Wang Nan, Ma Qianzi, Zhai Jiayuan, Che Yanlu, Liu Junjie, Tang Tianwei, Sun Yanan, Wang Jingting, Yang Wanchao
Department of Otorhinolaryngology, Head and Neck Surgery, Qingdao Women and Children's Hospital, Qingdao, China.
Department of Otorhinolaryngology, Head and Neck Surgery, The Second Affiliated Hospital, Harbin Medical University, Harbin, China.
World Allergy Organ J. 2024 Sep 11;17(10):100970. doi: 10.1016/j.waojou.2024.100970. eCollection 2024 Oct.
Allergic rhinitis (AR) is an allergic reaction dominated by the Th2 immune response in the nasal mucosa. The bacterial infection process affects the balance between Th1 and Th2 immune responses, and the level of exposure to environmental flora is closely related to the development of AR. Hydrogen (H) is a medical molecule with anti-inflammatory and antioxidant properties. This study aimed to explore the possible mechanism of action of H on AR through its ability to regulate the balance of nasal flora.
Serum eosinophil count (EOS), immunoglobulin E (IgE) concentration, visual analog scale (VAS), total nasal symptom score (TNSS), and rhinoconjunctivitis quality of life questionnaire (RQLQ) were observed before and after hydrogen inhalation in AR patients. Skin prick test (SPT) was used to determine allergen sensitisation. Community composition and relative abundance of nasal flora were examined before and after hydrogen inhalation and in normal subjects using 16S rRNA gene sequencing.
There were no adverse reactions during and after hydrogen inhalation in AR patients, with a favorable safety profile and significant improvements in VAS, TNSS, EOS, and IgE (P < 0.05). Cavity flora 16S rRNA gene sequencing showed higher abundance of Ruminococcus and Erysipelotrichaceae flora in the nasal cavity of AR patients than in normal subjects, and their abundance could be down-regulated after H inhalation. H significantly increased the abundance of Blautia_faecis and negatively correlated with VAS, TNSS, EOS, and IgE.
H may improve symptoms in AR patients by modulating the distribution of nasal flora. Trials with larger sample sizes are required to further test this hypothesis.
This trial was registered in the China Clinical Trial Registry (Registration No. ChiCTR2200062253).
变应性鼻炎（AR）是一种以鼻黏膜Th2免疫反应为主导的过敏反应。细菌感染过程影响Th1和Th2免疫反应之间的平衡，环境菌群的暴露水平与AR的发生密切相关。氢气（H）是一种具有抗炎和抗氧化特性的医学分子。本研究旨在通过其调节鼻腔菌群平衡的能力，探讨H对AR的可能作用机制。
观察AR患者吸入氢气前后的血清嗜酸性粒细胞计数（EOS）、免疫球蛋白E（IgE）浓度、视觉模拟评分（VAS）、总鼻症状评分（TNSS）和鼻结膜炎生活质量问卷（RQLQ）。采用皮肤点刺试验（SPT）确定过敏原致敏情况。采用16S rRNA基因测序检测AR患者吸入氢气前后及正常受试者鼻腔菌群的群落组成和相对丰度。
AR患者吸入氢气期间及之后均未出现不良反应，安全性良好，VAS、TNSS、EOS和IgE均有显著改善（P < 0.05）。鼻腔菌群16S rRNA基因测序显示，AR患者鼻腔中瘤胃球菌属和丹毒丝菌科菌群的丰度高于正常受试者，吸入H后其丰度可下调。H显著增加了粪便布劳特氏菌的丰度，且与VAS、TNSS、EOS和IgE呈负相关。
H可能通过调节鼻腔菌群分布改善AR患者的症状。需要更大样本量的试验来进一步验证这一假设。
本试验在中国临床试验注册中心注册（注册号：ChiCTR2200062253）。
