Small P, Biskin N, Barrett D
SMBD-Jewish General Hospital, Montreal, Quebec, Canada.
Ann Allergy. 1994 Sep;73(3):252-8.
Thirty-seven asymptomatic ragweed-sensitive patients and ten controls were challenged both epicutaneously and intranasally with ragweed. Clinical assessments of both early (20 minutes) and late (six hours) phase reactions of skin (mm) and nose (clinical score) were performed. A positive routine nasal challenge was defined as a clinical score 5 (0-12). Augmented nasal challenges were 10-fold higher than routine for each patient. Nasal lavage was performed at baseline, after positive challenge, one, two, and six hours postchallenge. Mediators assayed included histamine, eosinophil cationic protein (ECP), leukotrine C4 (LTC4), and prostaglandin D2 (PGD2). All 37 patients had an early skin reaction. Only 28/37 had a late response correlating with the early. Twenty-one patients had routine nasal challenges; 14 then volunteered for an augmented challenge. The remaining 16 had augmented challenges only. All had a nasal clinical early response, but late responses were infrequent (9). The early phase PGD2 was higher in augmented compared with routine challenges (P < .05) as were the late histamine (P < .05) and ECP (P < .05). The early skin test correlated with early LTC4 (P < .001) and PGD2 (P < .05). The early and late LTC4 (P < .05) and PGD2 (P < .01) were also related. In summary, late phase reactions of both the nose and skin are related to the intensity of the early response.
37名无症状的豚草敏感患者和10名对照者接受了豚草的皮肤和鼻内激发试验。对皮肤（毫米）和鼻子（临床评分）的早期（20分钟）和晚期（6小时）阶段反应进行了临床评估。常规鼻激发试验阳性定义为临床评分为5（0 - 12）。每名患者的增强鼻激发试验剂量比常规剂量高10倍。在基线、阳性激发试验后、激发试验后1小时、2小时和6小时进行鼻腔灌洗。检测的介质包括组胺、嗜酸性粒细胞阳离子蛋白（ECP）、白三烯C4（LTC4）和前列腺素D2（PGD2）。所有37名患者都有早期皮肤反应。只有28/37有与早期反应相关的晚期反应。21名患者进行了常规鼻激发试验；其中14名随后自愿接受增强激发试验。其余16名仅接受增强激发试验。所有人都有鼻临床早期反应，但晚期反应很少见（9例）。与常规激发试验相比，增强激发试验的早期PGD2更高（P < 0.05），晚期组胺（P < 0.05）和ECP（P < 0.05）也是如此。早期皮肤试验与早期LTC4（P < 0.001）和PGD2（P < 0.05）相关。早期和晚期LTC4（P < 0.05）和PGD2（P < 0.01）也相关。总之，鼻子和皮肤的晚期反应都与早期反应的强度有关。
