Shelley W B, Shelley E D, Ho A K
Lancet. 1983 Apr 16;1(8329):843-6. doi: 10.1016/s0140-6736(83)91386-7.
A patient with cholinergic urticaria syndrome was found to have an unusually large number of muscarinic cholinergic receptors in the urticarial sites. The amplification of these receptors may account for her heightened sensitivity to acetylcholine discharge following exercise, heat, and emotion. The acetylcholine presumably acts directly on the mast-cell membrane to initiate histamine release and thereby punctate urticaria. In addition, an otherwise occult sensitivity to copper was detected with a 48 h contact patch test to the metal followed by an exercise challenge. Under these conditions, the patch test site developed hives after the autonomic stress stimulus of exercise but showed nothing on conventional patch testing before exercise. Such "cholinergic patch testing" is recommended for the demonstration of other examples of antigen enhancement of acetylcholine-mediated reactions.
一名患有胆碱能性荨麻疹综合征的患者被发现其荨麻疹部位的毒蕈碱型胆碱能受体数量异常之多。这些受体的扩增可能解释了她在运动、受热和情绪波动后对乙酰胆碱释放的敏感性增强。乙酰胆碱大概直接作用于肥大细胞膜，引发组胺释放，从而导致点状荨麻疹。此外，通过对金属进行48小时接触斑贴试验并随后进行运动激发试验，检测出了一种原本隐匿的对铜的敏感性。在这些条件下，斑贴试验部位在运动的自主应激刺激后出现了荨麻疹，但在运动前的传统斑贴试验中却没有任何表现。推荐进行这种“胆碱能斑贴试验”以证明乙酰胆碱介导反应的抗原增强的其他实例。
