Fanales-Belasio E, Ciofalo A, Zambetti G, Ansotegui I J, Scala E, Paganelli R, Filiaci F
Department of Allergy and Clinical Immunology, University Hospital La Sapienza, Rome, Italy.
Rhinology. 1995 Sep;33(3):126-31.
Intranasal immunotherapy (IT) has been proposed as a means to induce an effective immunity of the nasal mucosa in patients with allergic rhinitis, avoiding systemic side effects. In the present study 20 individuals with chronic allergic rhinitis, and skin prick test reactive to Dermatophagoides pteronyssinus (DP) only, were randomized and subjected to a three months' double-blind placebo-controlled trial of intranasal IT with DP extract. All patients received also sodium cromoglycate as pre-medication. Before and at the end of the treatment the patients performed specific nasal provocation tests, and samples of serum and nasal secretions were collected to measure total and specific IgE, levels of eosinophil cationic protein (ECP), and mast-cell-derived tryptase. A clinical score was computed by the symptoms indicated by the patients. The clinical score did not change in the two groups after the treatment, whereas a decrease in nasal reactivity was observed. Total IgE increased only in secretions from placebo-treated patients, but were not modified in sera. IgE to DP in sera and nasal secretions did not change significantly. Tryptase levels in nasal secretions decreased in both groups, while ECP was unchanged after IT. Serum ECP levels decreased more in actively treated patients than in the placebo group. The data suggest that changes of IgE and inflammatory mediators may be affected by the use of sodium cromoglycate in both groups, but some parameters change early in different directions in IT- and placebo-treated groups.
鼻内免疫疗法（IT）已被提议作为一种在过敏性鼻炎患者中诱导鼻黏膜有效免疫的方法，以避免全身副作用。在本研究中，20名患有慢性过敏性鼻炎且仅对屋尘螨（DP）皮肤点刺试验呈阳性反应的个体被随机分组，并接受了为期三个月的用DP提取物进行鼻内IT的双盲安慰剂对照试验。所有患者还接受了色甘酸钠作为预处理药物。在治疗前和治疗结束时，患者进行了特异性鼻激发试验，并采集了血清和鼻分泌物样本以测量总IgE和特异性IgE、嗜酸性粒细胞阳离子蛋白（ECP）水平以及肥大细胞衍生的类胰蛋白酶。根据患者指出的症状计算临床评分。治疗后两组的临床评分均未改变，然而观察到鼻反应性有所降低。总IgE仅在接受安慰剂治疗患者的分泌物中增加，但血清中未改变。血清和鼻分泌物中针对DP的IgE没有显著变化。两组鼻分泌物中的类胰蛋白酶水平均降低，而IT治疗后ECP未改变。积极治疗患者的血清ECP水平比安慰剂组下降得更多。数据表明，两组中色甘酸钠的使用可能会影响IgE和炎症介质的变化，但在IT治疗组和安慰剂治疗组中，一些参数在早期会朝着不同方向变化。
