Górski P, Krakowiak A, Pazdrak K, Palczynski C, Ruta U, Walusiak J
Department of Occupational Diseases, Nofer Institute of Occupational Medicine, Lodz, Poland.
Occup Med (Lond). 1998 Feb;48(2):91-7. doi: 10.1093/occmed/48.2.91.
The objective of this study was the evaluation of the usefulness of the nasal challenge test in the diagnosis of allergic respiratory diseases in subjects occupationally exposed to flour. A single-blind, placebo controlled study was conducted in 100 subjects with occupational atopic asthma with rhinitis. The control groups consisted of 20 atopic subjects not sensitized to investigated allergens and 20 healthy subjects. A 'nasal pool' technique was used to evaluate the changes of the cellular response and protein level in nasal washings after topical provocation with allergen or placebo. The concentrations of eosinophil cationic protein and mast cell-derived tryptase in nasal fluid were evaluated in 60 cases. There were significant increases in eosinophil and basophils number, albumin/total protein ratio, eosinophil cationic protein and tryptase levels in occupationally sensitized patients challenged with specific allergens. There were neither severe bronchial reactions or an increase of bronchial hyperreactivity in occupationally sensitized patients after the nasal provocation with flour. The nasal challenge test appears to be a very useful and safe tool for diagnosing occupational allergy.
本研究的目的是评估鼻激发试验在诊断职业性接触面粉的受试者过敏性呼吸道疾病中的实用性。对100名患有职业性特应性哮喘合并鼻炎的受试者进行了一项单盲、安慰剂对照研究。对照组由20名对所研究过敏原未致敏的特应性受试者和20名健康受试者组成。采用“鼻池”技术评估过敏原或安慰剂局部激发后鼻洗液中细胞反应和蛋白质水平的变化。对60例患者的鼻液中嗜酸性粒细胞阳离子蛋白和肥大细胞衍生的类胰蛋白酶浓度进行了评估。用特异性过敏原激发的职业性致敏患者中，嗜酸性粒细胞和嗜碱性粒细胞数量、白蛋白/总蛋白比值、嗜酸性粒细胞阳离子蛋白和类胰蛋白酶水平均显著升高。职业性致敏患者经面粉鼻激发后，既没有出现严重的支气管反应，也没有出现支气管高反应性增加。鼻激发试验似乎是诊断职业性过敏的一种非常有用且安全的工具。
