Mosimann B L, White M V, Hohman R J, Goldrich M S, Kaulbach H C, Kaliner M A
Allergic Diseases Section, National Institute of Allergy and Infectious Diseases, Bethesda, MD 20892.
J Allergy Clin Immunol. 1993 Jul;92(1 Pt 1):95-104. doi: 10.1016/0091-6749(93)90043-f.
There is suggestive evidence that neuropeptides participate in allergic reactions. Substance P (SP) and calcitonin gene-related peptide (CGRP) are released by sensory nerves, whereas vasoactive intestinal peptide (VIP) is released mainly by parasympathetic nerves. Both sets of nerves are thought to be stimulated by allergic inflammation. The aim of this study was to assess nasal secretions to determine whether SP, CGRP, and VIP were increased after allergen challenge.
Eight patients with allergic rhinitis were challenged nasally with 1 mg histamine or increasing doses of allergen. Nasal lavages were collected into a cocktail of protease inhibitors in order to restrict neuropeptide degradation. Radioimmunoassay for SP, CGRP, and VIP were performed on each sample.
All patients had immediate clinical reactions to both histamine and allergen challenges, and seven patients experienced a later allergic reaction. After histamine challenge, SP and CGRP did not increase significantly above baseline in the nasal lavages, whereas VIP did (p < 0.02). In contrast, SP, CGRP, and VIP all significantly increased immediately after allergen challenge and returned to baseline within 2 hours. At the clinical peak of the late allergic reaction, SP, but not CGRP or VIP, was increased slightly but significantly (p < 0.01).
Thus SP, CGRP, and VIP are found in nasal secretions after allergen challenge, which confirms that neuropeptides are released in human beings during allergic reactions. The selective stimulation of VIP secretion by histamine challenge suggests that histamine-induced cholinergic reflexes induce the release of VIP. These data support the suggestion that neuropeptides may be partly responsible for some of the nasal symptoms of allergy.
有提示性证据表明神经肽参与过敏反应。P物质（SP）和降钙素基因相关肽（CGRP）由感觉神经释放，而血管活性肠肽（VIP）主要由副交感神经释放。这两组神经都被认为会受到过敏性炎症的刺激。本研究的目的是评估鼻分泌物，以确定变应原激发后SP、CGRP和VIP是否增加。
8例变应性鼻炎患者经鼻给予1 mg组胺或递增剂量的变应原进行激发。将鼻灌洗液收集到含有蛋白酶抑制剂的混合液中，以限制神经肽降解。对每个样本进行SP、CGRP和VIP的放射免疫测定。
所有患者对组胺和变应原激发均有即刻临床反应，7例患者出现迟发性过敏反应。组胺激发后，鼻灌洗液中SP和CGRP没有显著高于基线水平，而VIP升高（p<0.02）。相比之下，变应原激发后SP、CGRP和VIP均立即显著增加，并在2小时内恢复到基线水平。在迟发性过敏反应的临床高峰期，SP略有但显著增加（p<0.01），而CGRP和VIP没有。
因此，变应原激发后在鼻分泌物中发现了SP、CGRP和VIP，这证实了在过敏反应期间人体会释放神经肽。组胺激发对VIP分泌的选择性刺激表明，组胺诱导的胆碱能反射会诱导VIP释放。这些数据支持了神经肽可能部分导致某些鼻部过敏症状的观点。
