Pawankar R, Ra C
Department of Immunology, Juntendo University School of Medicine, Tokyo, Japan.
J Allergy Clin Immunol. 1996 Dec;98(6 Pt 2):S248-62. doi: 10.1016/s0091-6749(96)70073-8.
Allergic diseases like atopic rhinitis, bronchial asthma, and urticaria are prevalent and on the rise. The need to better understand the pathophysiology of these diseases is therefore crucial to the development of newer and more effective modes of treatment. We hypothesized that in inflammatory diseases like allergic rhinitis and asthma characterized by profound local clinical manifestations and inflammation of the relevant mucosae, the most important immunopathological findings must occur locally. Although studies on the cellular elements and mediators in the peripheral blood compartment may provide useful information, they may not accurately reflect events occurring within the target organ itself. Even in the normal mucosa there is a resident population of lymphocytes and mast cells. Taking perennial allergic rhinitis (PAR) and chronic infective rhinitis (CIR) as representative chronic airway inflammatory diseases we investigated the phenotypic and functional characteristics of mast cells and lymphocytes in the nasal mucosa of patients with PAR and CIR during the natural course of the disease. We further compared the characteristics of lymphocytes in the nasal mucosa with that in the peripheral blood compartment. Our results demonstrated heterogeneity of mast cells and T cells in the nasal mucosa. Furthermore, the mucosal changes at the site of allergic inflammation were characterized by an increase in the proportion of CD4+ CD45RO+ T cells (memory cells); oligoclonal expansion and activation of V gamma 1/V delta 1+ T cells; an increased number of Fc epsilon RI+ cells; an increased proportion of TH2-type cytokine expressing mast cells and lymphocytes and of very late antigen-4 and very late antigen-5 expressing nasal mast cells, independent of alterations in CIR; and autologous peripheral blood. These findings strongly suggest heterogeneity of lymphocytes and mast cells in the nasal mucosa based on the underlying inflammatory disease, and compartmentalization of inflammatory cells in the nasal mucosa and peripheral blood.
过敏性鼻炎、支气管哮喘和荨麻疹等过敏性疾病普遍存在且呈上升趋势。因此，更好地了解这些疾病的病理生理学对于开发更新、更有效的治疗方式至关重要。我们推测，在以局部临床表现明显和相关黏膜炎症为特征的过敏性鼻炎和哮喘等炎症性疾病中，最重要的免疫病理学发现必定发生在局部。尽管对外周血中的细胞成分和介质进行研究可能会提供有用信息，但它们可能无法准确反映靶器官本身发生的事件。即使在正常黏膜中也存在常驻的淋巴细胞和肥大细胞群体。以常年性变应性鼻炎（PAR）和慢性感染性鼻炎（CIR）作为代表性的慢性气道炎症性疾病，我们在疾病的自然病程中研究了PAR和CIR患者鼻黏膜中肥大细胞和淋巴细胞的表型及功能特征。我们还进一步比较了鼻黏膜中淋巴细胞与外周血中淋巴细胞的特征。我们的结果表明鼻黏膜中肥大细胞和T细胞存在异质性。此外，变应性炎症部位的黏膜变化特征为CD4+ CD45RO+ T细胞（记忆细胞）比例增加；Vγ1/Vδ1+ T细胞的寡克隆扩增和激活；FcεRI+细胞数量增加；表达TH2型细胞因子的肥大细胞和淋巴细胞以及表达极晚期抗原-4和极晚期抗原-5的鼻肥大细胞比例增加，这与CIR以及自体外周血中的变化无关。这些发现有力地表明，基于潜在的炎症性疾病，鼻黏膜中淋巴细胞和肥大细胞存在异质性，且鼻黏膜和外周血中的炎症细胞存在分隔。
