肠道黏膜屏障的评估：特应性皮炎患儿抗原转移增加的证据。

Evaluation of the gut mucosal barrier: evidence for increased antigen transfer in children with atopic eczema.

作者信息

Majamaa H, Isolauri E

机构信息

Medical School, University of Tampere, Department of Pediatrics, Finland.

出版信息

J Allergy Clin Immunol. 1996 Apr;97(4):985-90. doi: 10.1016/s0091-6749(96)80074-1.

DOI:10.1016/s0091-6749(96)80074-1

PMID:8655895

Abstract

BACKGROUND

Intestinal antigen handling determines subsequent immune response to the antigen. Antigens are absorbed across epithelium along two functional pathways. The main pathway is degradative, which reduces the immunogenicity of the antigen. A minor pathway allows the transport of intact proteins, which is crucial for antigen-specific immune responses. The Ussing chamber method allows the quantitative measurement of protein transfer across the intestinal mucosa.

OBJECTIVE

This study was designed to explore the theory that altered antigen transfer across the intestinal mucosa is a factor in the pathogenesis of atopic eczema, characterized by hyperactivity to environmental antigens.

METHODS

The absorption and degradation of horseradish peroxidase (molecular weight, 40,000 d) were studied in vitro in Ussing chambers. Eighteen biopsy specimens of upper small intestinal mucosa from 14 patients (aged 0.5 to 8 years) with atopic eczema and 18 specimens from 15 age-matched control subjects were examined.

RESULTS

The mean (95% confidence interval) absorption of intact horseradish peroxidase was significantly higher in children with atopic eczema than in control subjects: 242 (81-404) pmol . hr(-1) . cm(-2) versus 23 (12-33) pmol . hr(-1) . cm(-2); t = 2.86, p = 0.007. The absorption of degraded horseradish peroxidase was 972 (732-1213) pmol . hr(-1) . cm(-2) in patients with atopic eczema and 672 (532-811) pmol . hr(-1) . cm(-2) in control subjects; t = 2.29, p = 0.03.

CONCLUSIONS

Our results may reflect a primarily altered antigen transfer in patients who have atopic eczema, which may initiate and perpetuate prompt immune responses to common environmental antigens, including foods.

摘要

背景

肠道抗原处理决定了随后对抗原的免疫反应。抗原沿两条功能途径穿过上皮细胞被吸收。主要途径是降解途径，可降低抗原的免疫原性。次要途径允许完整蛋白质的转运，这对抗原特异性免疫反应至关重要。尤斯灌流小室法可定量测定蛋白质穿过肠黏膜的转运情况。

目的

本研究旨在探讨肠道黏膜抗原转运改变是特应性湿疹发病机制中的一个因素这一理论，特应性湿疹的特征是对环境抗原反应亢进。

方法

在尤斯灌流小室中体外研究辣根过氧化物酶（分子量40,000道尔顿）的吸收和降解情况。检查了14例（年龄0.5至8岁）特应性湿疹患者的18份上小肠黏膜活检标本以及15例年龄匹配对照者的18份标本。

结果

特应性湿疹患儿完整辣根过氧化物酶的平均（95%置信区间）吸收显著高于对照者：242（81 - 404）皮摩尔·小时⁻¹·厘米⁻² 对 23（12 - 33）皮摩尔·小时⁻¹·厘米⁻²；t = 2.86，p = 0.007。特应性湿疹患者降解辣根过氧化物酶的吸收为972（732 - 1213）皮摩尔·小时⁻¹·厘米⁻²，对照者为672（532 - 811）皮摩尔·小时⁻¹·厘米⁻²；t = 2.29，p = 0.03。