance between Th1- and Th2-dependent immune responses towards the latter.
To assess the prevalence of lipid metabolism abnormalities in children with AR and their influence on the clinical course of AR.
The study sample comprised 80 children (7-17 y.o.) with AR, including 28 with associated asthma, and 40 healthy children. Total blood cholesterol, HDL, LDL and triglyceride levels were evaluated (ARCHITECTcSystem). Skin prick tests (Allergopharma) for airborne allergens and a methacholine challenge test (Lungtest 1000, Ispa) were performed. Allergen-specific IgE for airborne allergens (Biocheck GmbH), FeNO and nNO concentrations (HypAir FeNO Medisoft) were measured.
Children with AR were significantly more likely to have normal HDL levels than the control group ( = 70; 87.5% vs. = 27; 67.50%; = 0.03). No significant differences were observed between these two groups regarding total cholesterol, LDL or triglyceride levels ( > 0.05). Abnormally high total cholesterol levels were associated with a higher risk of sensitisation to D. pteronyssinus ( = 18; 72%, = 0.023). Children with normal levels of total cholesterol and normal triglyceride values were less likely to be sensitized to dog dander ( = 43; 78.18%, = 0.049) ( = 42; 72.41%, = 0.042). No significant correlations were observed between lipid parameters and the clinical course of AR, FeNO concentrations, nNO concentrations and bronchial hyperreactivity in children with AR ( > 0.05).
Children with AR are as likely to demonstrate dyslipidaemia as the general population. However, the presence of lipid abnormalities in this group may increase the likelihood of sensitization to perennial allergens.
高胆固醇血症可能是变应性鼻炎（AR）发病机制中的一种潜在机制，它可能会使Th1和Th2依赖的免疫反应之间的平衡偏向后者。
评估AR患儿脂质代谢异常的患病率及其对AR临床病程的影响。
研究样本包括80名患有AR的儿童（7 - 17岁），其中28名伴有哮喘，以及40名健康儿童。评估总胆固醇、高密度脂蛋白（HDL）、低密度脂蛋白（LDL）和甘油三酯水平（ARCHITECTc系统）。进行针对空气传播变应原的皮肤点刺试验（Allergopharma）和乙酰甲胆碱激发试验（Lungtest 1000，Ispa）。测量针对空气传播变应原的变应原特异性IgE（Biocheck GmbH）、呼出一氧化氮（FeNO）和鼻腔一氧化氮（nNO）浓度（HypAir FeNO Medisoft）。
与对照组相比，AR患儿HDL水平正常的可能性显著更高（χ² = 70；87.5%对χ² = 27；67.50%；P = 0.03）。在总胆固醇、LDL或甘油三酯水平方面，这两组之间未观察到显著差异（P > 0.05）。总胆固醇水平异常升高与对屋尘螨致敏的风险较高相关（χ² = 18；72%，P = 0.023）。总胆固醇水平正常且甘油三酯值正常的儿童对狗皮屑致敏的可能性较小（χ² = 43；78.18%，P = 0.049）（χ² = 42；72.41%，P = 0.042）。在AR患儿中，脂质参数与AR的临床病程、FeNO浓度、nNO浓度和支气管高反应性之间未观察到显著相关性（P > 0.05）。
AR患儿出现血脂异常的可能性与普通人群相同。然而，该组中脂质异常的存在可能会增加对常年性变应原致敏的可能性。
