Prieto J L, Gutiérrez V, Bertó J M, Camps B
Unidad de Alergia, Hospital Dr Peset, Valencia, Spain.
Clin Exp Allergy. 1996 Jan;26(1):61-7. doi: 10.1111/j.1365-2222.1996.tb00057.x.
Airway hyperresponsiveness to pharmacological agonists is a common feature in subjects with allergic rhinitis.
The aim of this study was to investigate differences in threshold value and shape of the concentration-response curves to methacholine between subjects with perennial allergic rhinitis and subjects with seasonal rhinitis.
We studied a sample of 72 non-asthmatic patients with allergic rhinitis. They were subdivided into two groups: subjects with only seasonal symptoms and skin sensitization to grass and/or Parietaria pollen allergens (seasonal group, n = 38), and subjects with perennial symptoms and skin sensitization to house dust mite, alone or with other allergens (perennial group, n = 34). They were challenged with methacholine (up to 200 mg/mliter), and concentration-response curves were characterized by the threshold value (PC20 = provocative concentration of methacholine required to produce a 20% fall in FEV1) and maximal response plateau, if possible. The measurements in the seasonal group were done within the pollen season.
The geometric mean methacholine PC20 for subjects of the perennial group was 6.9 mg/mliter, compared with 23.4 mg/mliter in subjects of the seasonal group (P < 0.01). A plateau response was detected in 16 subjects of the perennial group and in 28 subjects of the seasonal group (P < 0.05). Moreover, the level of plateau was higher in subjects of the perennial group when compared with subjects of the seasonal group (23.8 +/- 2.0% vs 19.2 +/- 1.6%, P < 0.05).
In subjects with allergic rhinitis, sensitization to perennial allergens is associated not only with lower methacholine threshold values, but also with lower prevalence and higher level of plateau than sensitization to pollen allergens.
气道对药理学激动剂的高反应性是变应性鼻炎患者的常见特征。
本研究旨在调查常年性变应性鼻炎患者和季节性鼻炎患者对乙酰甲胆碱浓度-反应曲线的阈值和形状差异。
我们研究了72例非哮喘性变应性鼻炎患者样本。他们被分为两组：仅有季节性症状且对草和/或墙草花粉过敏原皮肤致敏的患者（季节性组，n = 38），以及有常年性症状且对屋尘螨单独或与其他过敏原皮肤致敏的患者（常年性组，n = 34）。他们接受乙酰甲胆碱激发（最高至200 mg/升），浓度-反应曲线以阈值（PC20 = 使第一秒用力呼气容积（FEV1）下降20%所需的乙酰甲胆碱激发浓度）和最大反应平台期（若可能）来表征。季节性组的测量在花粉季节内进行。
常年性组患者的乙酰甲胆碱PC20几何均值为6.9 mg/升，而季节性组患者为23.4 mg/升（P < 0.01）。在常年性组的16例患者和季节性组的28例患者中检测到平台期反应（P < 0.05）。此外，与季节性组患者相比，常年性组患者的平台期水平更高（23.8 ± 2.0% 对19.2 ± 1.6%，P < 0.05）。
在变应性鼻炎患者中，对常年性过敏原的致敏不仅与较低的乙酰甲胆碱阈值相关，而且与对花粉过敏原致敏相比，平台期患病率更低且水平更高相关。
