Baroody F M, Rouadi P, Driscoll P V, Bochner B S, Naclerio R M
Section of Otolaryngology/Head and Neck Surgery, The University of Chicago, Illinois 60637, USA.
Am J Respir Crit Care Med. 1998 Mar;157(3 Pt 1):899-906. doi: 10.1164/ajrccm.157.3.97-07060.
Previous investigations have suggested that nasal secretions, obtained by lavage or scraping, and the nasal submucosa, sampled by biopsy, are two distinct compartments. We investigated the effect of intranasal corticosteroids on antigen-induced eosinophil influx into both compartments. We performed a double-blind, placebo-controlled study in 15 patients with seasonal allergic rhinitis. Beclomethasone dipropionate, 84 microg twice a day, was delivered to one nostril while the other nostril received placebo for 1 wk. Subjects were then challenged with grass or ragweed extracts on each inferior turbinate. Nasal scrapings from both inferior turbinates were obtained before and 24 h after challenge, and bilateral inferior turbinate biopsies were obtained 24 h after challenge, with the subjects still receiving treatment. Intranasal steroids led to a significant reduction in sneezes and eosinophil influx in nasal secretions without affecting the number of eosinophils in the submucosa. Furthermore, intranasal steroids had no effect on the numbers of submucosal EG2+ (activated eosinophils) or CD25+ (IL-2-receptor-bearing) cells, nor did they decrease the endothelial expression of vascular cell adhesion molecule-1 (VCAM-1). These data show that pretreatment with intranasal steroids successfully inhibited the clinical response to allergen and reduced eosinophils in the superficial compartment of the nasal mucosa, but it had no effect on inflammation in the deeper compartment. This might be related to a different distribution of the active medication and antigen into the nasal mucosa or to a specific effect of the active medication on the epithelium resulting in inhibited migration of eosinophils across this layer.
先前的研究表明，通过灌洗或刮取获得的鼻分泌物以及通过活检取样的鼻黏膜下层是两个不同的腔室。我们研究了鼻内皮质类固醇对抗原诱导的嗜酸性粒细胞流入这两个腔室的影响。我们对15名季节性变应性鼻炎患者进行了一项双盲、安慰剂对照研究。将丙酸倍氯米松84微克，每天两次，输送到一个鼻孔，而另一个鼻孔接受安慰剂，持续1周。然后在每个下鼻甲上用草或豚草提取物对受试者进行激发试验。在激发试验前和激发试验后24小时从两个下鼻甲获取鼻刮片，并在激发试验后24小时获取双侧下鼻甲活检组织，此时受试者仍在接受治疗。鼻内类固醇导致喷嚏显著减少，鼻分泌物中嗜酸性粒细胞流入减少，而不影响黏膜下层嗜酸性粒细胞的数量。此外，鼻内类固醇对黏膜下层EG2 +（活化嗜酸性粒细胞）或CD25 +（携带IL - 2受体）细胞的数量没有影响，也没有降低血管细胞黏附分子-1（VCAM - 1）的内皮表达。这些数据表明，鼻内类固醇预处理成功抑制了对变应原的临床反应，并减少了鼻黏膜浅层腔室中的嗜酸性粒细胞，但对深层腔室的炎症没有影响。这可能与活性药物和抗原在鼻黏膜中的不同分布有关，或者与活性药物对上皮细胞的特定作用有关，从而导致嗜酸性粒细胞跨该层的迁移受到抑制。
